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Keratoconus

Keratoconus is a common degenerative condition of the eye where the cornea (front window of the eye) gets progressively thinner. As a result of this thinning, the normally round shape of the cornea becomes distorted and a cone-like bulge develops. This results in significant visual impairment.

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Who is at risk?

Despite continuing research, the exact cause of keratoconus remains unknown. There are several risk factors including excessive eye rubbing, allergy, connective tissue problems, and contact lens wear. Some cases also seem to have a genetic origin, with studies showing that up to 50% of subjects with keratoconus have at least one close relative affected by the disease.

Keratoconus

What are the symptoms?

In the early stages, keratoconus does not normally produce any symptoms. The first symptoms of keratoconus are usually a blurring and distortion of vision, that may be corrected with glasses.  Frequent changes to the glasses prescription may be required as the cornea becomes progressively thinner.

How is keratoconus treated?

As the disease progresses, glasses will no longer be strong enough to correct the patient’s vision and rigid contact lenses are required. Soft contact lenses are usually not an option, because they cannot correct for the irregular astigmatism associated with the keratoconus.

In a small number of patients, the central cornea becomes so severely thin and irregular that corneal transplantation surgery is required to restore vision. Glasses or contact lenses are often still necessary after the surgery. As in any eye surgery, complications such as transplant rejection, infection and loss of vision can occur, so results cannot be guaranteed.

Recently a new minor surgical treatment to slow or stop the progression of the disease in younger people has become available called corneal collagen crosslinking. First, riboflavin (vitamin B2) drops are applied to the patient’s eye. Once the riboflavin has penetrated through the cornea, Ultraviolet A light therapy is applied to induce collagen crosslinking.  This is a process where collagen fibres form strong chemical bonds with neighbouring fibres and act like a scaffold to support the cornea and stop it from losing its shape.  Collagen crosslinking is still being investigated but several studies have shown it is able to stabilise keratoconus and results are promising.

Keratoconus research

The Ocular Genetics Unit at the Centre for Eye Research Australia is working to better understand the causes of keratoconus through assessment of clinical features using latest imaging technologies, hereditary components through genetic studies and impact of keratoconus on an individual’s quality of life. These studies will lead to a better understanding of keratoconus including ways of either preventing or slowing its progression.

How can I help?

You can support keratoconus research at CERA by making a donation.

Read the latest Australian Study of Keratoconus (ASK) newsletter.