Keratoconus

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Keratoconus can cause substantial distortion of vision, with multiple images, streaking and sensitivity to light all often reported by the patient. It is typically diagnosed in the patient's adolescent years. If afflicting both eyes, the deterioration in vision can affect the patient's ability to drive a car or read normal print.

In most cases,corrective lenses fitted by a specialist are effective enough to allow the patient to continue to drive legally and likewise function normally. Further progression of the disease may require surgery, for which several options are available, including intrastromal corneal ring segments, cross-linking, mini asymmetric radial keratotomy and, in 25% of cases,corneal transplantation.
Estimates of the prevalence for keratoconus range from 1 in 500 to 1 in 2000 people, but difficulties with differential diagnosis cause uncertainty as to its prevalence. It seems to occur in populations throughout the world, although it is observed more frequently in certain ethnic groups, such as South Asians. Environmental and genetic factors are considered possible causes, but the exact cause is uncertain. It has been associated with detrimental enzyme activity within the cornea, and is more common in patients with down syndrome.

People with early keratoconus typically notice a minor blurring of their vision and come to their clinician seeking corrective lenses for reading or driving.At early stages, the symptoms of keratoconus may be no different from those of any other refractive defect of the eye. As the disease progresses, vision deteriorates, sometimes rapidly.Visual acuity becomes impaired at all distances, and night vision is often poor. Some individuals have vision in one eye that is markedly worse than that in the other. The disease is often bilateral, though asymmetrical. Some develop photophobia ( sensitivity to bright light),eye strain from squinting in order to read, or itching in the eye,but there is normally little or no sensation of pain. It may, in certain cases cause luminous objects appear like cylindrical pipes with the same luminous intensity at all points.