What are the Symptoms of Keratoconus
Keratoconus (corneal disease)
- Signs and Treatment -
What is Keratoconus?
Keratoconus is a progressive corneal disease characterized by the increasing thinning and conical bulging of the cornea. Usually the cornea is curved approximately like a segment of a sphere. Since the quality and evenness of the cornea is crucial for good visual function, keratoconus leads to increasing loss of vision.
- About one person in every 1,000-2,000 inhabitants suffers from keratoconus.
- Keratoconus is mostly diagnosed in Europe between the ages of 18 and 25 years. The person concerned complains that he sees worse and worse despite glasses.
Signs of keratoconus
The first signs are frequent eyeglass corrections with changes in the curvature of the cornea and changing eyesight. Often this is first noticed in one eye. Early diagnosis is only possible in the initial stage with a three-dimensional representation of the cornea. Changes in the cornea (Fleischer’s rings and Vogt lines) that the ophthalmologist can see with conventional diagnostics only appear in the late stages.
In the case of an advanced clinical picture, keratoconus can be seen from the side with the naked eye. If corneal edema (fluid build-up in the cornea) occurs, it is acute keratoconus. It can heal with scarring after three to four months.
Keratoconus as such can only be treated to a limited extent - but there are numerous ways to compensate for the impaired vision. First of all, glasses are usually chosen. If the disease progresses, hard contact lenses are used. They enable individual correction of the irregular corneal curvature. In some cases, this allows full vision to be established for the patient.
Stabilization of the cornea through UV crosslinking
Crosslinking serves to stabilize the cornea, which is created by cross-linking tissue fibers (so-called collagen fibers) in the cornea. The cornea is treated with a special substance called riboflavin (a vitamin B2 derivative). This allows the existing corneal shape to be retained. Some patients experience improvement in vision after crosslinking. The earlier you treat, the better the prognosis that you will maintain your visual acuity.
In order for the substance to reach the collagen fibers of the cornea well, the outer protective layer of the cornea is gently removed and then riboflavin is added. (A few days after the treatment, the protective layer regenerates itself.) The actual cross-linking then takes place by irradiating the cornea with a specially developed UV light for 30 minutes. At the end of the treatment, a so-called therapeutic contact lens is placed on the cornea. The lens remains on the eye for a few days and should only be removed by the attending ophthalmologist.
Lastly, the corneal transplant remains to improve eyesight. The diseased cornea is surgically removed and replaced with a clear donor cornea. Since this is a transplantation of foreign tissue, there are residual risks such as B. transplant rejection. The best possible vision is usually achieved two years after the transplant.
Ophthalmologists Gerl & colleagues
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