Dr. Sandra Belmont is a cornea specialist and has done extensive research on keratoconus. NYC patients often ask about the causes of keratoconus. There is still no explanation for what causes this disorder, but Dr. Belmont has pioneered studies designed to find a biochemical explanation for keratoconus. She has also conducted research designed to determine the best options for vision improvement and overall treatment of keratoconus.
What is keratoconus?
Keratoconus is the vision disorder caused by a thinning of the cornea which results in the formation of a rounded cone shape bulge. The cornea serves to control, focus, and refract light entering the eye onto the retina. When the cornea is misshapen, light is distorted which negatively impacts an individual’s vision. The smallest corneal irregularity can impair vision, even in those individuals with otherwise perfectly functioning eyes. The cause of keratoconus is unknown, but some research suggests potential causes are genetic, environmental (injury/allergies), or hormonal.
What are the symptoms of keratoconus?
In the early stages (which tend to fall between adolescence and early adulthood) the disorder causes blurring, distortion, and increased sensitivity to light. It can take 10-20 years for keratoconus to progress, but as it progresses, the corneal bulge becomes more significant, further distorting vision. There is currently no way to stop the progression of keratoconus, but severe vision loss only occurs in rare cases when swelling from the cone-like protrusion of the cornea causes a tiny crack to develop. The crack will eventually heal, and eye drops can be provided for relief. In most cases, the disorder resolves itself before adulthood.
How can keratoconus be treated?
While vision correction is necessary, most individuals with keratoconus should not have no-cut LASIK surgery. Most cases of keratoconus resolve themselves after a few years without causing permanent vision damage. Those that do not may benefit from any of the following treatments:
Corneal crosslinking is not a cure for keratoconus; rather, it is intended to stop the progression of early-stage keratoconus by strengthening the cornea. Dr. Belmont administers riboflavin (vitamin B2) drops to the eye and activates them with a UV light. This is thought to increase the number of collagen crosslinks or “anchors” in the cornea that help it maintain its shape and prevent it from distorting.
Hybrid Contact Lenses
Hybrid contact lenses are a non-surgical alternative to other keratoconus treatment options. They are specifically designed for people who cannot tolerate traditional contact lenses due to the effects of keratoconus. The lenses have a rigid center with a softer ring around the outside, which makes them comfortable while offering clear vision.
Corneal implants called Intacs are often recommended for patients whose keratoconus has progressed to the point where regular contact lenses no longer restore clear vision, yet corneal transplant is not yet needed. This minimally invasive treatment involves placing tiny crescent-shaped implants inside the eye to reshape the curvature of the cornea. The implants improve the way light rays that enter the eye are focused, thus reducing some of the visual distortions associated with keratoconus.
Corneal Transplant Surgery
A small number of keratoconus cases advance considerably and eventually require corneal transplant surgery, which has been successful in 90 percent of advanced keratoconus cases. Depending on the specific circumstances, part or all of the cornea can be replaced with a donor cornea.
Will I go blind from keratoconus?
Keratoconus generally does not progress to complete blindness, even if it is treated in the very late stages or not treated at all. However, moderate to severe cases of keratoconus can cause vision to deteriorate so much that it makes daily activities challenging. Someone with late-stage keratoconus may be considered legally blind and require corneal transplant to reclaim clearer vision.
Does early diagnosis make any difference in keratoconus?
Diagnosing keratoconus in its early stages allows doctors to potentially stop the progression of the disease with minimally invasive treatments. For example, special contact lenses can be prescribed and worn to control the bulging and distortion of the cornea and restore clear vision. Another minimally invasive option that has shown promise in preventing the progression of early-stage keratoconus is corneal crosslinking, which can be conveniently performed in the doctor’s office.
To learn more about Keratoconus Disorder, contact the Belmont Eye Center today by calling (212) 486-2020.