Many doctors are sure that the tendency to keratoconus in most people is present from birth. True, the disease begins to progress much later. Most often, such a corneal pathology occurs in adolescence and in people no older than 30 years. Moreover, this ailment up to a certain point can be disguised as astigmatism or myopia. The disease is very dangerous, because in advanced cases it can lead to rupture of the cornea and even loss of the eye.
Keratoconus: what is it?
Such an eye disease is a chronic progressive process in which the cornea becomes thinner. A similar state develops due to a weakening of the bond between the collagen fibers of its inner layers. As a result of this, under the influence of pressure inside the organ of vision, a change in the cornea occurs, which leads to the formation of astigmatism and myopia.
With severe deformation, the shape of the ocular cornea becomes conical. And after a certain time, due to the progression of the disease, clouding and swelling of this membrane occurs, which further reduces vision.
Such an ailment can begin to develop in adolescence, while the main signs of the disease can appear only in 20-30 years. The formation of the disease in older people is extremely rare. In such patients, a similar ailment occurs mainly after laser correction in the eyes. Not every one of them knows what it is - keratoconus, so they ask for help late.
Contact lenses and glasses with this ailment do not help completely get rid of vision problems. The disease can lead to complete blindness, in addition, it remains with a person for life.
Keratoconus: degree of the disease
This ailment is primary and secondary, it all depends on the cause of its occurrence. Moreover, in 95% of cases, the deformation is bilateral, in other words, both eyes undergo thinning of the cornea. Unilateral keratoconus occurs in only 5% of patients. Corneal deformity may be as follows:
- Mastoid. The cone is increased to 5 mm, the change is located in the center.
- Oval. The protrusion of the cornea is about 6 mm, the deformation is directed downward.
- Spherical. The size of the cone exceeds 6 mm, most of the cornea is covered by the disease.
The progression of keratoconus can last a long time (up to 15 years), while the stages of the disease will gradually increase. The detection of pathology is often delayed, since the accompanying symptoms are very blurred. In other cases, the disease develops in jerks, the symptoms with it first appear, and then disappear for a long period.
But the most difficult form of the disease is considered to be corneal dropsy - acute keratoconus of the eye. This degree of pathology is detected in 7% of patients. With it, a rupture of the thinned cornea occurs, as a result of which watery water flows out and forms a cloudy spot on the organ of vision. After about 1.5 months, the process of corneal scarring occurs and the patient may experience a temporary improvement, but the resulting clouding will become an obstacle to good vision.
The described disease is also classified according to the degree of increase in symptoms. The entire period of the disease is divided into the following stages:
- At an early stage, the curvature of the cornea is less than 45 diopters. Ophthalmologists record small morphological changes.
- In the second stage, doctors find myopia and astigmatism, which are poorly corrected with glasses.
- Further, the deformation of the cornea is 45-52 diopters. With it, the appearance of cracks in the Descemet sheath is observed, through which moisture penetrates into the cornea from the anterior chamber, and the top of the cone also becomes cloudy. Points of cloudiness are formed on the cornea, there is a likelihood of developing acute keratoconus. A person sees practically nothing at night.
- The curvature of the cornea reaches 52-62 diopters, turbidity covers most of it. The patient does not see well during the day, his visual acuity is greatly reduced, and there are even more cloud points. Visually, he can notice the bulge of the cornea.
- With this severe form of the disease, the cone-shaped deformation of the cornea exceeds 62 diopters. At this stage, the cornea becomes completely cloudy, and vision is greatly reduced. There is a danger of rupture, which can lead to loss of eye. Therefore, immediate surgical intervention is required.
Why does the disease occur?
What is keratoconus, and how it develops, it is necessary for every person to know, the only way to avoid complications. True, the pathology in question is still not fully understood. Many doctors believe that keratoconus is a chronic degenerative disease. Its main reasons include hereditary factors, structural features of the cornea and the negative impact of the environment.
With keratoconus in the cornea, the bowman membrane is destroyed. This pathological process leads to the fact that the cornea acquires an uneven thickness, with areas of turbidity and thinning. As a result, it stretches and deforms under the influence of pressure inside the eye, which leads to a deterioration in visual acuity.
There are several hypotheses that explain the reasons that contribute to the development of this ailment. For example, endocrine diseases. In patients with similar disorders, the activity of protease inhibitors in the lacrimal fluid and cornea is reduced. At the same time, the activity of proteases, enzymes that are destructive for collagen, increases. A decrease in the number of protease inhibitors leads to the fact that they cannot resist damage to collagen ligaments in a transparent layer of the cornea.
In addition, the accumulation of oxidants and free radicals in the cornea contributes to the progression of the disease, due to a decrease in the activity of aldehyde dehydrogenase. With an increase in the number of markers of oxidative stress, keratoconus can also develop.
Heredity is also the reason for the formation of this ailment. According to some scientists, corneal pathologies are transmitted at the genetic level. Similar diseases are inherited in an autosomal dominant manner. True, they have not yet been able to find the gene in which the disorder appears, however, according to statistics, in patients with Down syndrome, thinning of the cornea occurs much more often than in healthy people.
Experts also suggest that keratoconus is based on a genetically or hereditarily determined feature of the body, which is expressed in a decrease in activity, absence, deficiency of one or another enzyme. Hereditary fermentopathy does not manifest itself in any way until a certain point. A similar process can be triggered by a sharp deterioration of the immune system, hormonal changes or a serious illness - all this leads to changes in the cornea.
The reasons for the development of keratoconus should also include immunological. According to this hypothesis, bioactive substances are formed in the cornea, under the influence of which the processes of regeneration of the epithelium of the eye are disrupted. Such disorders lead after some time to a thinning of the cornea. Along with keratoconus, the patient may experience the following problems: atopic dermatitis, eczema, allergic reaction, hay fever and bronchial asthma.
Researchers also noted that among patients with hepatitis B virus there are many who have corneal thinning.
Often, keratoconus appears with permanent damage to the cornea and the use of improperly selected contact lenses. Such a disease can also develop after surgery, for example, laser vision correction.
Some experts attribute the occurrence of keratoconus to psychological disorders: psychological trauma, stress, or severe negative experiences. But such a theory, like many others, is just an assumption by scientists.
Signs of thinning of the cornea
Understanding what it is - keratoconus, it should be noted and its signs. So, there is a change in the shape of the cornea and its clouding. It comes down to astigmatism with a tendency to constantly change axes as the disease progresses and visual acuity worsens. Myopia with keratoconus develops gradually, diplopia (double vision) still joins it.
Vision with keratoconus worsens in stages. Patients have to change points all the time due to an increase in the number of diopters. Often, such a vision correction is adversely tolerated, since it does not give positive results. And sometimes the patient does not have time to acquire new glasses, as the disease progresses too quickly. In this case, keratoconus must be treated.
The reviews left by experts make it possible to understand that in advanced cases, contact lenses also do not help, since they cannot fit snugly against the cornea of the eye.
Quite often, with keratoconus, while watching TV or reading in patients, it begins to double in the eyes. In addition, the following symptoms may be present:
- itching and irritation of the organs of vision;
- photophobia;
- eye fatigue;
- burning sensation.
If at the first stage of the pathology there is only a deterioration in twilight vision, then as it progresses, even in daylight, a person ceases to distinguish objects. At the last stages of the disease, corneal bulging becomes visually noticeable.
As a rule, all stages of keratoconus progression take about 10-15 years. In most patients, the disease can stop its development, entering a state of prolonged remission. But in 5% of people, on the contrary, the disease is rapidly becoming acute. At this stage, the descemetic membrane breaks and intraocular fluid flows out.
With acute keratoconus, a person is disturbed by discomfort, severe discomfort and swelling of the cornea. After 2 weeks, the tissues of the cornea are scarred, which can lead to a temporary improvement in visual acuity.
Diagnostic procedures for keratoconus
As a rule, in the early stages of the development of this disease, the patient complains of a sharp deterioration in vision. In the process of pathology progression during a physical examination, a specialist discovers clouding of the bowman membrane and protrusion of the cornea. Diagnosis of keratoconus also involves the conduct of procedures such as:
- Skioscopy. It is performed to determine the ability of the pupil to refract light.
- Refractometry Such an examination can detect astigmatism and myopia.
- Pachymetry. Necessary to establish the uneven thickness of the cornea.
- Biomicroscopy of the organ of vision. This study helps to detect cracks in the membrane, proliferation of nerve endings in the center of the cornea, clouding, changes in epithelial cells and stromal dystrophy.
- Ophthalmoscopy Such an examination is carried out to assess the vessels of the fundus, the optic disc and the retina.
If you have any doubts, then to clarify the diagnosis, you can contact the interdisciplinary scientific and technical complex "Eye Microsurgery" named after Acad. S. N. Fedorova to conduct computer keratometry. This research method is used to accurately determine the degree of astigmatism, the refractive power of the cornea and the thickness of the ophthalmic membrane. Computed tomography can also be assigned to determine the magnitude of the cone-shaped protrusion.
Unfortunately, in many cases, the detection of keratoconus in the earliest stages is difficult. Therefore, quite often with such a disease, patients are sent to the ISTC. Fedorova.
Therapeutic methods
An ophthalmologist prescribes treatment procedures depending on the degree of the disease. At stages 1-2 of keratoconus, patients are advised to wear glasses and soft contact lenses for vision correction, the price of which is not too high. These optical instruments help correct astigmatism and uncritical myopia.
However, conservative therapy is not able to completely eliminate corneal deformity. Such treatment is resorted to to increase its tone, reduce irritation and discomfort. Specialists, as a rule, advise using special drops for keratoconus: “Taufon”, “Oftan-katahrom”, “Phloxal”, “Quinax”. In addition, they recommend taking anti-inflammatory drugs such as Diclof and Naklof.
With this disease, doctors still prescribe:
- applying an eye patch using an ointment of sodium chloride;
- "Emoksipin" in injections;
- immunostimulating agents and vitamin complexes;
- hormonal drugs ("Maxidex");
- Sea buckthorn oil as eye drops.
Treatment of keratoconus involves taking these medications to protect the cornea from external influences, activate regenerative function and eliminate irritation. In addition, they resort to physiotherapeutic methods that give good results: phonophoresis and magnetotherapy.
With thinning of the cornea, Sidorenko glasses are often worn. This ophthalmic device is used for vacuum massage around the eyes.
Corneal Crosslinking
Such an operation in our country can be done at the ISTC Fedorov, it is done by qualified specialists. This effective and modern procedure consists in the photopolymerization of stromal fibers, which release oxygen under the influence of ultraviolet and riboflavin. As a result of this, they begin to form special bonds in collagen fibers, which improves their resistance to various mechanical factors and strengthens the cornea.
Riboflavin (in other words, vitamin B2) is an essential substance for redox processes. It is necessary for the production of antibodies and red blood cells that support the health of the appearance of nails, skin, hair and the whole organism.
Crosslinking is performed under local anesthesia using special drops. Doctors use surgical instruments to remove the upper layer of the corneal epithelium and instill riboflavin onto the liberated area. Then they treat the treated area with ultraviolet light. The next stage of the operation is the application of an antibiotic, on top of which a special contact lens is installed. This optical device will have to be worn about 4 days after surgery.
The elimination of the disease in an operational way
Surgical treatment of keratoconus is not prescribed to all patients. A specialist only after examining the patient and receiving all tests can send him for medical reasons for the operation.
When the cornea is thinning, through keratoplasty is performed. But resort to surgical intervention in extreme cases. This method of treatment involves transplantation of a donor cornea to a patient in whom keratoconus is detected.
An operation to implant annular corneal intrastromal segments is also performed with this eye disease. During the procedure, thin arcs created from polymeric materials are implanted in the tissue of the cornea. These devices exert pressure on the cornea, balancing the intraocular, which is directed outward. As a result, the cornea is corrected.
But it should be remembered that with keratoconus laser vision correction is contraindicated. The price of this procedure is in the range of 25-30 thousand rubles per eye.
Elimination of pathology by non-traditional methods
It is best to resort to such treatment in the early stages of the disease in order to stop the progression of the disease. Still folk recipes help during the rehabilitation period. However, you need to know that it is impossible to correct the cornea with non-traditional methods of treatment, they only help to slow down the pathological process. Without medical help, getting rid of this ailment will not work.
With keratoconus, compresses from chamomile and sage flowers will help eliminate itching and tension from the eyes. To strengthen the immune system, a rosehip broth should be taken. To improve vision, it is recommended to use blueberry or carrot juice every day.
How to avoid the development of keratoconus?
In most cases, the described disease progresses slowly. Sometimes its development may even stop at any stage. The later the corneal keratoconus appeared, the better the prognosis and its slower course.
And in order to exclude the probability of the appearance of this eye pathology, it is necessary to treat in time the disorders that contribute to its occurrence - inflammatory, endocrine, immune, allergic and others.