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Home » Your Eye Health » Eye Conditions » Keratoconus

Keratoconus

Keratoconus is a rare, progressive disease that affects the cornea, which is the clear, transparent layer at the front of the eye. The cornea is responsible for focusing the light that comes into your eye onto the retina for clear, sharp vision. Keratoconus causes the corneal tissue to thin out and bulge into a cone-like shape which deflects the light entering the eye and distorts vision.

Causes of Keratoconus

The exact cause of keratoconus is not known. The disease usually starts to appear in the late teens or twenties and can affect one or both eyes, usually progressing at a slow pace and slowing or stabilizing after around 10-20 years. It is believed that there is a genetic component as often it runs in families.

New research suggests that there may be a link between keratoconus and oxidative damage which weakens the cornea. There is also an association with overexposure to ultraviolet (UV) radiation from the sun and chronic eye irritation.

Symptoms of Keratoconus

With the gradual change in the shape of the cornea, vision becomes progressively worse. The patient may experience nearsightedness, astigmatism, distorted vision (straight lines look wavy), blurry vision, light sensitivity and glare, and eye redness or swelling. Typically, patient’s eyeglass prescription will change often as the vision becomes worse and contact lenses will be difficult to wear due to discomfort and improper fit.

When keratoconus become more severe (which usually takes a long time however on occasion can happen rather quickly), the cornea can begin to swell and form scar tissue. This scar tissue can result in even further visual distortion and blurred vision.

Treatment for Keratoconus

In the early stages of the disease, standard eyeglasses and soft contact lenses will usually correct the nearsightedness and astigmatism experienced by the patient. As the disease progresses however, glasses and soft contact lenses may no longer correct vision and soft lenses may become uncomfortable. This is when other forms of vision correction will be recommended.

Gas Permeable and Scleral Contact Lenses
At the more advanced stage of keratoconus rigid gas permeable (RGP) contact lenses, scleral or semi-scleral lenses may be used for increased comfort and visual acuity. Since they are more rigid, RGP and scleral lenses are able to create a smooth, round shape around the cornea, creating a smoother surface for better vision. Scleral or semi-scleral lenses have a larger diameter which covers the entire cornea and reaches over into the white part of the eye, which is known as the sclera. Many patients find these more comfortable than regular RGPs and find that they move around less when the eyes move. The main disadvantage of these rigid lenses is that for some, they are somewhat less comfortable than soft lenses and they must be continually refit as the shape of the eye changes.

Whether it is glasses or contact lenses being used to correct vision, patients will likely have to undergo many tests and prescription changes as their vision needs change.

Intacs
Intacs are small, surgically implanted plastic inserts which are placed on the cornea to flatten it back to shape. Usually they are able to restore clear vision, with the continued use of glasses. Intacs are often recommended when contact lenses and eyeglasses are no longer able to correct vision adequately. Intacs take about 10 minutes to insert and can delay the need for corneal transplant.

Corneal Crosslinking (CXL)
In corneal crosslinking, a UV light and eye drops are used to strengthen and stiffen the cornea which helps to reduce bulging and restore the cornea to its natural shape.

Corneal Transplant
When corneal scarring occurs and eyeglasses and contact lenses no longer help, doctors may suggest a corneal transplant to replace the corneal with healthy donor tissue to restore vision. Most patients will still require eyeglasses or contact lenses for clear vision following the transplant.

Keratoconus is a condition that requires ongoing treatment by a qualified eye doctor. If you or a loved one suffers from this disease make sure that you find an eye doctor that you like and trust to accompany you on this journey.

Dear Richie Eye Clinic & LASIK Center Family and Friends,

As we head into the Holiday Season and the New Year, I have some news to share.

As many of you know, we have added some new doctors to our team in the last couple of years. Dr. Josh Spedding OD, our new Optometrist, joined us last summer and is currently seeing patients in both our Northfield and Faribault offices. We are thrilled to have Dr. Spedding on our team and welcome him and his family to the area.

Dr. Cory Miller, MD joined us in 2021 and we welcomed Dr. Mike Reinsbach, MD to our team this past summer. Both are Board Certified Ophthalmologists and skilled surgeons specializing in High Technology Cataract Surgery with Advanced Lens Implants, LASIK, Retinal injections, MIGS Surgery for Glaucoma, as well as the usual medical and surgical management of eye disease.

With the addition of these high performing providers, I am transitioning my role in 2023 to concentrate on Practice Development while continuing to serve as the Medical Director overseeing our practice protocols and procedures. Dr. Miller and Dr. Reinsbach will be assuming my day-to-day patient care duties.

I have done my best over the past several months to tell everyone of this transition plan while personally introducing Dr. Miller and Dr. Reinsbach; please accept my apologies if I missed any of you during this time.

Rest assured, we will continue our commitment to providing cutting edge care. Starting in 2023 look for Dropless Cataract Surgery, Light-Adjustable Lens Implants, and so much more…

Thank you for the Trust and Confidence you have shown me over the past 32 years. Please feel free to call us at (507) 332-9900 for questions, concerns, or clarification.

Sincerely,

Mike Richie, MD

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