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Keratoconus

Keratoconus

Keratoconus is a progressive, degenerative disease in which the cornea becomes thinner and loses its natural symmetry. The cornea slowly becomes cone-shaped, hence the name KERATO (cornea) and CONUS (cone shaped). With Keratoconus, the changes to the shape of the cornea can happen quickly or progress over several years. Karatoconus can lead to vision problems such as blurred vision, glare, seeing “halos” around lights at night, and streaking of lights, which can interfere with your daily activities and impact your overall quality of life. 

Fortunately, there are many ways to treat keratoconus in order to prevent the condition from worsening. Our specialized ophthalmologists are experienced in diagnosing and treating keratoconus and can help you explore and understand your options.

 

Keratoconus Causes

The exact cause of keratoconus remains unknown, but it is believed to be caused by genetic and environmental factors. There are certain factors that may increase your risk of keratoconus, including: a family history of keratoconus, chronic and vigorous rubbing of the eyes, and certain other medical and allergic conditions. Keratoconus is triggered by decrease in protective antioxidants in the cornea, which causes the cornea to weaken and bulge out.

Keratoconus Symptoms

The common symptoms of keratoconus include: blurred or distorted vision, an increase in sensitivity to light and glare, mild eye irritation, and eye redness or swelling. In the later stages of keratoconus, you may experience increased nearsightedness or astigmatism, or notice that your contact lenses no longer fit properly. The symptoms of keratoconus may change or become more severe as the disease progresses. It often affects both eyes, though symptoms can vary between them. 

Keratoconus Stages

Keratoconus usually takes years to progress from early- to late-stage. At its onset, keratoconus is only a very slight distortion of the cornea and has very little effect on quality of vision, though it progresses over time. The later stages of keratoconus involve more severe symptoms and vision impairments and may require surgical treatment. 

Keratoconus Treatment

The goal of keratoconus treatment is twofold: to prevent the progression of the condition and improve the vision of the patient. Spectacles and soft contact lenses are often used early in the course of the disease, but as the corneal shape becomes more atypical, specialty rigid lenses (such as RGP, hybrid, or scleral lenses) may be needed. With advances in specialty lens design and fitting, many patients achieve good vision with these lenses.

Keratoconus Surgery

If there is scarring of the cornea or if the keratoconus is in an advanced stage, a corneal transplant of the entire corneal thickness (penetrating keratoplasty) or of the front 95% of the cornea (deep anterior lamellar keratoplasty – DALK) may be needed for visual rehabilitation. Surgery is generally only performed if a patient is unable to achieve good vision with contact lenses because of the long recovery time and risk of surgical complications.

The only FDA-approved treatment shown to reduce the risk of progression of keratoconus is corneal collagen cross-linking. This procedure is performed in the office for one eye at a time. The recovery time is up to 3-6 months and it has been shown to reduce the risk of progression in numerous clinical trials. By avoiding progression, the patient is able to maintain their current level of vision and avoid a riskier and more costly corneal transplant.

Surgery Cost

The cost of a corneal transplant for keratoconus depends on several factors, including the severity of the condition, the type of procedure performed, and your insurance coverage. According to the Agency for Healthcare Research and Quality, a corneal transplant for an advanced condition typically costs around $13,000 for an outpatient procedure or $28,000 for an in-hospital procedure for individuals without health insurance. Fortunately, in the United States, the cost of corneal transplant surgery and related exams is typically fully or partially covered by insurance. You should talk this over with your eye doctor and insurance provider for a more accurate cost estimate. 

The average cost of a corneal cross linking procedure for keratoconus typically ranges from $2,500 to $4,000 per eye. Insurance coverage is widely available, depending on the type of procedure. Again, for a more accurate idea of the total out-of-pocket cost, talk to your eye doctor and your insurance company about your options. 

Keratoconus FAQs

What is Keratoconus?

Keratoconus is a progressive degenerative eye disease in which the cornea becomes thinner, loses its natural symmetry, and becomes cone-shaped. 

What Causes Keratoconus?

The exact causes of keratoconus are unknown, but risk factors include: a family history of keratoconus, chronic and vigorous rubbing of the eyes, and certain other medical and allergic conditions. 

How to Get Rid of Keratoconus?

Keratoconus can be treated with spectacles and contact lenses, or in advanced cases, with corneal transplant surgery. Worsening of the condition can be prevented with corneal cross linking procedure. 

How Fast Does Keratoconus Progress?

It typically takes years for keratoconus to progress. However, in some cases, symptoms can progress rapidly. 

What Happens if Keratoconus is Not Treated?

Keratoconus is a progressive degenerative condition, so it will only get worse over time if left untreated. 

How Much Does Keratoconus Surgery Cost?

The cost of surgery depends on several factors including the type of surgical procedure. A corneal cross linking procedure ranges from $2,500 to $4,000 per eye, while a corneal transplant can cost up to $18,000, for example. 

What Causes Keratoconus to Get Worse?

Chronic and vigorous eye-rubbing is strongly associated with keratoconus and progression of the disease. Conditions associated with eye rubbing such as allergic conjunctivitis, eczema, and floppy eyelid syndrome (which is often associated with obstructive sleep apnea) should be treated to reduce eye rubbing.  

How to Treat Keratoconus?

There are different methods of treating keratoconus, depending on the stage of your condition. Talk to a specialized eye doctor to determine the best treatment plan for your case. 

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NW Cornea Institute Team

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