WHAT IS KERATOCONUS?
Keratoconus Definition: Keratoconus is the thinning and conical deformation of the cornea of the eye (called cornea in medicine). The disease usually begins in one eye. Nevertheless, both eyes are usually affected. A keratoconus can be in both bursts and flow. In Germany, about every 2,000 men – twice as often as women – are affected.
The disease mostly affects the central cornea of the eyes and causes them to become deformed and thinned ( usually like a cone). A keratoconus usually affects both eyes, but occurs very rarely at the same time and incomparable strength in both eyes. If, however, the disease is recognized in time, an early drastic advance of the corneal deformation and thinning can be largely restrained.
The affected person usually suffers from myopia, which becomes more and more intense with the severity of the deformation. The form of myopia, as occurs with one eye, however, can usually not be corrected completely and only with a visual aid (such as a pair of glasses). This is due to the conical convexity of the cornea.
WHAT CAUSES KERATOCONUS?
Keratoconus Causes: What causes or favours a keratoconus is still not fully known, despite numerous studies, According to various assumptions is a metabolic disorder of the affected persons the triggers. However, an inherited eye could also be considered more closely. In addition, a variation of the chemical composition of the cornea could be observed in a keratoconus in different long-term studies. On the other hand, individual observations have shown that the natural curvature of the skin of the leather (sclera) often deviated slightly from the norm in one eye. In addition, a keratoconus is triggered by an infection or by a weakening of the collagen, which is present in the cornea. These assumptions have not yet been substantiated by further studies.
WHAT ARE THE SYMPTOMS OF KERATOCONUS?
Keratoconus Symptoms: In rare cases, the cornea may tear in the eye during the course of the disease, so that fluid from the anterior chamber of the eye can penetrate the cornea. The result is an acute keratoconus, which can become painful and often has to be treated directly (for example, by an operative procedure) since the view quickly and drastically deteriorates (nebula). Acute keratoconus is the only case of the disease in which the eye can cause pain and noticeable discomfort. The pure deformation and thinning of the eye can be seen only by the loss of vision.
WHAT TREATS KERATOCONUS?
Keratoconus Treatment: The keratoconus can be treated today in two different ways. On the one hand, the aim is to eliminate the defective vision caused by keratoconus.
- Visual aids for compensating for defective vision: In the case of a slight keratoconus, as usually occurs in the initial stage, the deformation and thinning of the cornea can still be compensated with a pair of spectacles. In an advanced or progressive keratoconus, however, drastic changes of the cornea usually occur. In this case, however, the defective vision must usually be compensated for with the aid of stable contact lenses or special lenses ( called keratoconus lenses ). Approximately 80 percent of patients suffering from keratoconus are permanently exposed to hard contact lenses. Partially, however, these must also be combined with an additional visual aid (such as a pair of spectacles) in order to largely remedy the defective vision on the eye.
- Networking the cornea: On the other hand, a further advance of the disease is to be avoided with a timely treatment. In the best case, a further deformation and thinning of the cornea on the eye is largely stopped. This is possible, for example, by a cross-linking treatment (also called cross-linking or collagen crosslinking ). CrossLinking prevents the progress of the keratoconus but is recommended only in stage I and II by experts, since the soft cornea is stiffened in the tissue of the cornea by the cross-linking of the cornea. To date, however, crosslinking is the only treatment method which can stop the advancing of keratoconus for several years .Various studies assume that the keratoconus might possibly be permanently stopped if the cornea is cross-linked in time. However, the long-term study values are still missing.
- Circular Keratotomy: Circular Keratotomy (CKT) is another method by which the keratoconus is largely stopped. In this case, an approximately 7 mm wide cut is made around the optical axis of the cornea. Subsequently, the cut is closed with a double-running seam. In this way, the cornea is tightened and the cone balanced. For this purpose, however, the cornea must be at least 400 μm thick and stable enough in the area of the cut. In addition, the CKT is also suitable only in stage I and II of the keratoconus and the actual effect of the CKT could not be proven to this day.
- Corneal Transplant: If the defective vision cannot be adequately corrected with pure visual aids, the cornea should usually be replaced by a transplant ( keratoplasty ). Transplantation is performed in keratoconus in an ophthalmic clinic specialized in transplantation. Here the cornea of the affected person is stabilized in rare cases by different methods, but more frequently by a donor’s horny skin. Often, the cornea is also only punched out. There is only a minimal margin, the cut out corneal part is replaced by the healthy donor tissue and sewn by a fine double seam. The cost of this is usually borne by the health insurance company if the visibility is made so severe that it affects the quality of life of the person concerned.
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