Keratoconus

Keratoconus is a progressive eye condition that sometimes is difficult to diagnose.  It usually affects both eyes and requires careful contact lens management.

Typically appearing during the teens to early 20s, keratoconus causes the cornea to thin and form scar tissue, until the eye is cone-shaped. Since the cornea is responsible for most of the eye's refraction, any disruption can cause considerable visual distortion that may not be corrected with spectacles. Individuals with keratoconus require specially designed contact lenses to manage vision.

It is a common misconception that contact lenses halt the progress of keratoconus. In fact, the lenses simply improve vision while the condition is developing. However, improperly fitted lenses may worsen the condition by increasing the rate of scar tissue formation.

Research

The condition does seem to run in some families, and a gene has now been identified. However, it does not act alone. It may require other genes or environmental influence to manifest itself.

Emory Eye Center was the first U.S. site to conduct an innovative clinical study in 2008 on patients with keratoconus, entitled Collagen Cross-Linking with Riboflavin, or CXL.

Diagnosis

Emory's Contact Lens Service specializes in managing keratoconus and fitting contact lenses. A specialist evaluates the cornea by using sophisticated computerized video keratography to provide a topographical map of the eye's surface. This allows specialists to follow the progression of keratoconus.

Treatment

In the past, managing keratoconus has included at the earliest involvement, glasses and/or rigid gas permeable contact lenses. When the condition has advanced to the corneal scarring point, a corneal transplant may be indicated. About half of keratoconus patients have no real problems with their lifestyle other than corrective lenses. The condition may even stabilize. For others, the condition can be resolved only by penetrating keratoplasty (PKP), often known as corneal transplant or corneal graft. In some cases, keratoconus can reoccur in that grafted cornea.

While they are not a cure for keratoconus, the specially designed rigid gas-permeable contact lenses available at Emory Eye Center give the eye a smooth surface to permit better vision.

Prognosis

The rate of progression often decreases during the 40s and 50s. In fact, it rarely develops in those over 40 and may halt progression at any stage. If keratoconus continues to worsen, corneal transplantation may be necessary. At Emory, our goal is to delay surgery as long as possible.

Links to more information:

National Library of Medicine/PubMed Health

National Keratoconus Foundation

Contact Lens

Keratoconus management and treatment

Emory Eye Center's Comprehensive Ophthalmology Service specializes in managing keratoconus and fitting contact lenses. A specialist evaluates the cornea using sophisticated computerized video keratography to provide a topographical map of the eye's surface. This allows specialists to follow the progression of keratoconus.

Our contact lens specialists fit patients from the tiniest newborn infants to those in their 90s with specialty contact lenses.

Research conducted by Emory contact lens specialists has resulted in major breakthroughs in preventing infection and increasing the comfort and function of contact lenses.

Our contact lens service, in addition to its special interest in treating patients with keratoconus and surgically altered corneas, provides complete lens services, including bifocal lenses and advanced computer-aided lens designs for therapeutic and cosmetic purposes.

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