so what is keratoconus? keratoconus is a progressive eye disease of the cornea the
front window to the eye that often leads to blurry and distorted eyesight keratoconus can even become
so severe that not just causes blurred vision but can require a corneal transplant if not caught
early so in this video we're going to explain keratoconus going over the symptoms the causes how
it can be diagnosed and then ultimately the best steps for keratoconus treatment let's take a look
hello and welcome this is Dr Allen here from the doctor eye health show and welcome to our part
one of our video series all about keratoconus the whole point of this video series is really
help people learn about keratoconus whether you yourself have been diagnosed with this or maybe a
friend or a family member has been diagnosed with this condition so we can better explain what's
going on as well as how your doctor can help you through the process of getting it treated to stop
the progression of this condition as well as help you see better so if this is your first time to
the channel definitely hit the subscribe button and look at the top of the video description for a
link to the complete series all about keratoconus that way you won't miss any of the critical videos
and understanding how this disease progresses and then ultimately how we treat it and get you
seeing better now let's talk about keratoconus. so what is keratoconus? keratoconus is again
a disease of the cornea the front window to the eye normally the cornea is round smooth and has a
regular surface but for somebody with keratoconus the cornea progressively thins over time and with
this thinning the cornea begins to protrude outward from the eye creating the shape of a
cone it even has kind of a tip-like appearance in fact in advanced cases of keratoconus we can even
have people look down and you can see the pointed edge of the cornea in their eyelid something that
we call munson's sign you can even see in this magnified view of a cornea where it begins to
protrude and you can even see it's thinning now again keratoconus is a progressive condition
meaning it often gets worse and worse over time and that leads to extreme thinning of the cornea
and an irregular surface and with this progression people often end up with irregular astigmatism
and scarring of the cornea which can cause visual problems so let's talk about the symptoms
the symptoms of keratoconus that people usually experience include blurry vision and shadowing of
letters that blurry vision and shadowing that people experience comes from the irregular
astigmatism that's caused by the shape of the cone of the eye imagine looking through a lens
that causes your vision to look like this makes it very difficult to see light just doesn't pass
through an irregular surface like this and that causes not only blurred vision but again that's
shadowing around letters and objects now because of the progressive nature of keratoconus an early
tip off to both patients and doctors is that if somebody's glasses prescription or their contact
lens prescription continues to progress and gets worse and worse over time usually in the matter
of only a few weeks to months and if keratoconus is left to progress it often leads to scarring
of the cornea which causes increased amounts of glare and blurred vision often so bad that
we can't even correct it with glasses and contact lenses and in extreme conditions of keratoconus
the cornea can become so thin that it even becomes painful so it's super important that we are able
to catch keratoconus early and begin treatment so we can slow it down and hopefully stop its
progression and again the earlier we catch it the better so what causes keratoconus the causes of
keratoconus are complex and not fully understood at this time but is believed to be caused by an
enzymatic breakdown of the collagen structures within the cornea a strong characteristic of
people who develop keratoconus is a history of eye rubbing whether they're rubbing their eyes
from eye allergies or just eye irritation the rubbing of the eye is strongly associated with
both the development and the progression of keratoconus so a good tip for everybody whether
you have keratoconus or not is to not rub the eyes i know it feels good momentarily but it
usually just makes things worse instead try to use lubricating eye drops or maybe a cold compress to
help with your symptoms now in addition to all of this keratoconus has been found to have a genetic
component to it so much so that we now have a genetic test that we can order and run here
in the clinic even through just as something as simple as a cheek swab and this genetic
test is super important especially for families as somebody who has keratoconus maybe will pass
on that gene to their children and again if we're able to test people and catch it earlier
the better so how do we diagnose keratoconus well the diagnosis of keratoconus is something that is
usually done through a comprehensive eye exam but we often have special tools and technologies that
help us make this diagnosis easier now i do want to show you a couple of different tools that you
may see in an eye clinic that help us make this diagnosis because i think it's going to be fun to
for one you do know what to expect when having this evaluation but also just to see what your
doctor is looking at to help make this diagnosis the first instrument you may see is something
called a corneal topographer this often has these circular rings on it that we call a placido
disc and by taking a picture of the surface of your eye with this instrument we can more easily
detect the subtle changes of the cone that is developing on the surface of the eye the second
instrument you may see is very similar but that one we call a corneal tomographer and that is kind
of like getting many b scan ultrasounds of the eye and is really helpful because we can see how thin
the cornea is at different locations especially on the back surface of the cornea which is in fact
the first sign of keratoconus that we can detect and we can detect that well before we start to see
any sort of a cone shaping on the surface of the eye and the third test that your doctor may order
is something called a corneal pachymetry which helps us measure and quantify the thickness of
that cornea as it progressively thins over time so don't be surprised if your doctor ever orders one
or all of these tests because it will help them determine if you have this condition and if it's
something that is progressing so now let's talk about keratoconus treatment but first if you're
finding this video valuable drop us a comment in the comment section below because i think
it'll be a good place just to connect with other people who may be going through this eye condition
now treatment for keratoconus is really broken down into two steps first is surgical treatment
and the second is vision correction now after the diagnosis the first step in keratoconus treatment
is that of trying to slow down or halt the progression and this is achieved through something
called corneal collagen cross-linking and this is the topic of our next video in this series
which we'll go really in detail about so that's going to be really important for you to watch
if you were just diagnosed with this but with corneal crosslinking we can hopefully stop the
progression of keratoconus and hopefully prevent somebody from ever needing a cordial transplant
in their lifetime now an important thing to know is that corneal collagen crosslinking
is aimed to slow down and stop the progression of keratoconus but doesn't improve vision so in
the eye clinic at this time we focus on glasses and specialty contact lenses to help people see
better now regular eyeglasses do often help people with keratoconus but they rarely get people to see
their best in fact most people with keratoconus i would say rarely see 20/20 with glasses alone
oftentimes because glasses don't achieve the best vision doctors often fit specialty contact lenses
for people to help them see even sharper this can be done with rigid gas permeable or RGP contact
lenses it can be done with hybrid contact lenses which are hard lenses that have a soft lens around
it or even using a piggyback technique where they have a soft lens on the eye and then another hard
lens on top of that one however many cornea and contact lens specialists now prefer fitting of
scleral contact lenses scleral contact lenses are hard and oversized contact lenses that touch
on the white part of the eye called the sclera and this creates kind of a bowl effect where
it vaults over the cone of keratoconus and with these large contact lenses they can neutralize
a lot of the distortions and irregularity that cause blurred vision which can often be really
amazing to see people see so sharply after living their life with blurred vision from
keratoconus but the fitting process including the insertion and removal of scleral lenses is
like a whole process in its own so stay tuned to future videos in this series where we go over what
scleral lenses are the fitting process and again helping you learn how to put them in take them out
but again at this time the most important step after the diagnosis of keratoconus is getting set
up for a corneal collagen cross-linking because again that's going to slow down and hopefully stop
the progression to learn more about that whole step and see that next video in our series go
ahead and click or tap the screen up over here to the side or check out the link for our whole
video playlist in the description below otherwise thank you so much for watching and i hope this
video helps you out in some way again this is dr Allen keep an eye on it and we'll talk to you soon