Possible consequences of keratoconus are abnormal fluctuations and reduction of visual acuity, irregular astigmatism, seeing halos around lighting sources, increased sensitivity to light and glares. If the disease stops at a stage in which the full conus shape has not developed yet, it is referred to as "forme fruste keratoconus". However, in 20% of patients, a progressive keratoconus develops which continues its progression swiftly. This can cause tears in the posterior cornea through which fluid from the anterior chamber gains access to the cornea, clouding it. This is called an acute keratoconus. At a late stage, a corneal transplant is frequently the only option.
What is keratoconus?
Keratoconus refers to progressive thinning and bulging of the cornea which is associated with unstable and declining visual acuity. Keratoconus is also one of the most frequent reasons for a corneal transplant. The earlier it is detected and stabilized, the greater the possibility to avoid this.
„Most of our keratoconus patients first come to us because they want to have a life without glasses.”
Dr. Breyer
Unfortunately, the disease still remains undetected much too frequently. However, within the scope of our thorough preliminary examinations in which we also measure the cornea's structure with a Pentacam HR, we are able to identify the typical bulging even at an early stage. We have more than 13 years of experience in keratoconus therapy and recommend that a stabilizing therapy is initiated as early as possible.
At first, I was told I had astigmatism. But then it turned out that I had keratoconus.
What are the symptoms of keratoconus?
Forme Fruste
Regarding its symptoms, forme fruste cannot be distinguished from normal astigmatism and is discovered accidentally during a detailed ophthalmologic check-up in frequent cases. It can be corrected with glasses or contact lenses and does not have to be treated if it is stable but has to be monitored and checked regularly. Forme fruste is ten times as frequent as the progressive form.
The progressive form of keratoconus
The progressive form of keratoconus is aggressive and frequently becomes noticeable in the patient's teens already. The progressive bulging causes a curvature of the cornea called astigmatism. Due to this irregularity of the cornea, correction by glasses becomes increasingly difficult. Contact lenses are more suitable since they exert pressure on the cornea and are able to level out the most severe irregularities. If the disease has not progressed too far, good correction, even up to the maximum visual acuity, can be achieved by contact lenses.
However, if the cornea's bulging continues to increase, even hard contact lenses are less stable in the eye and may fall out. In addition, the cornea below the center becomes increasingly thinner and scarring occurs due to the progressive bulging which makes the visual acuity worsen irretrievably.
A promising treatment is UV Riboflavin crosslinking.
Studies show that UV Riboflavin crosslinking can stop progressive bulging since it stabilizes the tissue. For this reason, Dr. Breyer and other keratoconus experts recommend performing this treatment as early as possible. The alternative to crosslinking is a corneal transplant.
Keratoconus and corneal ectasia
Keratoconus is a specific form of corneal ectasia. Ectasia is a medical term. It refers to bulging of a hollow space. Such a corneal ectasia can also occur after LASIK treatment. It is suspected that the flap incision weakens the cornea and bulging of the cornea occurs due to insufficient stability.
