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Diagnostics and Therapy of Keratoconus

Usually the first signs appear at adolescence or at the age of 20 - 30

The correction of vision by means of eyeglasses and soft contact lenses do not ensure sufficient visual acuity, which causes problems at home, makes driving difficult, as well as work in professions that require precision impossible.

The initial phases of keratoconus can be corrected by means of special gas permeable contact lenses for the therapy of keratoconus.
Previously progressing keratoconus resulted in corneal transplantation, or in delayed cases – rupture or perforation of the cornea. Nowadays the progression of keratoconus can be stopped surgically – by means of corneal cross-linking method (or CCL), which aims to increase the mechanical durability of the cornea. Cross linking method is offered by Dr. Lūkins Eye Clinic as well.

 

During the procedure the corneal epithelium is removed first (Trans-Epithelial Surface Treatment), followed by exposure of the cornea to UV-A ray impact for approximately 30 minutes. The therapeutic contact lens is applied at the end of the procedure. Anti-inflammatory eye drops are used in the post-surgical period.

This method can be used if the thickness of cornea is not less than 400 micrometres, since otherwise the risk of damage to the endothelium of the cornea exists. The sooner the therapy by means of cross linking method is commenced, the better therapy results are. The earliest age at which the procedure may be performed in 18, but exceptions to this rule is possible in the event of rapidly progressing keratoconus.

Adaptation

During the first month the vision acuity can even deteriorate, but afterwards it improves, reaching maximum effect in 6 months following the procedure. Rigid contact lenses may be used to improve vision after cross linking therapy, provided that the stabilisation period is observed before that. If both eyes are affected by progressive keratoconus, the interval between the procedures is usually at least three months.

Additional Information

  • Progressive deterioration of vision
  • Image with shadows caused by progressive astigmatism
  • Binocular vision disorders
  • Disorders of contrast sensitivity are dusk and at night
  • Hypersensitivity of the eyes to light
  • Increased lacrimation
  • Doubling of vision
  • Previously diagnosed astigmatism progresses and can change the axis
  • The thickness of cornea in the centre and the narrowest area of the cornea
  • Convexity radius of the anterior and posterior wall of cornea in different points of cornea
  • Keratoconus index
  • Index of surface variance (ISV)
  • Index of height asymmetry (IHA)
  • Corneal astigmatism (lens astigmatism also exists)
  • Specific coefficients (Zernike)