Keratoconus: Causes, Different Stages,Treatments and Cost

                                                    

                                                  

Keratoconus

Short Answer  Keratoconus is a Cornea defect, in this shape of the cornea, became is different from normal.

Detailed Answer In very simple words Keratoconus is an irregularity(thinner, dome-shaped) in the shape/structure of the cornea(outermost layer of our eye), as we know in Keratoconus cornea is not in its natural shape hence deflect the light that enters through it hence proper the image does not form on the retina due to this the person having Keratoconus see a blurred image which may vary with the age and growth of the eye.

Keratoconus is actually a disease of the surface of the eye. The front surface called the cornea and it's like a clear window to the eye. 

But the problem with keratoconus is that actually with the front surface has the central part called the stroma now the stroma actually begins to degrade over time and it actually begins to then thin so when that happens the thinning of the frontal part front part of the eye the cornea begins to thin and then it actually begins to bulge out in same shape as the shape of a cone.

Structure of Cornea 
Image Source- Flickr | Image by- Keratomania

Let's understand Keratoconus with an eye diagram

Keratoconus Eye Vs Normal Eye
Image Source- Flickr | Image by- Keratomania

In the above diagram, one can clearly see the difference in the cornea in the case of Keratoconus and the cornea of the normal person.

Look at the above diagram, Normal eye as the front surface which is pretty but in keratoconus cornea is again bulging out forming the shape of a cone and it actually is thinning so that's basically what keratoconus Is.

Keratoconus is actually bilateral disease it happens in both eyes however it's most likely asymmetric so most people it'll be more advanced in one eye than the other but it generally does present in both eyes.

Mild Keratoconus

Now some people can have really mild keratoconus that's not really affecting their vision they can usually just continue with glasses, regular kind of soft contact lenses.

Advanced Keratoconus

People who get really advanced, moderate to advanced keratoconus they have significant visual issues they actually have really irregular astigmatism.

Astigmatism can cause a really distorted vision so people with really moderate and advanced levels of keratoconus will end up having excessive amounts of kind of blurry in their vision and that could significantly affect their visual acuity so they may have difficulty learning in school

Keratoconus is a progressive disease so even if you have it really mildly early on in life, it usually progresses actually the earliest age.

What are the Different Stages of Keratoconus?

According to doctors, Keratoconus has different symptoms with age that are:

•  First Stage- Sudden weakening of eyesight is its first sign at this stage you think it as a normal and vision is corrected with glass but if at this stage the checkup is not proper then it becomes more and more in the future.

• Second Stage- Blur in eyesight.

• Third Stage- After blurring in vision, the stage comes when you not able to get proper vision with glasses from local optical. This is the stage when everybody goes for higher treatment and come to know about their eye problem.

What are the causes of the Keratoconus?

• It's kind of enzyme degradation of the corneal fibers the collagen fibers of the cornea get degraded and that causes them to thin and weaken. 

• Keratoconus is due to the weakening in the eye fiber named "collagen" which is important to hold the cornea.

• Keratoconus runs in families that means if you have a Keratoconus then it might be pass on to the next generation. So it is better to have Eye checkup of your family.

Pro Tips to save your eyes from Keratoconus

Pro-tip for everybody who has keratoconus or somebody who has really bad allergies of the eyes is eye rubbing so you've probably heard at some point the doctor says don't rub on the eye really hard and the whole idea is that when you rub a really hard on your eye, you actually cause really kind of like these micro damages to the collagen fibers of the eye and when you cause the damage to the cornea there then those enzymes try to repair the damaged tissue and they actually end up causing it to get worse.

So, people who rub their eye really badly and they have keratoconus it may actually cause keratoconus to advance even faster so yeah if you've got keratoconus try to do best to stop rubbing your eye if you have bad allergies or something like that talk to your doctor about your allergy so you can get you on oral medications or eyedrops or something that you can do to help control the itching and irritation.

What is the Treatment of Keratoconus?

Treatment No. 1  Corneal Cross-Linking

Corneal Cross-Linking

One is going to be what's called corneal cross-linking(C3R) so corneal cross-linking was approved in the United States here in 2016 it had been out much longer out in Europe in Europe and in Canada but it's actually a process where they use riboflavin which is Vitamin b2 and then they use ultraviolet A light (UVA) specifically to actually activate some cells on the surface of the eye and get them to strengthen.

This is really kind of a revolutionary treatment especially for keratoconus because again the keratoconus is a progressive disease it actually gets worse overtime but with corneal cross-linking you can basically stop it or at least slow it down from getting worse so this is basically kind of the first thing that comes to mind of most ophthalmologists.

Corneal cross-linking is done by a corneal specialist this is your ophthalmologist there's you know every state usually has a couple of them.

How this process of corneal cross-linking works?

They actually put riboflavin the vitamin b2 it's a certain mixture it's not just pure riboflavin. Its actually a medication that's put on the eye and then they shine the UV light on it and that causes the collagen fibers to stiffen and strengthen and that actually has been really just proven over the last couple of years to really help people with keratoconus.

Treatment No. 2  Intra Corneal Ring Segments.

In this a plastic ring that's actually put into the cornea and that actually causes the cornea to plateau out it actually smooths out the cone of the surface of the eye and that's really to help reduce advancing problems with myopia or nearsightedness as well as really bad astigmatism because again you're into the moderate and severe stages of keratoconus your astigmatism is so irregular that it causes problems with your vision and it's difficult to get correction with glasses and contacts so if inter corneal ring segments.

Treatment No. 3  Soft and Hard Contact Lenses(RGP Lenses)

Another treatment that is good for you, your surgeon, your eye care specialist will talk about that option is kind of getting more into people who have really mild keratoconus if you have really mild or moderate keratoconus the standard treatment is actually with glasses and contacts no we got a couple of contacts.

The soft contact lens for people with really mild keratoconus so you can still wear soft lenses and see very well.

Another one is hard rigid gas permeable or our GP lens than our GP lenses actually work great because they mask a lot of the distortions of the surface of the eye from the keratoconus, There's actually specialty kind of hard lenses.

How Much Does Keratoconus Treatment Cost/ Keratoconus C3R Surgery Cost?

United States
Corneal Cross-Linking  Cost	$2500-$4000 /per eye
Intacs Cost	$1500-$2500 /per eye
Corneal Transplant
For Outpatient Procedure	$12,500-$13,000/per eye
In Hospital Procedure	$27,500-$28000 /per eye

Keratoconus: C3R surgery cost in  India and USA

United States
Corneal Cross-Linking	$2500-$4000 /per eye
India–Government Hospitals
C3R operation kit-	16000-17000 (INR) /per eye
Operation fees	300 (INR) / per eye
Different eye drops	1500-2000 (INR) /per eye
Total cost	17500-18000 (INR) /per eye
Average total cost	17000 (INR) /per eye
India – Private Hospitals
Fortis Memorial Research Institute, Gurugram	70,000 (INR) /per eye
Average C3R surgery cost	40,000-50,000 (INR) /per eye