Keratoconus is a type of corneal ectasia. This is just a fancy word for a warpage of the cornea (the clear window on the front part of the eye) that is not due to inflammation, infection, or scarring. While there is a genetic component, things like eye rubbing can definitely make keratoconus more likely or progress more quickly.
To understand keratoconus better, let’s think of the cornea like an island. It should be a nice round island gently rising out of the sea. In fact, this is often how it looks on our state-of-the-art 3D cornea scans. These scans look just like state park maps where flat (like water) is blue and higher elevation (like mountains) is green. We’re looking for a nice green island. Here is a normal cornea scan and the equivalent appearance in our island metaphor.
Astigmatism is like having an mountain range running down your island. Because the mountain range creates some irregularity, vision appears streaky or blurry without correction. Here is an actual 3D scan and corresponding island to represent a cornea with astigmatism.
Keratoconus is like having a mountain range running down your island plus a volcano on one side. It’s literally a bulging or protrusion of the cornea. As you can see, this often accompanies astigmatism and because it’s even more irregular, is often hard to correct with glasses or soft contact lenses alone. Here is an actual 3D scan and corresponding island to represent a cornea with keratoconus.
A volcano is a good metaphor for keratoconus because without intervention and treatment, it’s possible for the volcano to erupt. The fluid inside the eye literally erupts through the volcano and causes a large scar that may require a corneal transplant. Don’t worry, there are plenty of ways to stop the progression of keratoconus and improve vision!
Keratoconus treatment typically involves two important steps. First, we need to stop the “tectonic activity” of your cornea, that is stop the vocano or mountain range from getting any bigger. Then we can focus on improving vision!
Corneal Crosslinking involves using a vitamin and UV light to effectively “glue” the cornea in place. This simple, painless procedure stops the disease from progressing and getting any worse.
We often combine crosslinking with a procedure like customized PRK. We take special scans of your eye (again, like a survey and state park map) to find all the elevation changes of your cornea. We then use this information to selectively treat the actual cone with a very precise laser to improve your vision!
If your keratoconus is moderately advanced or more, or located in a certain area, the answer might be CTAK! This is a special procedure where a customized piece of cornea is actually added to your cornea. This addition significantly reduces the elevation of the cone and the amount of astigmatism.
Even if you have an eye disease like keratoconus, there are ways to not only treat the underlying disease but also improve your vision.
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