Keratoconus Management

If you’ve noticed that your vision is becoming increasingly blurred or distorted—and your usual glasses aren’t helping anymore—you might be dealing with Keratoconus.

There are a wide range of conditions that can affect your eyes and impact your sight, but Keratoconus requires a different approach.

Keratoconus occurs when the cornea (the clear, front surface of your eye) thins and gradually bulges outward into a cone shape. This irregular shape prevents light from focusing correctly, leading to “ghosting,” light sensitivity, and significant distortion. Research indicates it is the combination of genetic and then environmental factors, and found that about 20% of those who have keratoconus also have relatives that are affected.

Often keratoconus can be made worse by rubbing your eyes if they’re itchy and people with keratoconus are known to have much higher rates of hayfever, eczema, asthma or allergies.

Excessive or vigorous eye rubbing can break down the fibres of the cornea and could be a factor in triggering the progression of keratoconus.

Keratoconus is a fairly common disease – with older studies suggesting 1 in every 2,000 people can develop it. And a recent Australian study done in 2020 found that it was prevalent in 1 in 84 people aged in their 20s (ie 23 in every 2000 people).

The onset of the disease can happen anywhere between 8 and 45, but most of the time it appears between 16 and 30 year olds.

THE POWER OF CORNEAL TOPOGRAPHY
To diagnose Keratoconus effectively, then be able to treat it effectively, we first have to map your eye. We do this using Corneal Topography.

This is like taking a high-definition 3D map of your eye’s surface. Unlike standard tests that only measure the basic curve of your eye, a topographer captures thousands of data points across the entire cornea and creates a map that highlights if a cone is developing.

The ‘map’ identifies exactly where the thinning and bulging are occurring and can help your optometrist spot the very early signs of Keratoconus before it’s visible in a standard eye test. Fire Station Optometrists have the only corneal topography technology in the region.

WHY RGP LENSES ARE OFTEN THE BEST OPTION
In the early stages of the condition, glasses are usually successful in correcting your vision.

However if you have contact lenses and an irregular cornea, standard soft contact lenses tend to drape over the cone, taking on its distorted shape and failing to correct the vision.

Rigid Gas Permeable (RGP) lenses are made of a firm, oxygen-permeable material. Because they maintain their shape, they provide a new, perfectly smooth surface for light to enter the eye. These lenses offer the best long term, non surgical solution for those with moderate to advanced keratoconus.

By “masking” the irregular cone shape, RGPs provide much clearer vision than glasses or soft lenses do for a Keratoconus patient. Because the lenses are gas permeable, you eye can breathe, which helps to maintain long-term corneal health.

RGP lenses are customised to each patient, so they have a stable fit, even on a complex corneal surface. They can be uncomfortable initially because your eye is sensitive, but most patients get used to wearing them and after 2-4 weeks don’t experience anymore discomfort

WHAT TO EXPECT DURING A FITTING
Because no two cases are the same, we use your Corneal Topography data to select the initial lens design.

During your appointment, we evaluate how the lens “lands” on your eye, and make sure that there is a healthy layer of tears between the lens and your cornea. It might take a couple of adjustments to get the fit perfect, but the result – seeing the world in high definition again – is well worth being patient to ensure you have the best fit.