Keratoconus treatment

Causes of Keratoconus

Dr. Amr Sheta indicates that the exact causes of keratoconus are still unknown, but it may be due to genetic factors, incorrect practices, or a balance disorder in the enzymes present in the cornea itself.

We can identify the risk factors for developing keratoconus as follows:

- Genetic factors, with one or both parents having keratoconus.
- Frequent eye rubbing due to eye inflammation or allergies.
- Certain medical conditions such as Down syndrome, asthma, and others.
- Excessive exposure to ultraviolet rays.
- Excessive and prolonged use of poorly made contact lenses.

Risks of Keratoconus

The risks of keratoconus extend beyond weakening vision or causing myopia. Ignoring proper treatment and allowing the condition to progress can lead to:

- Scarring of the cornea, which impairs vision.
- Bulging or swelling of the cornea, accumulation of eye fluids inside the cone-shaped area, causing serious vision problems.
- Developing the condition to the extent that it requires corneal transplant surgery.

Symptoms of Keratoconus

Dr.ibrahim osama notes that early detection and treatment in the initial stages are easier, but the question here is how the patient realizes that they need to undergo an examination to detect the problem early on. Typically, patients with keratoconus experience a range of symptoms, including:

Blurry vision.
- Excessive sensitivity to bright lights.
- Constantly changing prescriptions for corrective lenses.
- Multiple light shadows.

The stages of keratoconus are a progressive disorder of the eye where the cornea, which is usually round, thins and changes shape, causing it to weaken and bulge into a cone-like shape. This progressive development occurs in three consecutive stages, which are as follows:

Stage 1:
This stage involves minor changes in the cells lining the cornea and differences in visual measurements, but the patient can still see well with the help of glasses or contact lenses. Glasses or contact lenses may be an effective and sufficient solution, and in some cases, the doctor may perform a procedure to stabilize the cornea to prevent it from deteriorating.

Stage 2:
This is the next stage where vision does not improve with the use of prescription glasses, and the patient may require a procedure called corneal ring implantation, which aims to modify the surface of the cornea to remove the excess curvature.

Stage 3:
This is the most severe stage where the corneal tissue becomes extremely thin, and the patient may see halos or clouds in their field of vision that cannot be corrected with glasses, corneal stabilization, or ring implantation. The only remaining option is corneal transplantation because the cornea is too thin to allow any surgical intervention on the current cornea.
The stages of developing keratoconus typically begin in adolescence or early adulthood and progress until around age 40 when the development of keratoconus stops.

Treatment of Keratoconus
As mentioned in the previous paragraph, treatment is determined by the stage of the condition. The following are the treatments for each stage:

Treatment for Stage 1 Keratoconus:
The patient can still see well with prescription glasses, but corneal stabilization is a preferred procedure to prevent the condition from progressing. Corneal stabilization is performed as follows:

The surgeon saturates the cornea with a compound of riboflavin drops.
Appropriate doses of ultraviolet rays are applied to the surface of the cornea.
The ultraviolet rays enhance the links between collagen fibers in the corneal tissue, thereby strengthening it.
Corneal stabilization has a high success rate of up to 99% in preventing the deterioration of the cornea.

Treatment for Stage 2 Keratoconus:
Prescription glasses are ineffective in improving the patient's vision at this stage, and the doctor may decide to implant tiny supports or rings into the cornea using femtosecond laser technology. These rings help reduce the impact of scarring and curvature present in the cornea, leading to improved visual quality. In some cases, if the cornea is not sufficiently thick, the doctor may use surface laser to correct corneal curvature before corneal stabilization with ultraviolet rays and riboflavin drops.

The procedure for implanting rings to treat keratoconus is performed as follows:

The patient is given local anesthesia.
A special tool is used to separate the upper eyelid from the lower and widen the eye for surgery.
The rings are inserted through a small incision made by the surgeon at the edge of the cornea to pass the rings through a tunnel between the corneal layers.
The rings are then secured, and the incisions are closed.

Treatment for Stage 3 Keratoconus:
At this stage, the patient may experience cloudiness or halos in their field of vision that impede visual quality. Any attempts to reshape the corneal surface are ineffective due to the cornea's thinness, and the doctor will decide to perform a partial