Keratoconus

Normally the cornea is nearly spherically shaped thus allowing light to be focused clearly on the back of the eye (retina). However in a condition called Keratoconus, the cornea begins to thin, and this allows the normal pressure of the eye to make the cornea bulge forward taking on a cone-shape. As the cornea gradually becomes more cone-shaped, the vision blurs and becomes distorted due to a high degree of astigmatism. Initially vision may be correctable with spectacles, but as the condition progresses, and the cornea becomes more irregular causing distorted vision, spectacles become less effective. In such a situation, contact lenses not only provide better vision, but also help to retard the progress of the disorder. A rigid contact lens (RGP / “semi-soft” contact lenses) must be used, so that it can hold its shape, as a soft lens would simply mould to the existing shape and thus not allow complete correction of the problem. Sometimes the patient is fitted with soft lenses (for comfort), over which semi-soft lenses are fitted (“piggy-back” lenses).

Fitting contact lenses for keratoconus requires expertise. Well-fitting contact lenses dramatically improves such a patient’s vision to nearly that of a normal person’s, and significantly improves his or her quality of life. Any excessive pressure of a poorly fitting lens on the cone apex can cause permanent scarring within months or years (This scarring can also occur naturally). For this reason it is important for regular follow-up visits to be made so that any corneal changes that have occurred can be compensated for in the design of a new lens. It is quite common for patients to be refitted at irregular intervals as the condition progresses. Rarely, scarring is so severe that a corneal graft (transplant) is necessary.

A recent promising treatment modality for keratoconus is C3R (Corneal Collagen Cross-linking with Riboflavin). Shroff Eye Centre now offers you Cross Linking of the Cornea with Riboflavin (C3R), which is a new curative approach to increase the mechanical stability of corneal tissue. The aim of this treatment is to create additional chemical bonds inside the corneal stroma by means of a highly localized photo polymerization.

The indications for cross linking today are corneal ectasia the disorders such as keratoconus and pellucid marginal degeneration, iatrogenic keratectasia after refractive lamellar surgery and corneal melting that is not responding to conventional therapy.