S. Barry Eiden, OD, FAAO
President and Co-Founder, International Keratoconus Academy of Eye Care Professionals
Keratoconus, a progressive disease of the cornea where steepening, thinning and surface irregularity of the eye result in blurred or distorted vision, was formerly thought to be a relatively rare disease. However, recent studies have shown it to be far more common than previously thought. A recent study found keratoconus of one degree or another to be present in one in 375 persons.
The International Keratoconus Academy is dedicated to advancing its knowledge base and promoting the implementation of the most current technologies that will result in avoiding the vision loss and negative impact on the quality of life that individuals with keratoconus have suffered.
Over the past few decades, new treatments have been developed that can halt the progression of keratoconus. Corneal cross-linking (CXL) is a procedure where a formulation of vitamin B2 (riboflavin) is applied to the cornea in drop form followed by exposure to a specific wavelength of UV light for a specified time. Outcomes have found that following CXL, progressive keratoconus is halted in well over 90 percent of cases.
In light of this treatment, it becomes imperative for eye care professionals (ECPs) to be able to detect the disease in the earliest phase possible to preserve a patient’s vision and to treat before significant vision loss.
Fortunately, advanced technologies allow ECPs to detect keratoconus very early along. New diagnostic instruments can measure the back-surface shape of the cornea, thickness distribution across the cornea, thickness of the front surface corneal layers, and even the structural integrity of the cornea. All of which have been shown to change in advance of the front corneal surface irregularity in the disease that causes most of the visual distress.
Furthermore, genetic testing can identify patients at high risk to develop keratoconus before any other clinical findings become detectible.
Challenges to making treatment accessible to those in need
The challenge that remains is making these technologies accessible and affordable so that general ECPs (not only keratoconus specialists) can incorporate them into their practices. Next, standards of care need to be developed for young individuals to be screened for keratoconus as its prevalence as an eye condition only becomes more common.
This piece was reviewed by Barry Eiden, O.D., FAAO, FSLS.