What is Keratoconus?
Keratoconus (KC) is a progressive disease that causes the degeneration and weakening of the structure of the cornea – the clear tissue that covers the front of the eye. A non-inflammatory disease that worsens over time, Keratoconus causes the normally round, dome-shaped cornea to thin, resulting in a cone-like bulge and progressive loss of vision. Corneal abnormalities severely affect everyday tasks like driving, watching television and reading. Patients with severe Keratoconus are unable to recognize even very close objects without glasses. With glasses or contacts, they may achieve only 20/100 or 20/200.
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“I chose this because I got a good recommendation and explanation from Dr. Furlong — a doctor I trust. He also explained why it was a good idea and why my vision might get worse if I didn’t have the surgery.”
Keratoconus Treatment Options – CXL, CK, Intacs
Historically, there have been few options to slow the progression of Keratoconus. The primary treatment consisted of regular eye exams to adjust glasses and contact lens prescriptions. Properly fitted hard contact lenses often provide the best attainable vision, but can be uncomfortable and cause corneal scarring.
A current treatment plan can combine up to three minimally invasive surgeries for good candidates: Corneal Cross-Linking (CXL), Intacs and Conductive Keratoplasty (CK). CXL is an exciting procedure that employs a biochemical reaction to strengthen the collagen fibers and reshape the cornea. Intacs and CK are surgeries on the surface of the eye designed to improve vision, reduce astigmatism and significantly improve both uncorrected vision and vision corrected with glasses or contacts.
If you have been diagnosed with Keratoconus or feel you have symptoms, we encourage you to make an appointment with Dr. Furlong to understand the options you have to improve your vision and lifestyle. Please call .
Please read below to find out more about the disease, causes and our breakthrough treatment.
Keratoconus Causes and Diagnosis
The cause of Keratoconus is unknown but the disease is believed to be hereditary and therefore present from birth as a defect in collagen, the tissue that makes up most of the cornea.
Keratoconus is not a common eye disease and has been estimated to occur in 1 out of every 1,000 persons worldwide with no known significant geographic, cultural or social pattern. Some experts believe the occurrence ratio may be even higher.
Some cases of Keratoconus are also associated with Down’s syndrome.
One of the first symptoms of Keratoconus is slightly blurred and distorted vision and increased sensitivity to light. Many with Keratoconus have a high degree of astigmatism and nearsightedness that worsens over time. Double vision, halos and glare are also symptoms of the disease.
While these symptoms are used in the diagnosis of Keratoconus, they may also indicate other vision problems. Keratoconus requires a diagnosis from a competent eye doctor or eye surgeon who is trained in not only recognizing the symptoms but also observing signs of Keratoconus through direct measurement as well as inspection of the cornea at a microscopic level. Typical vision problems with Keratoconus
Keratoconus usually reaches its most severe state in patients between the ages of 20 and 40.
In the early stage, many with Keratoconus don’t know they have the disease until their vision has significantly deteriorated. Glasses or soft contact lenses may be used to correct the mild nearsightedness and astigmatism. However, due to the irregular cornea shape, Glasses will not adequately correct the vision.
As the disease progresses to the moderate stage, the cornea continues to thin and change shape and patients with uncorrected vision will not be able to see beyond a few feet. At this point, rigid gas permeable (RGP) contact lenses are generally prescribed to correct vision more adequately. The contact lenses must be carefully fitted and frequent checkups and lens changes may be needed to achieve and maintain good vision. At this stage, the rigid lenses may be effective enough for the patient to drive and function normally, however, many patients find rigid contact lenses uncomfortable and can only tolerate them for a short period of time.
At the severe stage, a corneal transplant is the only option due to scarring, extreme thinning or contact lens intolerance. This is an invasive surgical procedure that replaces the Keratoconic cornea with a healthy donor cornea. The healing time is lengthy and there is also risk of rejection as with any donor surgery.
Keratoconus is often discovered during adolescence. The most accurate test for the disease is corneal topography, which creates a map of the curve of the cornea. It can also be diagnosed with a slit-lamp examination of the cornea that uses a low-power microscope combined with a high-intensity light source focused to shine in a thin beam.
As Keratoconus advances, the cornea thins at the point of the cone. Corneal pachymetry is a painless test that measures the thickness of the cornea.
With the advent of the recent FDA approval of a single treatment system and protocol, Dr. Furlong is not offering Corneal Cross Linking (CXL) at this time. He is researching several alternative treatment protocols that are being evaluated for patient comfort, recovery time and efficacy. Dr. Furlong will continue to examine and diagnose Keratoconus patients and offer Conductive Keratoplasty (CK) and Intacs treatments for those patients who will benefit from these procedures and will resume CXL treatment once he determines which protocol offers the best outcome and safety.