FAQ: LIVING WITH KERATOCONUS
Will I become blind with keratoconus?
Generally, keratoconus does not lead to complete blindness. However, this disease can worsen vision to a level where it becomes very difficult to lead a normal life.
As the disease progresses, situations such as corneal rupture (acute keratoconus) or intolerance to lenses that can lead to corneal transplant can occur.
Can someone with keratoconus drive a car?
As long as the motorist has the requisites required by the laws in force, there are no impediments to driving.
Keratoconus can, however, cause difficulty in night driving due to a vision disturbed by glare, halos and multiple images.
Can pregnancy make keratoconus worse?
It is known that pregnancy produces changes at the hormonal level. Sometimes, these changes can affect the eyes especially those of patients with keratoconus.
Turkish ophthalmologists have identified 4 cases of pregnant women with keratoconus that showed signs of change in visual acuity and corneal curvature (case report published in the magazine “Cornea”, June 24, 2011).
These women had no other diseases or risk factors to keratoconus, so the researchers concluded that, “Hormonal changes during pregnancy can negatively affect corneal biomechanics and pregnancy may be a previously unrecognized risk factor for progression of keratoconus. To our knowledge, this is the first study that shows a progression of pregnancy-induced keratoconus in patients without other related diseases”.
Are contact lenses for keratoconus painful?
There are many different types of contact lenses used for keratoconus. Generally, RGP (hard) lenses are less comfortable when worn for the first time but offer a superior vision to soft lenses. Most patients with keratoconus adapt to hard lenses but if reasonable comfort is not achieved, there are several options. If you have tried contact lenses some time ago and have not been able to use them, consult your eye doctor; there are probably new options that are more suitable for you.
Is it normal to experience eye pain, redness, and a sense of fatigue in the presence of keratoconus?
Many patients report experiencing discomfort and pain, as well as periods of fatigue. If you experience discomfort or redness, you can opt for artificial tears without preservatives. It is good to bear in mind that redness can also be caused by problems not related to keratoconus, such as dry eye syndrome or allergies.
What causes keratoconus?
The cause of keratoconus remains unknown, although recent research seems to indicate that it could be of genetic origin. Certainly, some cases of keratoconus have a hereditary component and recent studies indicate that about 8% of patients have relatives affected by the disease. Excessive eye rubbing is also indicated as a possible triggering factor.
How common is keratoconus?
Keratoconus is estimated to occur in 1 in 2,000 people in the world population. There does not seem to be a significant preponderance of either men or women.
What are the symptoms of keratoconus?
The initial symptoms of keratoconus are usually blurring and distortion of vision that can be corrected with glasses in the early stages of the disease. Frequent adjustments to vision correction may be necessary as the cornea becomes progressively thinner.
Is high blood pressure a factor in keratoconus development?
Ocular hypertension is not a symptom nor a trigger of keratoconus. However, if you have high blood pressure, share this information with your eye doctor, as it may be indicative of glaucoma or other eye conditions.
Does keratoconus always get worse over time?
Like most medical conditions, the progression of keratoconus is unpredictable and varies for each individual. In many patients, the pathology maintains a mild form unaltered over long periods of time, while in others it seems to progress faster. It can then spontaneously slow down but it never stops completely.
At what age does keratoconus occur?
Keratoconus manifests itself in adolescence around the age of 14, although the onset at infancy is not rare. Usually, it initially affects only one eye and after a few years, the other. The forms of keratoconus affecting only one eye are indeed very rare.
Do most people suffer from keratoconus on both eyes?
Most experts believe that keratoconus is always bilateral, that it always affects both eyes. However, because of its variability, the pathology can be so mild in one eye that it is practically invisible. It could stay that way or the eye could get worse over time. Unfortunately, there is no way of knowing if and when it will happen.
FAQ: DIAGNOSIS AND CARE OF KERATOCONUS
Can a diagnosis of early keratoconus change the progression of the disease?
Certainly. An early diagnosis means being able to intervene early and minimize eye damage. In these cases, it is good to evaluate therapies such as corneal cross-linking that can stabilize the disease and prevent the onset of further damage to eyesight.
When should keratoconus be checked on my child?
All children should undergo a visual check around three years of age to ensure that both eyes are well coordinated, have good vision, and are healthy. If there is a family history of keratoconus, a specific examination at about 8-9 years of age is recommended. Corneal topography can be performed reliably on children in this age group and can detect any early signs of keratoconus.
Is it true that corneal transplant definitely solves keratoconus?
Corneal transplant is a goal that we NEVER must try to reach.
What are the advantages of the cross-linking procedure compared to corneal transplant?
Corneal transplant is an invasive surgical procedure that requires the removal of a section of the cornea and its replacement with the donor tissue. Transplantation involves risks such as infections, rejection, cataracts, glaucoma, astigmatism, and other intraoperative dangers. It is likely that young patients with keratoconus will need one or more repeated transplants during their lifetime. Generally, it takes about 1 year to recover one’s vision after a very successful corneal transplant.
The cross-linking procedure is instead an outpatient surgery that works by increasing the cross-links to the collagen, the natural “anchors” inside the cornea. These “anchors” are essential to prevent the cornea from protruding forward and assume an irregular shape. Cross-linking involves creating a superficial scratch on the cornea which is much less invasive than a corneal transplant. The surgery is much safer and takes about only 1 week to heal significantly. Having performed a cross-linking treatment does not exclude the possibility of undergoing a cornea transplant in the future. In contrast, patients who have performed corneal transplants cannot undergo cross-linking anymore.
Do contact lenses improve (or worsen) keratoconus?
Keratoconus contact lenses are designed to provide a good level of vision during use. So the pathology does not improve but the quality of sight does.
Furthermore, as long as the lenses are well adjusted and treated, they do not worsen the condition. However, it is extremely important to undergo regular checks because dirty or unsuitable lenses can cause scarring or infection of the cornea.