Keratoconus is a progressive eye condition that affects the cornea, which is the clear domed front surface of the eye, causing it to thin and bulge into a cone shape. This deformation disrupts the normal focusing of light on the retina, resulting in blurry and distorted vision. As keratoconus progresses, it can significantly affect daily activities like reading, driving, and using digital devices. However, advancements in keratoconus treatments, including innovative therapies like CAIRS (Corneal Anterior Intrastromal Rings), have greatly improved the management and treatment of the condition. Local head of NHS corneal services, Kieren Darcy is at the forefront of these treatments, offering patients effective solutions that can stabilise the condition and improve their vision.
Early Detection and Diagnosis
Early diagnosis of keratoconus is crucial to managing the condition effectively. Symptoms often begin in the late teens or early twenties and can include blurred vision, glare, light sensitivity, and frequent changes in prescription glasses. Comprehensive eye exams, including detailed corneal mapping, assessment of aberrations, epithelial mapping and pachymetry, can help detect the early signs of keratoconus. These tests map the whole architecture of the cornea, allowing eye care professionals to identify the characteristic irregularities associated with keratoconus.
Stabilisation and Correction
Once keratoconus is detected, it is important to halt the progression of the dystrophy. There are multiple treatment options available, which can stop changes and treat the effects to improve corrected vision and even remove the need for glasses and contact lenses.
Treatment Options for Keratoconus
Corneal Cross-Linking (CXL)
One of the most widely used treatments for keratoconus is corneal collagen cross-linking (CXL). This procedure strengthens the cornea by using ultraviolet (UV) light and riboflavin (vitamin B2) to create stronger bonds between the collagen fibres in the cornea. CXL is typically used in the early to moderate stages of keratoconus to stabilise the cornea and prevent further progression. The procedure is minimally invasive, and patients can usually return to their normal activities within a few days.
Specialist Contact Lenses
For patients whose keratoconus is stable and perhaps not severe enough to warrant surgery, specialist contact lenses can be an effective solution for improved vison. Mini scleral lenses, and impression based, customised lenses are commonly recommended to help improve vision by compensating for the irregularities in the cornea. These lenses provide a smooth surface over the cornea, allowing light to focus properly and improving visual clarity.
Advanced, Customised Laser
Advanced Customised Laser procedure uses highly precise mapping technology to create a personalised treatment plan for each eye. It takes into account the unique shape and the effects of keratoconus on the cornea. Often performed with corneal cross linking, this procedure aims to regularise the corneal surface so individuals can benefit from improved quality of corrected vision and potentially lead to further refractive procedures.
Corneal Rings
For those with more advanced keratoconus, small, crescent-shaped prosthetic, corneal inserts which plump and reshape the cornea. These implants can reduce the cone shape and flatten the cornea, leading to improved vision.
Latest CAIRS Treatment
Among the many advanced treatment options available, CAIRS treatment has emerged as a particularly promising solution for patients with keratoconus. CAIRS (Corneal Anterior Intrastromal Rings) is a technique that involves the implantation of small, ring-shaped sections of donor corneal tissue to help correct its irregular shape.
The CAIRS procedure is specifically designed for individuals with moderate to advanced keratoconus and experiencing corneal thinning. The small, arc shaped implants are placed into the deeper layers of the cornea through a minimally invasive laser procedure. Once inserted, these rings flatten the cornea, reshaping it and improving its overall curvature. As a result, light is focused more evenly onto the retina, leading to clearer and more stable vision.
What sets CAIRS apart from other treatments is its ability to preserve the cornea’s natural structure, with natural tissue, while providing significant improvements in visual acuity. The procedure is an outpatient treatment, with most patients experiencing a relatively quick recovery time. This can be combined with other treatments, including either corneal collagen cross linking and/or customised laser eye surgery.
If you have been diagnosed with keratoconus or suspect that you may have it, it’s essential to consult an experienced corneal specialist, like Kieren Darcy. With the right diagnosis and treatment plan, you can take steps to manage your condition and preserve your vision for years to come.