The 25 keratoconus questions everyone is Googling — answered.
To celebrate Google's 25th birthday, in this blog post we will answer 25 of the most googled questions about keratoconus.
1. What is keratoconus?
Keratoconus is a condition where the cornea, which is the clear, dome-shaped front of your eye, thins out and bulges into a cone shape. This change in the shape of the cornea can cause light rays to go out of focus, resulting in blurry and distorted vision.
2. What are the symptoms of keratoconus?
Some of the symptoms of keratoconus are:
- Blurred or distorted vision, which may not be corrected by glasses or contact lenses
- Increased sensitivity to bright light and glare, which can cause problems with night driving
- Frequent changes in eyeglass prescriptions
- Sudden worsening or clouding of vision, which may indicate a complication called hydrops
- Double vision or seeing multiple images in one eye
These symptoms may vary from person to person and may change over time as the condition progresses. Keratoconus usually affects both eyes, but one eye may be more affected than the other.
3. What are the causes of keratoconus?
The exact cause of keratoconus is not known, but it is believed to be influenced by genetic, environmental, and hormonal factors. Some possible causes are:
- A defect in the genes that produce collagen, the protein that gives strength and shape to the cornea.
- An imbalance between the production and destruction of corneal tissue by the corneal cells, leading to a loss of collagen and thinning of the cornea.
- Chronic eye inflammation from allergies or irritants, which can damage the corneal tissue and make it more prone to bulging.
- Frequent eye rubbing, which can exert mechanical stress on the cornea and weaken its structure.
These factors may increase the risk of developing keratoconus or worsen its progression. However, they do not explain why some people develop keratoconus and others do not. More research is needed to understand the underlying mechanisms of this condition.
4. Can keratoconus be cured?
Unfortunately, there is no cure for keratoconus at the moment. However, there are several treatments that can help slow down the progression of the condition and improve vision.
5. What are the different treatments for keratoconus?
Keratoconus is a condition that affects the shape and clarity of the cornea, the transparent front part of the eye. The treatments for keratoconus depend on the severity of the condition and the individual needs of the patient. Some of the treatments are:
- Eyeglasses or soft contact lenses, which can correct blurry or distorted vision in early keratoconus, but may need frequent changes as the cornea changes shape.
- Hard contact lenses, which can provide better vision than glasses or soft lenses in more-advanced keratoconus, but may be less comfortable or stable for some people.
- Specialized contact lenses, such as hybrid or scleral lenses, which can offer more comfort and stability than hard lenses for some people with keratoconus, but may be more expensive or difficult to fit.
- Corneal collagen cross-linking (CXL), which is a procedure that aims to stabilize the structure of the cornea by strengthening the collagen bonds in the corneal tissue, and can slow down or stop the progression of keratoconus and prevent further vision loss.
- Corneal transplant surgery, which is a last resort option for people with severe keratoconus who cannot achieve satisfactory vision with other treatments, and involves replacing the damaged cornea with a healthy donor cornea.
6. Can people with keratoconus go blind?
The short answer is no, keratoconus does not result in blindness, although it can cause significant vision impairment. Keratoconus can lead to legal blindness, but this is rare and preventable with proper treatment. Legal blindness is defined as having a best-corrected visual acuity of 20/200 or worse in the better eye, or a visual field of less than 20 degrees.
7. What does a person with keratoconus see?
A person with keratoconus sees the world in a distorted and blurry way. Keratoconus is a condition where the cornea, the clear front part of the eye, becomes thinner and bulges outwards into a cone shape. This affects how light is focused on the retina, the light-sensitive tissue at the back of the eye. Keratoconus can cause significant distortion of vision, nearsightedness, irregular astigmatism, ghosting with multiple images, glare and light sensitivity.
To get an idea of how a person with keratoconus sees, you can look at some vision simulations that show how different objects and scenes appear to someone with this condition: World Through Keratoconus Patients' Eyes!
8. Can you still drive with keratoconus?
Driving with keratoconus is possible for most people who have their vision corrected with glasses or contact lenses. However, some factors may affect your ability to drive safely, such as the severity of your condition, the type and fit of your contact lenses, the presence of corneal scarring or hydrops, and the recovery time after any treatment. Therefore, it is important to consult your eye doctor regularly and make sure your vision meets the minimum required standard for driving in your country. You may also need to avoid driving at night or in bright sunlight if you have a sensitivity to light. Driving with keratoconus can be challenging, but not impossible, if you take the necessary precautions and follow your doctor’s advice.
9. What makes keratoconus worse?
There are some factors that can make keratoconus worse or increase the risk of developing it. These include:
- Genetics. If you have a family history of keratoconus, you are more likely to develop it yourself. Some genetic disorders, such as Down syndrome and Ehlers-Danlos syndrome, are also associated with keratoconus.
- Eye rubbing. Rubbing your eyes vigorously or frequently can damage the cornea and weaken its structure. This can lead to keratoconus or make it progress faster.
- Chronic eye inflammation. If you have allergies, dry eyes, or other conditions that cause your eyes to be inflamed or irritated, this can also harm the cornea and contribute to keratoconus.
- Age. Keratoconus usually starts in the teenage years and progresses until the mid-30s. Younger patients with advanced keratoconus may need more aggressive treatment to prevent further vision loss.
To prevent or slow down the worsening of keratoconus, it is important to take good care of your eyes and follow your eye doctor’s advice. You should avoid rubbing your eyes, wear sunglasses to protect them from UV rays, use eye drops to keep them moist, and wear glasses or contact lenses that correct your vision. You should also have regular eye exams to monitor your condition and get treatment if needed.
10. Can laser eye surgery fix keratoconus?
No, laser eye surgery is not suitable for keratoconus. Laser eye surgery involves removing some corneal tissue to reshape the eye and correct vision problems. However, keratoconus is a condition that causes the cornea to become thin and bulge outwards. Removing more tissue from the cornea would weaken it further and potentially worsen the keratoconus. Therefore, laser eye surgery is not recommended for anyone with keratoconus.
11. Does keratoconus run in families?
Yes, keratoconus can run in families. Many studies have shown that genetics play a role in the development of keratoconus. A familial association appears to play a role in KC, and current literature indicates that there is less than a one in ten chance that a blood relative of a KC patient will also have the disease. Furthermore, relatives of keratoconus patients are 15-67 times at higher risk to develop keratoconus compared to those with unaffected relatives.
However, keratoconus is not caused by a single gene mutation. Researchers believe that keratoconus is a complex disease that involves the interaction of multiple genetic and epigenetic factors. Epigenetic factors are environmental factors that can affect gene expression, such as eye rubbing, contact lens trauma, and exposure to ultraviolet (UV) radiation. Therefore, not everyone who has a genetic predisposition for keratoconus will develop the condition.
12. Can keratoconus be corrected with glasses?
Glasses can correct blurry or distorted vision in early keratoconus. But people frequently need to change their prescription for eyeglasses as the shape of their corneas change. Glasses or soft contact lenses can only correct lower order aberrations, which are symmetrical blurring caused by nearsightedness, farsightedness, or regular astigmatism.
However, most people with keratoconus have higher order aberrations, which are complex and asymmetrical distortions caused by the irregular shape of the cornea. Glasses or soft contact lenses do not correct higher order aberrations. Therefore, glasses are not suitable for most people with keratoconus.
As keratoconus progresses and worsens, glasses are no longer capable of providing clear vision, and patients need to wear a contact lens, usually a hard contact lens. Hard contact lenses include rigid, gas permeable types. These lenses create a smooth surface in front of the cornea and correct both lower and higher order aberrations. Some patients with keratoconus can enjoy rigid surface scleral contact lenses for unsurpassed clear vision with the stability and comfort approaching a soft disposable contact lens.
In some people with keratoconus, the cornea becomes scarred with advanced disease. For others, wearing contact lenses becomes difficult. In these people, cornea transplant surgery might be necessary. This is a surgery that replaces the damaged cornea with a healthy one from a donor.
13. How is keratoconus diagnosed?
Keratoconus is diagnosed through an eye examination conducted by an ophthalmologist, who will review the patient’s medical and family history. The diagnosis involves several tests to understand the shape of the cornea. These tests include eye refraction, which uses special equipment to measure the eyes and determine the sharpest vision. A slit-lamp examination is conducted to evaluate the shape of the cornea and identify potential problems in the eye. Keratometry focuses a circle of light on the cornea and measures the reflection to determine its basic shape. Computerized corneal mapping, including corneal tomography and corneal topography, creates a detailed shape map of the cornea. These tests can often detect early signs of keratoconus before it’s visible by slit-lamp examination.
14. Is there a support group for people with keratoconus?
Yes, there are several support groups for people with keratoconus. The Keratoconus Group is a community where people living with keratoconus can share their experiences and learn more about the condition. The National Keratoconus Foundation (NKCF) is another resource that provides information and support to individuals with keratoconus. They also sponsor patient education seminars in cities throughout the United States.
15. What are the best contact lenses for keratoconus?
There are different types of contact lenses that can help people with keratoconus improve their vision. The best type of contact lens for keratoconus depends on the severity of the condition, the shape of the eye, and the personal preference of the wearer.
16. Can I play sports if I have keratoconus?
Yes, you can play sports if you have keratoconus, but you need to take some precautions to protect your eyes and vision.
Some sports and athletic activities may pose a higher risk of eye injury or irritation for people with keratoconus. For example, sports that involve flying objects, such as baseball, soccer, or hockey, can potentially damage your cornea or dislodge your contact lenses. Sports that expose your eyes to dry or windy conditions, such as skiing or cycling, can also cause discomfort and reduced vision.
Depending on the sport you play, you may need glasses with shatterproof plastic lenses, goggles, face shields, or visors to protect your eyes from impact, dust, wind, and UV light. These can be worn with your contact lenses or glasses to provide both protection and correction. Make sure your protective eyewear fits well and does not interfere with your vision.
17. Is keratoconus linked to autism?
There is no definitive evidence that keratoconus and autism are causally linked, but some studies have suggested a possible association between them.
One study explored a case report of a child with autism spectrum disorder (ASD) who developed progressive keratoconus after standard corneal cross-linking (CXL) due to abnormal eye rubbing, which is a repetitive motor stereotypy associated with ASD symptoms. The authors suggested that eye rubbing may be a risk factor for keratoconus in patients with ASD, and that behavioral modification intervention may help prevent further keratoconus progression.
Another study reported that a gene called PPIP5K2, which is involved in eye and cornea development, is associated with both keratoconus and autism. The authors speculated that PPIP5K2 may play a role in the pathogenesis of both conditions, and that further research is needed to elucidate the molecular mechanisms.
However, these studies are limited by their small sample size, lack of control group, and observational nature. Therefore, they cannot establish a causal relationship between keratoconus and autism, nor can they rule out other confounding factors. More large-scale and rigorous studies are required to confirm or refute the hypothesis of a link between keratoconus and autism.
18. Can keratoconus occur in children?
Yes, keratoconus can occur in children, although it is more common in adolescents and young adults.
Keratoconus typically has its onset at puberty and progresses until the third to fourth decade of life, when it usually stabilizes. However, some cases of keratoconus have been reported in children as young as 4 years old. In pediatric patients, keratoconus is often more advanced at diagnosis and its progression may be more frequent and more rapid with a sevenfold higher risk of requiring corneal grafting.
19. What are the long-term effects of keratoconus?
Keratoconus is a progressive condition and can get worse gradually over time. The speed of change and severity varies between affected people. If left unchecked, further changes in shape, thinning of the cornea and, in advanced stages, scarring cause loss of transparency of the cornea which impairs the ability of the eye to focus properly.
20. Do any celebrities have keratoconus?
Yes, there are some celebrities who have keratoconus, a condition that affects the shape and clarity of the cornea. Here are some examples of famous people who have keratoconus and how they cope with it: 13 Celebrities Who Know What It's Like to Have Keratoconus
21. Can I go swimming with keratoconus?
You can go swimming with keratoconus, but you need to take certain safety precautions to protect your eyes and your vision. Here are some tips for swimming with keratoconus:
If you wear contact lenses, you should either remove them before swimming or wear waterproof swimming goggles over them. Contact lenses can get contaminated by bacteria and other microorganisms in the water, which can cause infections, irritation, and corneal ulcers. Contact lenses can also fall out of your eyes while swimming, which can make it hard to see and find them. Swimming goggles can prevent these problems by keeping your eyes and lenses dry and secure.
If you do not wear contact lenses, you may still want to wear swimming goggles to protect your eyes from the chlorine and other chemicals in the pool water. Chlorine can dry out your eyes and make them more sensitive to light. Swimming goggles can also help you see better underwater by reducing glare and distortion.
After swimming, you should rinse your eyes with clean water or artificial tears to remove any traces of chlorine or other irritants. You should also clean and disinfect your contact lenses if you wore them while swimming.
22. Is keratoconus a rare eye disease?
Keratoconus is not a very common eye disease, but it is not considered rare either. The worldwide prevalence of this condition is estimated to be 1.38 per 1,000. This means that about one in every 725 people has keratoconus. However, the prevalence and incidence may vary depending on the ethnicity, geographic location, and diagnostic criteria. Keratoconus affects both sexes and all races, but it is more common among South Asians and Middle Easterners compared with those of European ancestry.
23. What is the average age of keratoconus diagnosis?
The average age of keratoconus diagnosis is not well established, as the onset and progression of the condition may vary among individuals. However, some studies have suggested that the typical age of diagnosis is around 20 years old, with most cases being detected between 10 and 30 years old. Keratoconus usually starts in adolescence and progresses until the third or fourth decade of life, but it can also begin earlier or later in some cases. Therefore, it is important to have regular eye exams and monitor any changes in vision or corneal shape.
24. What is the prognosis for people with keratoconus?
The prognosis for people with keratoconus depends on several factors, such as the severity, progression, and treatment of the condition. Keratoconus can progress slowly for 10 years or longer before it stabilizes. Keratoconus can’t be cured or reversed, but it can be treated with various methods to slow down its progression and improve vision. If left untreated, it can lead to permanent vision loss or the need for a corneal transplant.
The prognosis for people with keratoconus varies depending on how early the condition is diagnosed and treated. In most cases, keratoconus does not result in blindness or severe vision loss. However, some people may experience frequent changes in their vision and prescription, and may have difficulty wearing contact lenses or glasses. Some people may also develop complications such as corneal scarring, infection, or inflammation.
25. Can keratoconus be prevented?
Unfortunately, there is no known way to prevent keratoconus from developing or progressing. The exact cause of keratoconus is still unclear, but it may involve a combination of genetic, environmental, and hormonal factors. However, some studies have suggested that eye rubbing may be associated with worsening of keratoconus. Therefore, one possible way to reduce the risk of keratoconus is to avoid rubbing your eyes vigorously or frequently, especially if you have a family history of the condition or suffer from allergies or asthma.
@KeratoconusGroup