It is important to understand that there is no definitive treatment for keratoconus yet, and the damage caused cannot be repaired. Therefore, all available treatment options aim to either slow or stop the progression of the disease (such as corneal stabilization) or improve vision (such as contact lenses or corneal transplant surgery).

To clarify further, it can be said that there are two goals for treatment: They are: (1)


1. Corneal stabilization: The corneal stabilization process aims to prevent the progression of the disease, as it helps stabilize the cornea to the stage it has reached and stabilizes vision, but it has nothing to do with improving vision, so the person will continue to use glasses or contact lenses, but it may reduce the need for the corneal transplantation in the future.


2. Improving vision: In the early and middle stages, glasses or contact lenses may be sufficient to improve vision, and they may be the only treatment the patient needs throughout his life if the cornea stabilizes to a certain limit over time alone or after undergoing a corneal stabilization procedure. However, a corneal transplant may be it is necessary in advanced cases in which there is significant damage to the cornea or when other treatments fail. 


Keratoconus Treatments in Detail

1- Medical glasses

Prescription glasses help improve vision in the early stages of keratoconus or simple cases, but they may become insufficient as the disease progresses and blurred vision increases. (2)


2- Contact lenses

Contact lenses are also a common option for keratoconus. Initially, patients may benefit from traditional soft contact lenses, but as the disease progresses, they may need stronger types, such as hard contact lenses. (2)


In general, all keratoconus patients need frequent examinations from time to time. To adjust the shape and strength of the contact lens according to the extent of change in the shape of the cornea. Types of contact lenses include: (2)

 

  • Soft Contact Lenses: An option in early cases of keratoconus. They are more comfortable than other types, and can be designed specifically according to the eye, but they give less clear vision than other lenses.


  • Hard contact lenses: The most commonly used type for cases of keratoconus. They include a hard lens that can be worn and removed easily. It is made of materials that allow gases to pass through it, allowing oxygen to reach the cornea when worn. They help improve vision to an excellent degree, but some may He finds it uncomfortable when worn for a long time.


  • Piggyback lenses: They include two types of lenses, a soft contact lens directly on the cornea, and another hard lens above it. Through this technique, the patient can see better, while avoiding the discomfort that hard lenses may cause.


  • Hybrid lenses: This modern type combines hard and soft lenses in one lens, with the center made of hard lenses, and the edges made of soft lenses. To increase eye comfort.


  • Scleral lenses: They are a type of large-sized scleral lenses, suitable for advanced cases. Unlike other types, this lens does not touch the cornea itself, but only the white part of the eye (sclera). (1)




Keratoconus requires specialized care. Get the best and most advanced diagnostic and therapeutic services from our Ophthalmology department At Al-Ahli Hospital.




3- Corneal Crosslinking

Corneal Crosslinking is the only procedure that helps stop / prevent the progression of keratoconus. It involves placing drops of vitamin B2 on the cornea under ultraviolet light, which causes a chemical reaction that strengthens the bond between the corneal tissues. 


Usually one eye is treated per session, in most cases, the most affected eye is treated first.


It is important to know that this procedure is not suitable for everyone (especially for cases of already stable keratoconus), nor does it return vision to its normal state before keratoconus, rather, it only aims to stop the progression of the disease. If the person was on contact lenses before the procedure, they will continue to wear them. However, he may not need a corneal transplant in the future. (3)


4- Surgery

Surgery may become necessary in advanced stages if there is significant scarring and damage to the cornea, or an inability to see even after using the strongest contact lenses, (1) Surgical options include:

 

  • Intacs: These are clear, arc-shaped hard plastic material, which are surgically implanted at the edges of the cornea with the aim of resurfacing it and improving vision. It is used when it is difficult to obtain good vision using glasses or contact lenses, and it may help delay the development of the disease, but it does not prevent it. (4)
  • Corneal transplantation: It is used in advanced cases of keratoconus when scarring and severe weakness of the cornea occur. Part or all of the cornea is transplanted from a healthy donor. (1) 


A final word

There is still no definitive cure for keratoconus, but treatment options are available that help slow or stop the progression of the disease and improve vision, such as: eyeglasses, contact lenses, corneal cross-linking, and surgery. Therefore, early detection of the disease and rapid treatment is important to prevent vision loss.

 

References