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Understanding Keratoconus

If you’re struggling with vision impairment and find everyday tasks like reading, driving, or simply recognizing faces a challenge, you may be dealing with keratoconus. This condition affects the cornea, the transparent front part of your eye, and can drastically impact your vision. At Dr. Boshnick’s specialty practice, we utilize leading-edge treatments, including scleral lenses, to improve vision for keratoconus patients.

The Nature of Keratoconus

Keratoconus is a non-inflammatory ocular condition leading to the protrusion or ectasia of the cornea. This degenerative condition is marked by the progressive thinning and steepening of the cornea’s central region. As the cornea morphs and thins, vision is impacted, ranging from minor to severe disturbances depending on the extent of the affected corneal tissue. Keratoconus usually manifests during teenage years or early twenties and seldom develops post 35 years of age. This condition shows no gender preference and affects both eyes in over 90% of cases. However, it usually progresses asymmetrically, with the second eye diagnosed with the condition typically lagging by 6-7 years from the first. The incidence of keratoconus is estimated to be about 2-3 individuals per 1000 population.

As keratoconus advances, the deformed cornea often requires a contact lens, typically a rigid gas permeable type. However, the progression of this condition can be unpredictable. Although keratoconus can impair vision clarity, it seldom leads to blindness. With the advent of contact lenses specifically tailored for keratoconus, the necessity for a corneal transplant has become extremely rare. Recent advances have introduced several soft lenses for treating keratoconus, such as the Soft K lens and the Flex lens.

Even though keratoconus’ characteristics have been recognized for at least two centuries, the precise causes remain elusive. Several theories have been proposed, with one suggesting a genetic origin to the condition as about 7% of patients have family members afflicted with the disease. Another theory considers keratoconus secondary to some disease process. Despite these theories, research into keratoconus persists as we strive to fully comprehend this condition.

The Enigma of Keratoconus Causes

Despite being known for at least 200 years, the exact causes of keratoconus remain elusive. Several theories have been proposed, with genetics being a key suspect as about 7% of patients have other family members affected. Alternatively, keratoconus may be secondary to another disease process. Regardless, research into the causes of keratoconus continues, with the goal of enhancing prevention and treatment options.

The Symptoms and Diagnosis of Keratoconus

The primary symptom of keratoconus is a progressive deterioration of vision, with patients often reporting blurred or distorted vision and increased sensitivity to light. Advanced cases may involve a noticeable bulging of the cornea. In the early stages, standard eye tests might miss keratoconus, but corneal topography and other sophisticated imaging technologies can detect the corneal changes indicative of the disease.

Treating Keratoconus Effectively

As keratoconus advances, rigid gas permeable lenses are typically the first choice for adequately correcting vision. Most of the time, this serves as a permanent remedy. Given the disease’s progression, it’s vital that these lenses are fitted with utmost care and reassessed at least annually by eye care professionals. Dr. Boshnick’s practice uses lenses with a complex geometry, taking into account the conical shape of the cornea at all stages of the condition. These lenses have multiple curves and are custom designed to fit each individual cone without traumatizing the delicate, compromised corneal tissue. For nearly all patients, this means improved comfort and optimum visual acuity.

The intricate geometry of the lenses Dr. Boshnick uses can be customized to correct all of the myopia and astigmatism associated with keratoconus. These lenses are easy to insert, remove, and clean, and they provide excellent health benefits for the eye by allowing the cornea to “breathe” oxygen directly through the lens.

Moreover, Dr. Boshnick’s practice uses scleral lenses for treating advanced cases of keratoconus, as well as Pellucid Marginal Degeneration and Post-Lasik Ectasia. When the cornea’s outer cellular layer, known as the Epithelium, degrades, smaller diameter gas permeable lenses will not suffice. In such cases, a gas permeable scleral lens is the only solution that provides clear, comfortable, and stable vision.

Scleral Lenses – A Revolution in Eye Care

Scleral lenses vault over the compromised cornea without touching it, supported by the white part of the eye, known as the sclera. The space between the back surface of the lens and the front surface of the cornea is filled with unpreserved Sterile Saline Solution, ensuring the eye’s front surface is always in a liquid environment. As a result, vision and comfort are almost always excellent.

Apart from treating advanced keratoconus, these scleral lenses are also used to restore vision and comfort in patients who have undergone corneal transplant surgery, post-refractive surgeries like Lasik, R-K, PRK, or those suffering from chronic dry eye due to disease and ocular trauma. Interestingly, scleral lenses have a therapeutic effect on the cornea, significantly improving the health of many compromised corneas by protecting the delicate tissue from the environment and lids rubbing against it.

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Frequently Asked Questions

Keratoconus is a non-inflammatory eye condition characterized by progressive thinning and steepening of the central cornea, leading to impaired vision.

While the exact causes are still undetermined, theories suggest genetic factors and secondary disease processes as potential triggers. Ongoing research aims to uncover the root causes.

Treatments include the use of rigid gas permeable lenses and, in more advanced cases, scleral lenses. Dr. Boshnick’s practice provides custom-fitted lenses that suit each individual’s condition and promote improved comfort and visual acuity.

Scleral lenses are large-diameter gas permeable lenses that vault over the cornea, resting on the sclera. They provide clear, comfortable, and stable vision for advanced keratoconus patients, protect the cornea, and promote its health.

While keratoconus significantly affects vision, it rarely leads to blindness. With appropriate treatment, such as customized contact lenses or scleral lenses, most people with keratoconus can lead normal lives.

As of now, there is no cure for keratoconus. However, with proper treatment and regular monitoring, the progression of the disease can be managed, and vision can be significantly improved.

If your lenses aren’t fitted correctly, they might move excessively over the cornea, causing abrasions and leading to pain and light sensitivity. It’s crucial to get your lenses fitted by a specialist like Dr. Boshnick to ensure optimal comfort and vision.

 

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