Keratoconus is a degenerative condition of the cornea (front window of the eye). Normally, the cornea helps to bend (refract) and focus light rays to enable us to see. Any abnormality in its shape leads to significant visual impairment. In keratoconus, the cornea gets progressively thinner. As a result of thinning, the normally round shape of the cornea becomes distorted and a cone-like bulge develops. This leads to decreased vision.
The onset of keratoconus is usually in the early teens to early adulthood but there are increasing reports of keratoconus occurring in children. Due to its early age of onset, it can have a significant impact on a person’s education, work, social and family life.
Who is at risk?
The exact cause of keratoconus remains unknown, although our recent research indicates that it may result from a combination of genetic and environmental factors. Patients with keratoconus report vigorous eye rubbing and have allergies and allergy-related diseases. However, the exact link to these risk factors remains unclear. Some cases also have a genetic origin, with studies showing that up to 50% of people with keratoconus have at least one close relative affected by the disease.
What are the symptoms?
In the early stages, keratoconus may not cause any symptoms. However, as keratoconus progresses, it causes blurring and distortion of vision, resulting in frequent changes in glasses prescriptions, or vision that cannot be fully corrected with glasses. Some patients also experience symptoms such as increased light sensitivity, halos around light sources and double/multiple images (especially at night), that can make driving at night difficult.
How is keratoconus treated?
In the early stages, vision may be correctable with glasses or soft contact lenses. As the condition processes and the cornea thins and changes shape, rigid (hard) gas permeable contact lenses are needed to correct vision more adequately.
In advanced cases, where the central cornea becomes extremely thin and irregular, corneal transplantation surgery is required to improve vision. However, even after corneal transplantation, glasses or contact lenses are often still necessary. Other complications such as transplant rejection, infection and loss of vision can occur, so results cannot be guaranteed.
Corneal collagen crosslinking (CXL) is a new treatment option to slow the progression of keratoconus. The procedure involves application of riboflavin (vitamin B2) drops and Ultraviolet A light to stiffen the cornea and stop it from losing its shape. The procedure is still being investigated and is not suitable for all patients.
The Ocular Genetics and the Corneal Research Unit at the Centre for Eye Research Australia (CERA), are working together to better understand the causes of keratoconus through a broad range of projects. These include assessment of clinical features using the latest imaging technologies, hereditary components through genetic studies, environmental risk factor studies and the impact of keratoconus on an individual’s quality of life through questionnaires. These studies will lead to a better understanding and treatments of keratoconus including ways of either preventing or slowing its progression.
Keratoconus International Consortium (KIC)
The Keratoconus International Consortium (KIC) is a global collaborative initiative. It is an overarching vehicle that consolidates all research within the field and generates collaborative opportunities to address key issues faced by keratoconus patients. KIC has over 20 national and international corneal specialists, willing to collect and share data with the overarching goal of expanding our knowledge about keratoconus. KIC will generate more data from a larger number of patients than can be achieved by a single research team, enabling more effective testing of hypotheses and treatments for keratoconus.
How can I help?
Keratoconus patients – Contact Dr Srujana Sahebjada to find out more about CERA’s research and to participate in ongoing studies
Researcher/ Clinician – Contact the KIC team to learn more about the Consortium and how you can get involved
You can support keratoconus research at CERA by making a donation.