Using cutting edge technology instruments, our eye doctors in North York, Toronto can diagnose Keratoconus in its early stage to start the treatment as soon as possible to prevent it from worsening and vision loss. Progression of keratoconus usually is faster in younger adults therefore early diagnosis is vital for early treatment and better outcome.
Keratoconus is a degenerative eye disease that affects the cornea, which is the clear, transparent layer at the front of the eye. The cornea is responsible for focusing the light that comes into your eye onto the retina for clear, sharp vision. Keratoconus causes the corneal tissue to thin out and bulge into a cone-like shape which deflects the light entering the eye and distorts vision.
We also incorporate advanced technology such as topography, Optical Coherence Tomography (OCT) and Bio-Microscope to fit specialty contact lenses such as Scleral, Rose K, Hybrid contact lenses, etc. to restore the vision in in those with Keratoconus. These costume made lenses provide dramatic improvements in vision , comfort and quality of life to patients with keratoconus and other corneal disorder such as pellucid marginal degeneration, post LASIK or other refractive surgery complications.
As part of ongoing treatment of Keratoconus, we also teamed up with top corneal specialists in Greater Toronto Area, to provide the most advanced and best possible surgical treatments when needed.
Causes of Keratoconus
The exact cause of keratoconus is not known. The disease usually starts to appear in the late teens or twenties and can affect one or both eyes, usually progressing at a slow pace and slowing or stabilizing after around 10-20 years. It is believed that there is a genetic component as often it runs in families.
New research suggests that there may be a link between keratoconus and oxidative damage which weakens the cornea. There is also an association with overexposure to ultraviolet (UV) radiation from the sun and chronic eye irritation.
Symptoms of Keratoconus
With the gradual change in the shape of the cornea, vision becomes progressively worse. The patient may experience nearsightedness, astigmatism, distorted vision (straight lines look wavy), blurry vision, light sensitivity and glare, and eye redness or swelling. Typically, patient’s eyeglass prescription will change often as the vision becomes worse and contact lenses will be difficult to wear due to discomfort and improper fit.
When keratoconus becomes more severe (which usually takes a long time however on occasion can happen rather quickly), the cornea can begin to swell and form scar tissue. This scar tissue can result in even further visual distortion and blurred vision.
Treatment for Keratoconus
In the early stages of the disease, standard eyeglasses and soft contact lenses will usually correct the nearsightedness and astigmatism experienced by the patient. As the disease progresses however, glasses and soft contact lenses may no longer correct vision and soft lenses may become uncomfortable. This is when other forms of vision correction will be recommended.
Gas Permeable and Scleral Contact Lenses
At the more advanced stage of keratoconus rigid gas permeable (RGP) contact lenses, scleral or semi-scleral lenses may be used for increased comfort and visual acuity. Since they are more rigid, RGP and scleral lenses are able to create a smooth, round shape around the cornea, creating a smoother surface for better vision. Many patients find these more comfortable than regular RGPs and find that they move around less when the eyes move. The main disadvantage of these rigid lenses is that for some, they are somewhat less comfortable than soft lenses and they must be continually refitted as the shape of the eye changes.
Scleral contact lenses
Topography and OCT guided scleral contact lens design is the treatment of choice for Keratoconus and variety of other complicated corneal diseases, at Empress Eye Clinic in North York, Toronto. If you have failed in contact lenses for keratoconus in the past, ask us about other advanced treatments that may be the solution for you.
Scleral or semi-scleral lenses have a larger diameter which covers the entire cornea and reaches over into the white part of the eye, which is known as the sclera (the white part of eyeball).
Whether it is glasses or contact lenses being used to correct vision, patients will likely have to undergo many tests and prescription changes as their vision change.
Intacs are small, surgically implanted plastic inserts which are placed on the cornea to flatten it back to shape. Usually, they are able to restore clear vision, with the continued use of glasses. Intacs are often recommended when contact lenses and eyeglasses are no longer able to correct vision adequately. Intacs take about 10 minutes to insert and can delay the need for a corneal transplant.
Corneal Crosslinking (CXL)
In corneal crosslinking, a UV light and eye drops are used to strengthen and stiffen the cornea which helps to reduce bulging and restore the cornea to its natural shape.
When corneal scarring occurs and eyeglasses and contact lenses no longer help, doctors may suggest a corneal transplant to replace the corneal with healthy donor tissue to restore vision. Most patients will still require eyeglasses or contact lenses for clear vision following the transplant.
Keratoconus is a condition that requires ongoing treatment by a qualified eye doctor. If you or a loved one suffers from this disease make sure that you find an eye doctor that you like and trust to accompany you on this journey.