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Keratoconus

What is Keratoconus?

Keratoconus is a condition where the front window to the eye (cornea) is cone-shaped hence the name keratoconus.  Normally the cornea is smooth and relatively aspheric (round in the middle and flatter toward the edge).  With keratoconus, the cornea is thinner and therefore bulges forward due to internal fluid pressure.   Because of this irregularly shaped cornea, the patient’s vision is compromised greatly due to a distorted image getting to the retina and ultimately the brain.  It is most often a progressive condition which begins in the adolescent years and can progress all the way into middle aged adulthood.  The cause is unknown.  It occurs in approximately 1 in 750 Americans.  It does tend to run in families.

How is Keratoconus Managed?

It is important to note that keratoconus doesn’t have a quick fix.  It can be compensated for with contact lenses which increase in complexity as the condition becomes more advanced.   Spectacles are rarely an option for keratoconus.  Rigid contact lenses provide excellent vision and hybrid lenses work well for patients who can’t tolerate rigid lenses. Hybrid lenses are rigid in the center and soft around the periphery to maximize comfort.  Occasionally, if the keratoconus is mild, specially designed soft lenses (NovaKone) lenses can be worn.   Recently, a treatment called collagen cross linking has been performed in the U.S. and around the world to stabilize keratoconus.

What is Collagen Cross Linking?

Corneal Cross Linking (CXL) was first devoloped in 1998 and is one of the most promising treatments for keratoconus to date.  It is currently in Phase 1 of FDA clinical trials but we have access to this exciting technology here in Jacksonville through an affilliated ophthalmology group.

Corneal Cross Linking uses a combination of vitamin drops on the cornea followed by UV light exposure to strengthen the collagen bands or “support beams” of the cornea.  This treatment makes the cornea more resistant to the thinning and bulging the cornea suffers through in keratoconus.  It is most effective on younger patients who are most at risk for progression.

What is INTACS?

Another mode of treatment for keratoconus is INTACS.  This is a procedure where two arc-like plastic inserts are placed into the cornea to normalize the shape of the front surface.  This can reduce the extreme distortion of the cornea but does not eliminate the need for correction.  It does allow for more options in contact lens therapy.

If you have been recently diagnosed or just want an evaluation for keratoconus, please call our office at 904-280-9000 to set up a comprehensive examination.  We specialize in the type of contact lenses that are needed for keratoconus.

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