FREQUENTLY ASKED QUESTIONS

Q.1- What is keratoconus?

Ans- The literal meaning of keratoconus is ‘conical cornea’ or ‘cornea cone’. Cornea is the front part of eye acting as a transparent window to the eye. It is normally clear, transparent and round shaped. When light enters through the healthy cornea, it gets refracted properly but when someone suffers from keratoconus eye disease, the cornea becomes thin and bulges outwards in cone shape.

Difference between normal eye and keratoconic eye
Image by:
keniaeyehospital.com

Due to this corneal thinning, cornea becomes irregular and cone shaped losing the normal round shape. Keratoconus can also be defined as irregular astigmatism, since in keratoconus cornea becomes irregular in shape. 

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Because of the keratoconus eye disease, it becomes difficult for the light rays to focus properly on the retina, as the corneal surface distorts and acquires the shape of a cone. This eye condition is known as the keratoconus. Keratoconus is a degenerative eye disease, if left untreated can ultimately lead to corneal transplant.

Q.2- What are the causes of keratoconus?

Ans- What causes keratoconus is still unknown but some possible causes may be like –

 · Genetic issues and hormonal causes

 · Free radicals damage

 · Excessive eye rubbing

 · Allergies causing irritation and leading to eye rubbing                  

 · Poor fitting of contact lenses

Click here to know more about keratoconus causes

Q.3- What are the symptoms of keratoconus?

Ans- When someone suffers from keratoconus, the vision cannot be corrected with glasses because of the irregular and distorted shape of the cornea. So if any one or more of the following signs are observed then these may be keratoconus signs and the person must visit an eye doctor or cornea specialist.
· Appearance of halo around the bright lights especially at night
· Difficulty in driving mainly at night time
· Increased sensitivity of eyes for light
· Irritation in eyes

Click here to read more about keratoconus symptoms

Q.4- How can the keratoconus be diagnosed?

Ans- So if any person finds one or more of these symptoms as described above; he or she must visit an eye doctor or cornea specialist as soon as possible. Keratoconus diagnosis is mainly done by a very common technique known as Corneal Topography.

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Patients suffering from keratoconus should keep visiting the eye doctor regularly to examine their eyes. As keratoconus also has genetic effects, so regular eye check-up of the children of keratoconus patients is advised.

Q.5- Is it possible to stop the progression of keratoconus?

C3R procedure
Image by:
www.corneaclinic.com

Ans- Yes it possible to stop the progression of keratoconus. It’s also very important to stop the progression on time. Corneal collagen crosslinking is a modern technique used to stop the progression of the keratoconus. It is also known as C3R or CXL. If corneal collagen crosslinking is not done on time, it may lead to cornea transplant in future.

Click here to read more about C3R

Q.6- Can contact lenses stop the worsening of keratoconus?

Ans- No, it is not possible to stop the progression of keratoconus with contact lenses. Contact lenses can only provide good vision. To stop the progression C3R (CXL) is mandatory.

Q.7- What are the non-surgical treatment options available for keratoconus?

Contact lenses for keratoconus
Image by:
www.eye.hk

Ans- Many techniques are available for keratoconus cure which can offer good vision to the keratoconus patients. For the starting phase of the keratoconus vision can be corrected by using eye glasses or soft contact lenses but as the eye condition deteriorates, eye glasses or soft contact lenses cannot be used, since the cornea shape becomes more irregular and distorted, making eye glasses and soft contact lenses insufficient to provide good vision. So various kinds of contact lenses especially designed for keratoconus are used.

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These contact lens techniques include-

· Rigid Gas Permeable (RGP) contact lenses

· Hybrid contact lenses 

· Scleral contact lenses

· Piggybacking contact lens technique etc.

But to find proper fitting of these keratoconus contact lenses is not easy. So lenses keratoconus need to be manufactured and designed by visiting experienced eye doctor or cornea specialist.These above mentioned customized contact lenses can provide satisfactory vision in most of the keratoconus cases.

Click here to read more about non-surgical treatment options

Q.8- What are the surgical treatment options available for keratoconus?

ICL inside the eye
Image by:
www.weyeclinic.sg

Ans- Surgical options are also available for the keratoconus patients. These keratoconus surgery options include-

· Corneal collagen crosslinking (C3R/CXL) used to stop the progression of keratoconus

· Implantable collamer lenses (ICL)

· Intacs

 Click here to read more about surgical treatment options

Q.9- Who needs corneal transplant?

Ans- When the worsening of keratoconus does not stop and therefore the cornea becomes increasingly irregular and conical in shape, then it becomes almost impossible to get functional vision with eye glasses or contact lenses. In that case corneal transplant is advised. 

Click here to read more about Cornea Transplant

  

Q.10- Can eye exercises prove to be helpful in keratoconus?

Ans- Although it is best to stop the progression of the keratoconus eye disease at the earlier stage, as soon as it is diagnosed. Some eye exercises are also there which can help in reducing the rate of progression of the keratoconus to some extent and are good for entire health of the eye.

Palming

 Eye relaxing technique

Image by:
stylesatlife.com

Eye exercises which are useful for keratoconus are listed here-     

• Palming 
• Focusing
• Sports

Don't underestimate the healing power of these eye exercises for keratoconus

Q.11- What should I do if diagnosed with keratoconus?

Ans- Since keratoconus is a degenerative corneal disease so if diagnosed with keratoconus, keep on visiting your eye doctor as advised, to observe the progression of keratoconus if any. If it is progressive then consider going for corneal collagen crosslinking (CXL/C3R), without any delay to halt the progression of keratoconus.

Q.12- Is Corneal Collagen Crosslinking (C3R/CXL) really worth it?

Ans- Corneal topography is used to measure the progression of the disease in the keratoconus eye. Keratoconus is a very rare disease and affects approximately one in every 2000 persons (0.05%). Keratoconus eye disease generally develops in late teenage years but its progression halts in most of the cases in person’s thirties or forties on its own. 

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But no one can wait for such long periods to let the progression stop by itself, as it is a progressive corneal disease. It is very important to stop the progression of the keratoconus on time. Corneal collagen crosslinking is a modern technique used to stop the progression of the keratoconus. It is also known as C3R or CXL. If corneal collagen crosslinking is not done on time, it may lead to cornea transplant.

Click here to read more about Corneal Collagen Crosslinking

Q.13- Will I have to use contact lenses even after corneal transplant?

Ans- Yes, even after cornea transplant, the patient most probably would have to use glasses or contact lenses for functional and satisfactory vision.  Hence it is better to diagnose the early symptoms of this corneal disease and take preventive treatment like C3R/CXL to halt its progression.

Q.14- Does diet has any role in controlling keratoconus?

Healthy foods for your eyes

Image by:
www.lifehack.org

Ans- According to researches, it has been shown that it is possible to slow-down the worsening of keratoconus to some extent by making some changes in our diet. Keratoconus is a degenerative corneal disease caused by corneal thinning by the action of free radicals. Since the patients suffering from keratoconus lack the self defence system to fight with these harmful free radicals, generated during the metabolism process. These free radicals cause harm to our body cells. Antioxidants have the power to protect the cells from these harmful free radicals.

So by adopting a diet plan which incorporates plenty of antioxidants; the damage due to free radicals can be controlled.

Click here to know health benefits of having a Diet plan especially for keratoconus

Q.15- Can keratoconus cause blindness?

Ans- Although keratoconus does not cause blindness but as it is a progressive corneal disease, if not treated on time may deteriorate the vision to a point which can be called as virtual blindness. So on diagnosis of the disease; keep on visiting your eye doctor as advised, to observe the progression of keratoconus if any. If it is progressive then consider going for Corneal Collagen Crosslinking (C3R) to stop the progression. 

Q.16- Can you please suggest me any alternative of Rigid Gas Permeable (RGP) contact lenses as I cannot tolerate it any more.

Ans-.Various kinds of contact lenses especially designed for keratoconus are used. As an alternative of RGP you can use-           · Hybrid contact lenses 
· Scleral contact lenses
· Piggybacking contact lens technique etc. 

But to find proper fitting of these keratoconus contact lenses is not easy. So lenses keratoconus need to be manufactured and designed by visiting experienced eye doctor or cornea specialist. These above mentioned customized contact lenses can provide satisfactory vision in most of the keratoconus cases.

Click here to read more about various types of keratoconus contact lenses with detailed comparison

Q.17- Can someone having keratoconus drive?

Ans- For keratoconus patients driving becomes difficult especially at night time because of blurred vision and halos around bright lights.
The rules and regulations of vision required for getting driving license vary as per the country or region. So check it for your country.

Q.18- Why keratoconus patients generally cannot get good quality vision with eye glasses or soft contact lenses?

Ans- Patients suffering from keratoconus eye disease can use eye glasses or soft contact lenses only if their keratoconus is in very initial stage. But as this corneal disease worsens, it becomes difficult to acquire good vision by using eye glasses or soft contact lenses.

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Since with the progression of the keratoconus the cornea becomes more conical in shape, therefore eye glasses or soft contact lenses cannot provide satisfactory vision any more. Therefore at higher stages of the keratoconus, especially designed contact lenses like RGP, scleral or hybrid contact lenses have to be used for keratoconus.

Q.19- Why keratoconus patients should wear sunglasses?

Ans- keratoconus patients should wear sunglasses to protect their eyes from harmful Ultra Violet (UV) radiations. Since Ultra Violet radiations can accelerate the production of harmful free radicals (by product of cell metabolism activities) in the cornea which are responsible for further thinning of cornea, leading to worsening of the keratoconus.  

Q.20- Why persons suffering from keratoconus should not opt for LASIK eye surgery?

LASIK eye surgery
Image by:
eye.uams.edu

Ans- Keratoconus is a corneal disease arising because of the corneal thinning. It is not recommended for the keratoconus patients to go for LASIK eye surgery. Since in LASIK eye surgery some corneal tissues are removed, which is not acceptable in keratoconus eye, as keratoconus eye is already affected by corneal thinning. So for keratoconus eye disease other surgical options may be adopted.

Q.21- What are intacs?

Intacs inside the eye
Image by:
www.nkcf.org

Ans- Intacs are very thin semi circular rings of plastic inserted into the cornea. When inserted into the cornea of a keratoconus patient, can flatten the cornea by reducing the cornea cone. In this way, intacs can reduce the irregularities of the corneal surface, which leads to improved vision.

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Depending on the severity of the keratoconus, eye glasses or contact lenses may still be required even after intacs implantation to get satisfactory vision. Initially intacs were used for low myopia but after knowing its special advantages like its capability to flatten the cone of the cornea, it has been approved recently by FDA for keratoconus.

Q.22- Is there any risk associated with ICL surgery?

Ans- Some potential risks involved in ICL surgery are mentioned here-
· The ICL implanted can be of too weak power. For correction of this glasses can be used or ICL can be replaced.
· Contrary to this the prescriptive power of ICL implanted may be too strong. To correct this in the same way either glasses can be used or ICL replacement can be done.
· In some cases, need may arise to reposition or remove the implantable collamer lens.
· In very rare cases some cases of eye infections have been observed in ICL surgeries.
· Intraocular pressure may build up after ICL surgery in the eye. The eye doctor must necessarily notice it as soon as possible.
·  It has been noticed that ICL may be the causes of cataract formation at an earlier age. Although it has been estimated that by the age of 65, more than 50% of the population will develop cataract.
· There is also some risk of damage to the natural crystalline lens during the ICL surgical procedure.
· In very rare cases, due to untreated eye, infection or bleeding, there is some possibility of vision loss.
·  In rare cases retinal detachment may occur. The possibility of retinal detachment increases with increase in myopia.

Here it is important to note that all the risks mentioned above related to ICL are generally not common and are rare, and most of them are not associated only with ICL but are common to other eye correction surgeries.

Q.23- What option of surgery for vision correction is right for me, ICL or LASIK? Please help me in comparing the two techniques.

Ans- keratoconus eye disease patients are not suitable candidates for the LASIK eye surgery, because of already thin cornea.
Here a comparison table of ICL and LASIK eye surgery has been provided-

Particulars	ICL surgery	LASIK eye surgery
Time duration of the surgery	20 minutes approx.	20 minutes approx.
Quality of vision	Excellent	Excellent
Recovery time after surgery	Quick	Quick
Possibility of surgery for thin cornea	Possible	Limited
Dry eye problem	No	Occasional
Removability	Yes	No
Ultraviolet (UV) protection	Yes	No

Comparison table of ICL surgery and LASIK eye surgery

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