Keratoconus and Collagen-Crosslinking

Keratoconus is a degenerative eye disease responsible for blurred vision, double vision, light sensitivity, astigmatism, or near-sighted vision. It is caused by the thinning and deformation of the cornea into a cone-like shape. Keratoconus treatments vary depending on the severity of the condition. Mild cases can be addressed with corrective lenses, although corrective lenses don’t address the degeneration. Collagen cross-linking is an option for more advanced keratoconus in order to prevent the progression of the disease. Unaddressed, advanced cases may require a corneal transplant.

Causes

Keratoconus (KC) may be caused by a combination of factors. Hormone changes and environmental factors can provoke cellular degeneration. Research has shown that excessive rubbing of the eyes in childhood can also cause keratoconus later in life due to the long-term effect on corneal thickness. Genetic research has also correlated KC to several genes in human DNA, and it’s likely more are undiscovered.

Symptoms

Some patients experience worse vision in one eye, whereas others have equal symptoms in both. Vision can deteriorate very quickly once degeneration begins. Diminished vision can present as difficulty reading, having a hard time seeing at night, seeing multiples, or light distortion. Distorted vision patterns morph gradually over time. The cornea becomes misshapen as the disease progresses, and eventually, the bulging becomes noticeable to the naked eye.

Diagnosis

Your doctor will test your vision, take your medical history, and examine the eye with sophisticated tools. A traditional eye chart is standard for measuring your vision. Some environmental factors influence the progression of keratoconus, so your doctor will ask about related topics such as whether you rub your eyes frequently and how often you wear contact lenses.
An irregular cornea can be a result of astigmatism, which is not a degenerative disease. However, if measurements show changes, it indicates deterioration has begun.
A few signs of degeneration are measurable, enabling doctors to classify the condition as mild, advanced, or severe.

  • Corneal thickness – Thin spots in the cornea and changes in thickness over time.
  • Curvature – Measuring the angles of protruding corneas.
  • Cone shape – The corneal protrusion can be an elongated tip, a sagging or oval cone, or an oversized globe.
  • Keratoconus Treatments

    Although keratoconus has no cure, it can be successfully managed. Early on, soft contact lenses or glasses are sufficient to correct vision. As the condition advances, the patient may be fitted for rigid gas permeable (RGP) contact lenses. Lenses correct a patient’s vision and improve the quality of life day to day, but vision correction only treats the symptoms not the cause. The only way to halt keratoconus progression is a procedure called corneal collagen cross-linking.

    What is Corneal Collagen Cross-linking?

    Regenerative medicine is a class of procedures that promote self-healing, and a regenerative procedure has been approved for keratoconus treatments. Corneal collagen cross-linking fits this category because the procedure prompts the immune system to create natural fibers of collagen. Your ophthalmologist will use Vitamin B2/riboflavin drops and focus a special UV-A laser on the cornea. The laser activates the riboflavin, which stimulates collagen production. Strands of new collagen form on the stroma, a layer of the cornea, strengthening it. This procedure is most effective on afflicted patients under the age of 35 before the keratoconus progression has reached its end. This procedure is performed here at New York Laser Vision by Dr. Julia Giyaur. Although often not covered by most major insurance companies, financing is available with us.

    Long-term prospects

    In most cases, the degeneration and vision impairment eventually stop progressing. Keratoconus treatments vary depending on individual cases’ severity. In rare cases, corneal scarring is so severe that the appropriate keratoconus treatment is a corneal transplant.
    If your vision affects your quality of life or is getting progressively worse, don’t wait to schedule an exam and discover the underlying cause.

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