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Keratoconus is an ocular disorder in which there is progressive deformation and thinning of the central or paracentral area of the cornea. It’s usual spherical shape changes to a conical one and causes an irregular astigmatism that distorts the images and a successive decrease in vision. Keratoconus is the leading cause of corneal transplantation in young patients.
It is believed to have a genetic basis and is linked to complex inheritance patterns, although external factors such as chronic and persistent eye friction must be taken into account, and there are also cases related to ocular allergies. It appears in young people in the post pubertal stage and can progress for decades until they reach their thirties, the age at which it usually stabilizes.
The main symptom is decreased vision and the appearance or sudden increase of astigmatism.
Astigmatism is usually induced by a refractive defect of the cornea that, unlike myopia and hyperopia, does not usually evolve naturally with age.
That is why it is important that any patient suffering from a sudden increase in this refractive defect, especially in the case of children and young people, undergoes a complete topographic study to rule out the presence of keratoconus.
There are also mild forms that do not cause visual alteration and that are only diagnosed with topographic studies.
There are different treatment options depending on the disease situation:
- In mild cases of keratoconus, good vision can be achieved by correcting it with glasses.
- More advanced cases will require rigid contact lenses to correct the irregular astigmatism that it produces.
- In some cases, it may be necessary to undergo surgical treatments, such as intrastromal rings, to regularize the cornea or corneal crossing, a procedure of proven efficacy to slow the evolution of keratoconus.
- In the most severe cases, when vision has been significantly reduced, the only solution is keratoplasty or a corneal Cross-Linking (CXL). Currently, transplantation can be performed, in many cases, selectively replacing the affected layers of the cornea and preserving healthy tissue.