Keratoconus Management

Keratoconus is a disease of the cornea (the curved, clear front surface of the eye) that is often visually debilitating. In Keratoconus there is progressive thinning of the cornea and as a result the cornea develops a cone-like bulge and becomes distorted. The distorted cornea affects the focusing ability of the eye impairing the vision.

Does Keratoconus cause blindness?

No, Keratoconus does not cause total blindness. If left untreated, Keratoconus can however lead to significant vision impairment resulting in legal blindness.

At what age does Keratoconus develop?

The onset of Keratoconus can be anywhere between the ages of 8 and 45. In the majority of cases, Keratoconus presents between the ages of 16 and 30 years. Keratoconus usually develops in both eyes, but the condition may be significantly advanced in one eye.

Causes of Keratoconus

The exact cause of Keratoconus is still unknown however risk factors for developing Keratoconus have been identified including having a family history of Keratoconus, allergies and excessive eye rubbing.

Symptoms of Keratoconus

The signs and symptoms of Keratoconus can include:

  • Blurring and distortion of vision that may be corrected by spectacles in the early stages of the condition.
  • Irregular astigmatism (irregular curvature of the cornea).
  • Short-sightedness (myopia).
  • Frequent changes to the spectacle prescription.
  • Once the condition has progressed it is often difficult to satisfactorily correct the vision with glasses.

Treatment

Diagnosis
  • History of frequent changes of the spectacle prescription.
  • Use of some advanced investigation and diagnostic tools such as scout and Sirius topography which is available in Dr. Haifa Eye Hospital. Schwind’s Sirius Topography gives ‘3D’ details of anterior and posterior cornea and also gives corneal thickness within few seconds.
Treatment plan
  • Eye glasses and contact lenses can correct the refractive error but cannot stop or prevent the progression of Keratoconus. We are providing special contact lenses such as Rose K lenses and Hybrid (Clearkone) contact lenses.
  • Clinical studies nowadays demonstrated that progressive Keratoconus can be stabilized by Corneal cross-linking procedures, where drops of vitamin B2 are instilled into the cornea for a specific period of time, with a subsequent UV radiation treatment. This interaction results in the strengthening of corneal tissue, which can slow down or stop corneal thinning.
  • Myoring Implantation using FEMTO laser: Nowadays several types of intracorneal rings are available to improve vision for Keratoconus patients such as 360 º flexible rings (Myoring), INTACS, keraring and Ferrara ring. These types of rings are surgically implanted into the cornea to flatten the corneal surface and improve vision with Keratoconus. Dr. Haifa Eye hospital provides new technology which is combined cross-linking with riboflavin (Vitamin B2) + MyoRing implantation. This procedure can be done under topical anaesthesia as it can save time
  • Keratoconus can also be treated by Keratoplasty, with more information about this in the Corneal Transplant Surgeries page.

MyoRing for Keratoconus

Dr. Haifa Eye Hospital is first in introducing myoring for Keratoconus treatment in the Gulf region and one of the few in the world.

MyoRing is a 360° continuous full-ring implant to be implanted into a corneal pocket for the treatment of Myopia and Keratoconus. The internationally patented device combines two a-priori contradictory qualities which are: rigidity for the modeling, and stabilization of the corneal shape after implantation and flexibility (shape memory) for the implantation via a small pocket entry to preserve the corneal biomechanics.

The treatment is minimally invasive and easy to perform. It is intra- and postoperatively painless with a very short rehabilitation time.

Indications

Myopia

All grades of Myopia between 1 dioptre and 20 dioptre, which are not eligible to Excimer Laser treatment such as:

  • Irregular corneal surface.
  • Keratoconus.
  • High myopia.
  • The patient wants a minimally invasive and reversible myopia treatment.
Keratoconus

All grades of non-central and central Keratoconus, PMD as well as post-LASIK Keratectasia as long as the minimal corneal thickness is larger than 350 microns. In very advanced cases, the MyoRing implantation should be combined with corneal crosslinking.

Advantages & Benefits

Myopia

In comparison to other alternatives to Excimer Laser treatment, which are intra-ocular procedures with significant risks, side-effects and long-term complications, MyoRing implantation into a corneal pocket is minimally invasive, reversible and easy to perform.

Keratoconus

In comparison to the treatment with ring-segments, MyoRing implantation into a corneal pocket is more effective in all grades of Keratoconus and allows the surgeon access to all 3 theoretically possible degrees of freedom of an intra-corneal implant in order to achieve the best possible result in every given case. Since the MyoRing is a continuous ring without free ends, typical complications of ring-segments such as e.g. extrusions are usually not seen in Myoring treatment.

FAQs

At what age does Keratoconus stop progressing?

Keratoconus can cause changes to the shape of the cornea usually until 35 years of age and rarely until the 40s. Keratoconus should actively be monitored regularly by your ophthalmologist to check for any progression. Cross linking treatment has been shown to stop the progression of the disease but does not improve the vision; it only stabilizes your vision from regression.