Envision Optical
Optometrist in QLD and NSW

What is Keratoconus?

August 16, 2017
Posted By: Envision Optical
Close up of eyes | optometrist tweed heads

Keratoconus is a condition affecting the cornea, the front clear part of the eye, in which the cornea weakens and becomes distorted into a cone shape. This affects the focussing ability of the cornea and leads to visual distortion and blur. Patients will commonly notice ”ghosting” blur around objects and have particular trouble focussing at night. Keratoconus is typically a bilateral condition but can be asymmetric between the eyes. It is associated with hayfever, allergic conjunctivitis and eye rubbing.

Keratoconus typically begins developing in teenage years and worsens through teens and twenties, and starts to stabilise in thirties. Patients present with blurred vision and the condition is detected with digital scans using a corneal topographer. A corneal topographer scans the surface of the eye and maps the shape showing the steeper zones typical of keratoconus.

Computerised mathematical analysis of the scans and any change between periodic scans will highlight progression and the need for possible treatment. During this period of progression, patients need regular monitoring every 6 months. Patients with keratoconus will have higher levels of astigmatism in their glasses. As the condition progresses, increasing distortion of the corneal shape will mean the vision achieved with glasses is not clear, and they will need to wear rigid contact lenses to achieve clear vision. If the condition continues to progress, some patients may even need a corneal graft/transplant.

Modern advances in treatment mean that the progression of keratoconus is able to be halted in more than 90% of cases. Corneal crosslinking was developed in the early 2000’s in Europe. It is a treatment to stabilise keratoconus and stop it getting worse. Patients whose scans show progression and worsening will be referred to a corneal specialist for treatment. Crosslinking is most useful in younger patients. Cross linking involves soaking the cornea in Riboflavin, and then exposing it to UV light which binds the corneal collagen fibres more strongly together and stiffens the cornea. After treatment, the patient still needs to wear contact lenses or glasses but will now usually be stable and not progressively worsen.

Envision Optical owner and principal optometrist, Andrew Bowden has fitted specialised contact lens designs to patients with keratoconus for over 20 years. Gold Coast and Tweed Heads region patients with keratoconus have experienced the clear vision and freedom of custom RGP, mini-scleral and large diameter scleral lenses fitted by Andrew to suit their specific corneal shape. Using a combination of trial lens fitting and design software, a totally customised solution can be created for each patient, maximising their clear vision and comfort for all day lens wear. Any patient with keratoconus, other corneal disorders, post corneal graft patients or extreme prescriptions will be suitable for specialised custom lens fitting.