Even in this modern era, an age of science and information, there are still no answers to all questions. One of the questions that remain unanswered is the disease keratoconus – an eye disease in which the cornea becomes increasingly thinner, resulting in a cone-shaped instead of a cap-shaped cornea. The result: significant decline in vision that might even deteriorate to blindness.
Numerous theories were raised with regards to the cause of the keratoconus. Certain studies indicate congenital causes, i.e. genetics that gives rise to the disease Other studies indicate acquired causes such as eye inflammation and chronic allergies in the eye, increased rubbing of the eyes, etc.
Keratoconus is treated in a variety of ways: eyeglasses, contact lenses, corneal ring transplant, crosslinking therapy and even corneal transplant.
The expertise required to treat keratoconus involves adapting the right treatment to the right person, since every case of keratoconus is characterized in a slightly different way.
As someone who has been specializing for many years in treating complex conditions of keratoconus, I encounter on a daily basis patients who suffer from the disease and who believe there is no solution for their condition. I can say with tremendous certainty: with the right and smart treatment – a solution can be found for nearly every case of keratoconus. Below are 3 cases for illustration.
Fitting lenses for keratoconus following 2 corneal transplants
55-year-old A suffers from keratoconus, and has undergone two corneal transplants. Unfortunately, even following the second transplant, A is forced to wear contact lenses – which bothered him a great deal.
“The lenses stabbed me in the eye, they began to burn at unexpected times and even fell out on several occasions. You go find a contact lens on the floor of a car, says A. After several failed replacements of contact lenses, he decided to give up. “It sounds petty to continue to complain about any discomfort when I in fact received my eyes back” he mentions with a smile.
Finally, out of despair and depression, A arrived at my clinic. After having calmed him down, I began a series of examinations that included an exact mapping of the cornea and measurements. I realized that hybrid lenses, with a hard center and soft edges would fit the shape of A’s eyes. They would be a better fit for the eye, and would be less uncomfortable.
I maintain contact with A to this date, who informs me that the pain in his eyes have completely disappeared and that the lenses no longer fall out but are well fitted to the eye. The tests show 6/6 vision.
Keratoconus at a young age: hard lenses are sometimes needed
Y, who is 25 years old, never wore glasses. One day, he experienced a sudden decline in his vision and was diagnosed with keratoconus. When the disease was diagnosed in its early stages, crosslinking treatment (stabilization of the corneal tissue) can stop the disease – and this is what happened. All that remains is to fit the contact lenses to correct the damage that was already caused.
Y’s attending physician referred Y to me, and I remember that he was extremely stressed and impatient. He was afraid that he would never regain 6/6 vision. After a thorough test and discussion with the patient, I decided to fit him with hard lenses. This means that initial adjustment would be slightly more difficult and the eye would require longer time to adjust to the lens. Due to technical constraints of the corneal diameter, and particularly due to the fact that the patient has no history of wearing contact lenses, hard lenses, which are easier to insert and remove, appeared to me to be better suited for him. One of the most important things to remember is that fitting contact lenses is not only a scientific and medical matter but a personal one as well.
Today, Y easily wears contact lenses, has perfect vision and is far more relaxed.
Keratoconus and chronic dry eye
Do you know what sudden dry eye feels like? The eyes burn, it is difficult to blink and you feel a severe and sudden burning sensation in the eye. 35-year-old M, who has keratoconus, has been walking around with this extremely uncomfortable sensation for five years.
In addition to the discomfort, chronic dry eye caused M to become unruly when regularly putting on the contact lenses. During significant parts of the day, he simply closed his eyes, preferring not to see rather than suffer. After several years of suffering, M met a friend, who also suffered from keratoconus who referred M to me.
A discussion with M revealed that he never thought that the problem could be resolved. The facts, however, is that there are many types of lenses, by many manufacturers, and occasionally a slight change in the type of structure of the lens solves the situation. In M’s case, it was clear to me that the scleral lens by Canadian company BLANCHART would resolve the problem of dry eye. The lenses have a large diameter that covers the white part of the eye, the sclera, and hence its name. The lenses also contain fluid that protects the eye from dryness.
The disadvantages of these lenses are that they are slightly harder to put on, and a special device must be used. After putting them on – the dry eye problem completely disappears.
The problem that M thought to be unresolvable was revealed to be easily resolved with the right type of lens and fitting that corresponds with a concrete and unique medical condition of each patient.
Summary: Keratoconus? There are solutions.
Many of the people diagnosed with keratoconus tend to become fixed on the first solution offered to them, even if it is not optimal and creates problems. The result is that many patients suffer from burning sensations in the eyes, impaired vision or uncomfortable lenses that fall out.
My message is that everyone deserves quality of life. Don’t lose hope. We may not know everything about keratoconus but we know enough to find solutions to nearly every situation.
Do you or your family member suffer from keratoconus? Schedule an appointment. There are solutions.