KERATOCONUS

Keratoconus is a condition where the cornea (front layer of the eye) becomes thin and bulges outwards. This makes the vision distorted and cloudy.

This condition is seen in young adults starting in the teens and progressing into the late 30's or early 40's.This is worsened by eye rubbing and allergic conditions.

The treatment offered is a two-prong approach.

The first treatment Collagen Crosslinking of the Cornea (also called UVX or C3R) is done if the cornea is thicker than 400 micron for progressive (worsening) cones. In this treatment the surface layer (or epithelium) is removed in the central 8 mm and Riboflavin (B2) eye drops are instilled every 5 minutes for 20-30 minutes.

UVA rays are focused in the same area for the next 30 minutes. The eye is patched for 24-48 hours. Eye drops are applied for 2-4 weeks. This treatment stops the worsening of the corneal degeneration of the cornea. As the beam is focused at 300 microns, it does not cause any damage to the deeper structures.

This is a painless out patient procedure and is done using local anesthetic drops. Rest for 4-5 days is recommended and lenses are fitted 3-4 weeks later. The treatment stops the worsening of keratoconus and can avoid corneal transplantation surgery.

Lenses restore the vision to 95-98%. In case of allergy or lens intolerance implantable contact lenses can be inserted after confirming that the cone is stable. After stabilizing the keratoconus vision can be improved with glasses to same extent contact lenses like the specialized Rose K lenses can correct the visual defect.

Other methods of restoring vision are intracorneal rings in mild to moderate cases. ie Intacs, and Ferrara rings

Boston Scleral contact lenses are suitable for advanced cones.

Rose-K are special lenses for keratoconus

Implantable contact lens (ICL) can be placed behind the pupil in conical corneas with stable parameters. It can correct errors up to -20.00, spherical and up to -6.00 D Cylindrical power. This is an out patient procedure and offered as a permanent correction for patient with stable cons

Corneal transplantation (keratoplasty) is performed in cones with optical scaring or after hydrops (sudden edema occurring in a cone) or in corneas that are too thin to undergo C3R. Results of partial thickness keratoplasty & full thickness keratoplasty are excellent with 85 to 95 % success rate after 5 years.

Conclusion.

This clinic works to assist in the care of all patients of keratoconus to maintain their quality of life and vision enabling a normal professional and personal life.

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