What is Keratoconus?

Mild and early cases of keratoconus can be managed with glasses or traditional non-specialty soft contact lenses if the degree of corneal distortion is not too severe. Typically, in these cases, soft astigmatism correcting contact lenses are required. More advanced cases can be treated with specialty soft lenses, designed specifically for keratoconus. These lenses typically have a thick central optic zone to mask the corneal irregularity and a thin periphery for comfort. Cases of moderate and somewhat severe keratoconus can be treated with these specialty lenses. These lenses are limited in terms of whether they can provide adequate vision correction for the individual, especially as the condition progresses.

Rigid Gas Permeable (RGP) contact lenses are rigid lenses made of durable plastic that can transmit oxygen; Scleral contacts are also gas permeable, but are larger diameter, designed to cover the entire cornea plus a portion of the white of the eye; Hybrid contacts are RGPs surrounded by a soft lens lining or skirt.

Intacs is the trademark name for micro-thin prescription corneal implants designed for the reduction or elimination of myopia and astigmatism in patients with keratoconus. Intacs are thin plastic, semi-circular rings, which are surgically inserted under the surface of the cornea. When inserted into the keratoconic cornea, they flatten the cornea, changing its shape. The placement of Intacs may reduce corneal irregularities cause by keratoconus.

Corneal cross-linking is a minimally invasive outpatient procedure that combines the use of ultra-violet (UV) light and riboflavin (vitamin B2) eye drops. Photrexa® Viscous (riboflavin 5’-phosphate in 20% dextran ophthalmic solution), Photrexa® (riboflavin 5’-phosphate ophthalmic solution) and the KXL® system are the first and only therapeutic products for corneal cross-linking which have been FDA approved to treat progressive keratoconus.

For more information go to: What is Cross-Linking?

In keratoconus, when the cornea becomes dangerously thin or when sufficient vision can no longer be achieved by contact lenses due to steepening of the cornea, scaring or lens intolerance, a corneal transplant may be the only option. The surgery is generally performed as an outpatient procedure with either general or local anesthesia. During the surgery, the part of the cornea affected by keratoconus is removed and replaced with a donor cornea. While the surgical transplantation of a new cornea will resolve the basic problem of corneal surface irregularity, eyeglasses or contact lenses are usually needed after the surgery for vision correction.