I have keratoconus, will I lose my sight?
Written by:
Ophthalmologist
Published: 21/09/2020
Edited by: Emma McLeod
Any condition that threatens eye health can create anxiety. The question “will I lose my sight?” is very often a question asked by patients suffering from keratoconus. Mr Arun Brahma is an expert consultant ophthalmologist and here he explains all you need to know about the condition and preserving your sight.
“Will I lose my sight?”
In short, the answer is no. With modern approaches, you should not lose your sight. This does, however, depend on the condition being diagnosed early, with adequate monitoring and treatment being initiated as soon as possible.
What is keratoconus?
It is a condition that primarily affects the cornea (the clear window of the eye) and can run in families. It can occur in conjunction with other medical conditions, such as allergic eye disease or it may occur on its own. It tends to start during the teenage years and is often picked up and diagnosed when glasses do not improve a patient’s vision. Fortunately, most cases of keratoconus stop progressing naturally after forty.
The main job of the cornea is to remain clear in order to allow light to pass from the front to the back of the eye so that it can focus on the retina. Secondly, it needs to remain spherical so that the light rays land on the same part of the retina, meaning a focused, sharp image is formed.
The term keratoconus literally means that the clear window has become cone-shaped. This occurs due to progressive thinning of the central part of the cornea, the stroma, which forms the main bulk of the tissue. As the cornea thins, the shape becomes more irregular, meaning the light is focused poorly onto the retina, and the quality of vision becomes progressively less sharp.
If the cornea thins too much, it begins to lose clarity and can become waterlogged as a result of the fluid within the eye. Although this only usually happens in advanced cases, it can lead to scarring, reduced corneal clarity and sudden loss of vision.
How the condition is managed
Modern keratoconus management depends on the stage and severity of the condition when diagnosed. Most surgeons want to catch the disease early, with the main aim being slowing or halting the progression of the disease. Most patients will not require surgical treatment, and patients usually only come to see a doctor if their eyesight is badly affected. If the progression of the disease can be delayed, and the cornea remains clear and thick enough, it may be possible to avoid more invasive operations such as profile.