What is Keratoconus and Can it Be Treated by Laser Eye Surgery?
Mr Tariq Ayoub - 22 May 2021
Keratoconus is a progressive eye disease that distorts the cornea and causes problems with vision. It can occur in one or both eyes and often begins in a person’s teens or early 20s.
In this blog we explore what keratoconus is, what treatments are most effective and whether laser eye surgery is an option.
What is keratoconus?
In a normal, healthy eye the cornea – the clear outer lens – is dome-shaped. However, in a person with , the cornea thins and begins to bulge, forming a cone-like shape. This is due to weakening of a protein called collagen that normally holds the cornea in place.
As the cornea bulges, it causes blurred and/or distorted vision. This is because the normally regular, smooth surface becomes distorted. As the front of your cornea expands, your vision becomes more nearsighted which means objects that are far away appear blurred.
Not everyone with keratoconus has symptoms, however. Asymptomatic keratoconus (called forme fruste keratoconus) is actually more common than the symptomatic form of the disease.
The reasons why some people develop keratoconus are not completely clear. However, certain risk factors increase a person’s likelihood of the disease, including:
Genetic factors – if someone in your family has keratoconus your own risk increases.
Age – it most often appears in teenagers, although the condition can develop in childhood or after the age of 30. It’s less common in people over 40.
Eye rubbing – constant eye rubbing from chronic eye irritation in, for example, allergic eye disease is associated with keratoconus.
In its early stages, glasses and contact lenses can improve the vision in a person with keratoconus. This may be combined with a technique called cross-linking.
Cross-linking increases rigidity in the cornea. It may help to slow or halt the progressive thinning and bulging associated with the disease.
In some patients who meet strict treatment criteria, cross-linking can be combined with laser resurfacing to reduce their prescription. Sometimes it may even make them less dependent on glasses and contact lenses.
In more advanced cases, keratoconus may be treated with corneal ring segments or corneal transplants. In selected patients who have stable keratoconus, ICL implants may be used to improve vision.
Can keratoconus be treated by laser eye surgery?
We do not recommend laser eye surgery as a refractive procedure to rid you of glasses and/or contact for patients with keratoconus.
As keratoconus is a degenerative disease that causes thinning of the cornea, laser refractive surgery procedures such as LASIK would weaken the cornea further by removing tissue from the already thinned cornea. This leads to unpredictable changes in the shape of the cornea and consequently loss of vision.
Refractive-CXL or CXL-plus, where PRK laser eye surgery is combined with cross-linking, is often used to improve the quality of vision. You would continue to need to wear contact lens or glasses for good vision but often night vision problems such as haloes, glare and starbursts improve after the procedure.
Selected patients, who are stable after CXL-plus, can have implantable contact lens surgery to rid them of glasses and/or contact lenses.
How to book keratoconus treatment
If you have keratoconus and are interested in discussing your treatment options, we recommend booking a consultation with our keratoconus specialist.
We will conduct a thorough examination of your eye and devise a personalised treatment plan. This may include cross-linking and laser-assisted cross-linking (CXL-plus) to stabilise your cornea and your vision. Depending on the outcome of this procedure, it may be possible to have implantable contact lens surgery at a future date.
In some cases, a patient’s keratoconus is only detected during screening for laser refractive eye surgery. Although this means you will not be able to have laser eye surgery, we will be able to discuss other treatment options to support your vision going forwards.
Oculase – The Eye Clinic, an eye specialist in London and Birmingham, offers personalised, consultant-led treatment for a wide range of eye conditions. We take care to explain treatment options simply and clearly so that you can make informed choices.
We strive to provide the highest standards of care possible, backed by leading edge technology and the latest treatments. Click the button below to book your appointment now.