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Keratoconus Keratoconus

Keratoconus

People with keratoconus have an abnormally shaped cornea that makes their sight fuzzy. This eye condition is progressive, and in 20 - 30% of patients experiencing it, the cornea becomes very thin and weak. As a result of this, the cornea takes an abnormal cone-like shape which leads to poor vision.

Definition Of Keratoconus

This is a persistent cornea disorder that is non-inflammatory and alters the shape of the cornea. Keratoconus can become so bad that the back surface of the cornea may split -  a condition called acute corneal hydrops.

The light that penetrates the retina is distorted by the irregular cone-shaped cornea causing images to have abnormal shapes when interpreted by the brain.

Features Of Keratoconus

This condition typically affects the two eyes, but the impact may differ from one eye to the other. One of the diagnostic signs opticians use to spot keratoconus sometimes is the increase in the astigmatism of patients. This means when a patient's astigmatism becomes severe, it is an indication that keratoconus may be around the corner, and special care should be sought. The kind of astigmatism that results in keratoconus is abnormal, so glasses cannot be used to treat it completely. When the case is still early and less serious, patients may have a clear vision using just glasses. However, a lot of keratoconus patients whose cases are severe may be able to see using special keratoconus contact lenses. At our practice, we are affiliated with different specialists recognised globally for keratoconus contact lens correction, and patients having very severe eye issues can get effective lenses.

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Symptoms Of Keratoconus

1 in 500 Asians and 1 in 2000 Caucasians are affected by keratoconus.

People having this eye condition experience a fuzzy vision with low quality, and may not be able to read or drive very well. Patients also have bright light sensitivity and see images like 'ghosts' especially while driving during the night. With time, the symptoms may change.

Keep in mind that keratoconus results in vision alterations from time to time. So, should your lens prescription change now and then, it may be a symptom of keratoconus.

The Causes Of Keratoconus

A pre-existing condition where the collagen fibres supporting the cornea becomes weak could result in the cornea losing structural and biomechanical strength. Those usually affected are teenagers, and it progresses through to their early 30s. People with Down's Syndrome are commonly affected too. Asians or Arabs and people who suffer with eczema or asthma are also affected. Men and women are equally affected, and the condition may be more serious in one eye than the other.

Other causes include:

  • Allergic reactions
  • Rubbing of the eyes
  • Genetic factors

Keratoconus Diagnosis

Should you have bad eyesight, consult your optician or schedule an appointment with us. Since keratoconus shares similarities with astigmatism, sometimes it is diagnosed during a consultation for astigmatism.

Using highly advanced elevation-based Scheimpflug corneal topography, keratoconus can be diagnosed. Subclinical forms of keratoconus like forme fruste keratoconus can be picked up using this technology. This is an essential aspect of safe assessment for laser eye surgery. With this, your eye condition can be measured, allowing the surgeon to know whether and by how much your condition is increasing. Another importance of this is that it aids in determining what treatment options would be suitable for keratoconus.

This cornea disorder may not easily show up; years may pass before a person develops keratoconus; however, if you have this condition, we recommend regular check-ups.

What Are The Treatment Options For Keratoconus?

Cases that are not severe can be corrected with specialist contact lenses and glasses. Where the case is severe, patients may need a corneal transplant or implant. About 1 in 4 keratoconus patients may have to undergo surgery.

A plethora of specialist contact lenses can be used to correct most keratoconus cases. Also, soft contact lenses can be combined with corneal surgery to treat this condition. Generally, this problem becomes less severe as people get to their thirties.

Though known to be a chronic eye problem, innovative technology can treat keratoconus. This means people suffering with this condition can read and drive better. There has been a high rate of successful keratoconus treatment, and with more research, this rate will continue to increase.

Surgery Options For Keratoconus

  • Accelerated corneal collagen crosslinking. With this approach, keratoconus can be better managed. It is so effective that the progress of keratoconus can now be stopped unlike before.

Treatment is completed in a day, and patients get topical anaesthetic drops before the procedure begins. The surgeon will soak up the cornea in Riboflavin drops and shine a UV light on it. If it is a traditional crosslinking method, the treatment will last for 1 hour. Should it be the Avedro accelerated crosslinking, you can be safely treated in a couple of minutes. Post-surgery, a bandage contact lens is placed on the cornea. Healing takes 3 to 5 days to complete after which the bandage lens is removed.

  • Intrastromal Corneal Rings (Kerarings). Two major rings options are used here: intacs and kerarings. We make use of kerarings since they are customised to fit each patient's corneal shape and thickness.

The cornea is prepped to receive plastic ring segment whose function is to make the bulge flatten out and give the cornea a more normal shape. With this approach, contact lenses don't have much use. These rings can be implanted before accelerated crosslinking or during the treatment. In cases where crosslinking is not necessary or mentioned, this treatment can be used. It is a pain-free solution carried out with anaesthetic drops.

  • Implantable Collamer Lens (Phakic IOL). For keratoconus patients who desire not to use glasses or contacts lenses, the Phakic IOL comes in handy. It is not possible to give people having keratoconus traditional laser eye surgery. This surgical operation takes 10 to 15 minutes for completion with a local anaesthetic. An implantable Collamer lens treatment doesn't cause any pain and patients recover very fast. Again, people whose vision get better with glasses will get more out of the Phakic IOL.
  • Topography guided Excimer Laser Advanced Surface Ablation. A great addition to corneal collagen crosslinking in special cases of keratoconus.

The procedure begins with a transepithelial ablation. After that, up to 60 microns of corneal tissue is reshaped to enhance vision and lower the pressure exerted by the cone on the cornea.

  • Big-bubble Selective Deep Anterior Keratoplasty. Here, only the infected part of the cornea is transplanted, leaving the endothelial cell layer untouched. Though it eliminates the risk of having an endothelial injection, the procedure is very technical. However, our specialist surgeons are well equipped for this treatment. 4 in 5 cases can be treated with this procedure. The other case gets the traditional penetrating corneal transplant.

Patients are placed under a general anaesthetic, and your eyes may be slightly uncomfortable for about one week post-surgery. You will have to use eye drops for some months. The sutures inserted during treatment are taken out after one year, and this treatment is highly successful.

Corneal Disease

When it comes to the diagnosis and correction of cornea infection, we are specialists. The cornea is the natural clear window of the eye. It can be affected by diseases like dry eyes and pterygium, corneal scarring, keratoconus, Fuchs endothelial dystrophy, complications of contact lens wear, and microbial keratitis (contact lens-induced corneal infection).

Why Choose Us?

Excellent experts

Our surgeons have received the best training at the best centres in London and around the world.

We're a consultant-led practice

Patients get customised treatment plans for specific needs, followed by great care and support after treatment.

State-of-the-art technology

Laser eye surgery and lens surgery are done using the latest technology and tools in the industry.

Easy access

You can visit our central clinic in London for eye treatment.

Video consultation

Should it not be possible for you to come in person to our clinic, you can get our professional help via video consultation. This is available for both patients who are insured and paying from their pocket.

Zero percent financing

We offer a 0% finance for patients who need any of our eye surgical treatments. With this, you can pay more conveniently by spreading payment over some months if required.

Are you having problems with eyesight and would like a diagnostic test and possible treatment options, feel free to contact us today.

Book A Consultation
With Ophthalmic Consultant
Book a Consultation Today

or call: 020 7183 3725

Dr Amir Mani - Specialist refractive surgeon

One of the most experienced refractive surgeons in London

Dr Mani has performed more than 20,000 ophthalmic procedures, including LASIK, LASEK, PRK, Femto Cataract, RLE, Lens ICL and Phakic IOL Surgery

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