keratoconus

[me109cito]

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I was told by an O.D I have keratoconus. What's the likelihood I will end up needing a corneal transplant and does that s**t get worse over time?

 

[rpames]

I'm only a first year, but this is what I THINK I know.

Only about 10% of patients progress to the severe stages of keratoconus. At this point a corneal transplant is indicated. But for most people vison can be correct by soft contact lenses in the mild stages, and later RGP lenses may need to be used. The whole purpose of these steps is to maintain a proper refractive surface at the cornea.

If a transplant is indicated, the success rate is very good, ~90%.

I hope this helped, I don't know much yet.

 

[r_salis]

Just to add to what rpames said -- here's a blurb from the National Eye Institutes of the National Inst of Health:

In most cases, the cornea will stabilize after a few years without ever causing severe vision problems. But in about 10 to 20 percent of people with keratoconus, the cornea will eventually become too scarred or will not tolerate a contact lens. If either of these problems occur, a corneal transplant may be needed. This operation is successful in more than 90 percent of those with advanced keratoconus. Several studies have also reported that 80 percent or more of these patients have 20/40 vision or better after the operation.

(The entire section is here: http://www.nei.nih.gov/health/cornealdisease/index.htm#h )

 

[Andrew_Doan]

Most keratoconus patients do well with RGP contact lenses. When RGP contact lenses no longer work b/c of severe corneal ectasia or clouding, then you'll need to have a corneal transplant.

 

[eyedream82]

yeah i've seen lots of patient coming in the office (where i work) with extremely thick lenses (like in the +/- 16 diopters is the highest i've seen). Boy, those glasses look really scary. Thank goodness for RGP.

Just out of curiousity (and i'm always curious), is there any type of therapy out there for treating keratoconous? i know that your eyes really whorped, but is there anyway you can "bend" that cornea back or closer a basketball shape to get a lesser refractive error? Chances are, i'm guessing, that it will get back to its original "egg" shape, right?

 

[Andrew_Doan]

Originally posted by eyedream82
yeah i've seen lots of patient coming in the office (where i work) with extremely thick lenses (like in the +/- 16 diopters is the highest i've seen). Boy, those glasses look really scary. Thank goodness for RGP.

Just out of curiousity (and i'm always curious), is there any type of therapy out there for treating keratoconous? i know that your eyes really whorped, but is there anyway you can "bend" that cornea back or closer a basketball shape to get a lesser refractive error? Chances are, i'm guessing, that it will get back to its original "egg" shape, right?

There's no exercises that will work.

You can try Intacs to bend the cornea back. One of the Cornea faculty at Iowa is studying the effectiveness of Intacs in keratoconus.

 

[rpames]

I have not heard the word Intacs for a few years. Are they still being used in the mainstream or just more so in research. I remember when my father came home from a confrence about Intacs and he thought they were pretty nice. But, they never really took off, in our area at least. I could probably venture a guess that is because most of the refractive correction docs in the area all bought Excimer laser about that time too.

But I do want to add to the question by eyedream82: The procedures we have all mentioned just help correct the vison of the patient, NOT cure/stop keratoconus. The center of the cornea will continue to thin, we can't stop that.

Like most of medicine, we treat the symptoms, not cure the disease.🙁

 

[Andrew_Doan]

Originally posted by rpames
I have not heard the word Intacs for a few years. Are they still being used in the mainstream or just more so in research.

Mainly for research.

 

[docjolly]

Hi Everyone,

My opthalmologist informed me that I have keratoconus, and I've been told that I must wear RGP lenses. I've been wearing them for about a week and they're working fine. However, my eyes are always so very dry. I purchased some RGP lens wetting drops, but no matter how many drops I place in my eyes, they are incessantly dry (hence, sometimes the lenses fall out on their own). Is this normal? Is there anything that I can do to keep my eyes moisturized?

Thanks!

 

[cpw]

it's not that normal for the lenses to fall out very easily. They should only fall out when you pull on your eyes. Has your ophthalmologist seen you to check your fit on your RGPs? If your eyes are that dry I'm thinking the lenses might not be fitting you that well. People usually notice more dry eyes with soft contact lenses, not RGPs.

 

[ituryu]

😎 This is the deal , was the examination done well , and if so I think you would need a work up exam to assess you for dry eye , this is one thing that must be assessed before fitting a px with cotact lens .