Corneal eye disease in focus
Dr Srujana Sahebjada is an optometrist and Research Fellow at the Centre for Eye Research Australia (CERA) with a special interest in keratoconus. “Most people are aware of common eye disease such as cataracts, glaucoma and macular degeneration, but many have never heard of keratoconus. Often the first time a patient hears the word ‘keratoconus’ is when they are diagnosed,” she says.
“I’ve had patients tell me that their boss isn’t happy with them for taking frequent time off work for regular eye care appointments and they think the patient is making it up. This lack of community awareness about this disease and the impact it has on the patients is a big problem,” says Dr Sahebjada.
Keratoconus is a condition where the clear window at the front of the eye (the cornea) progressively thins, causing it to bulge and distend, becoming cone-shaped rather than the regular round shape found in a healthy eye.
When the cornea loses its round shape, light is unable to pass through effectively, causing blurry vision, double vision, astigmatism, short-sightedness and light sensitivity. Left untreated, vision will continue to deteriorate, and the cornea may become so damaged that a corneal transplant is required.
“Corneal transplantation is a major eye surgery and carries risks such as infection and rejection. Some keratoconus patients requiring a transplant will need up to five corneal grafts in their lifetime. If surgery is needed it is often when the patients are quite young; in their teens or twenties. More and more, we’re seeing children presenting with keratoconus now which is a big concern,” says Dr Sahebjada.
One of the biggest challenges facing researchers and clinicians is that they are still unclear what causes the cornea to start thinning in keratoconus, although it is thought to be a combination of genetic and environmental factors. There is also no known cure for the disease, although recent advances in therapies to slow the progression by corneal crosslinking are promising for early stages of the condition. However, diagnosing these early cases is also difficult, requiring a specialised camera to map the shape of the cornea.
To tackle some of these issues, Dr Sahebjada and 19 fellow eye researchers globally have formed the Keratoconus International Consortium. “We hope that by sharing our research data with one another, we can develop a global classification system to measure the stages of keratoconus and promote a more consistent approach to diagnosis and treatment,” she says.
Researchers from the Centre for Eye Research Australia (CERA) are joining together with eye care professionals and researchers around the world to celebrate World Keratoconus Day on 10 November 2018.