The keratoconus (keratos for “cornea” and designed for “cone”) corresponds to a deformation of the cornea (the transparent coating in front of the iris and the pupil of the eye) which thins gradually, loses its normal spherical shape and takes the form of an irregular cone.
This deformation, often occurring towards the end of adolescence, causes visual disturbances: the sight is blurred and distorted and the vision from afar is bad.
Keratoconus is usually bilateral and affects both sexes equally.
It seems that the Asians are more affected, Keratoconus is also common in our country and the Maghreb in general.
The exact causes of keratoconus are not yet known, but it is probably a genetic disease.
In addition to genetic susceptibility, mechanical stresses such as rubbing the eyes are mentioned, many patients suffering from keratoconus have a predisposition to allergies.
Keratoconus, often discovered at puberty, usually develops until the age of 30-40 before stabilizing.
The evolution is irregular, some keratoconus remaining stable for a few years, others worsening and then stabilizing again.
The stages of evolution can be classified according to various criteria, but one distinguishes often:
A corneal topographic map (or video-topography or corneal topography) confirms the diagnosis, objective form and seat of the cone and allows to follow its evolution.
The usual chronology of therapeutic management initially includes equipment in spectacles then, when the vision in spectacles becomes insufficient,
Adaptation into rigid oxygen-permeable contact lenses is essential, contact lenses will give the cornea a regular shape to obtain good vision.
Lenses are the only possible correction mode.
When the cone is too large, it is possible to adapt to scleral glasses.
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Only your ophthalmologist contactologist will guide you because as long as the cornea is transparent and the rigid or scleral lenses are tolerated and allow a gain in visual acuity, other surgical methods will not be discussed..
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Finally, in case of intolerance or if the vision remains insufficient, the recourse to the corneal surgery is essential. The latter has two options: the most favorable cases can benefit from the placement of intra-corneal rings; more severe cases involve performing a corneal transplant.
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But it should be kept in mind that the use of contact lenses may be indicated after corneal transplantation or intraocular ring placement.
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Rigid lenses will not cure keratoconus, their goal is to restore clear vision to an eye that is not correctable or impossible to correct by glasses and that as long as the cornea remains transparent.
Rigid lenses can not stop the progression of keratoconus.
The only way to stop or even stop the progression of keratoconus is cross-linking.
An annual check is required for monitoring the evolution and monitoring of contact lens tolerance.
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During pregnancy, hormonal changes can cause a slight myopization related to a change in curvature of the cornea but also a change in the quality of the tears partly to explain the discomfort that may be encountered by lens wearers .
In case of gene, wear them less during the day and alternate with a correction in adapted glasses.
This gene will spontaneously return to normal within three months after delivery.
During delivery do not forget to remove your lenses.
It is a common demand very often for an aesthetic motivation, more often by young girls.
The teenager can wear contact lenses, provided that he understands the interest of the interview and scrupulously respects the conditions, otherwise it will be better to stop the wearing of lenses.
The ophthalmologist, after an ophthalmological examination, will prescribe the type of lens adapted to his needs and ensuring the safety of his eyes.
Beware of anti-acne treatment, which contra-indicates the wearing of soft lenses because of the dryness of the eye induced.
Beware of swimming in the pool which is prohibited because of the risk of infection, he will seek advice from his ophthalmologist.
Yes, the question arises of the adaptation to lenses after refractive surgery of the cornea while the purpose of this surgery is to remove the constraints of wearing glasses or lenses.
The occurrence of irregular astigmatism (irregularity of the corneal surface) can occur:
Adjustment should not be performed until the sixth postoperative month. The geometry and metabolism of the eye must be allowed to stabilize.
The rigid gas permeable lens is the best solution.
The unusual shape of the cornea, however, makes the adaptation imperfect. It is often necessary to use scleral lenses.
It is not uncommon for the corneal transplant to be followed by a simple glass lens correction, if it is possible, it is the best choice on a weakened eye.
But very often the optimum vision requires the help of a lens.
We will use a rigid lens whose top Dk allows access to oxygen, these corneas are greedy because of their healing process.
The two most common causes of keratoplasty are keratoconus and bullous keratopathies.
The graft limit is often irregular despite the precautions taken.
If the rigid lens permeable to oxygen does not bring the expected results we can use scleral lenses.
The application of such a lens is possible quickly, it is usual to equip a month after the operation.
In a surgical team, the contactologist can recover cases that are often difficult to equip, and his know-how enhances the operative results.
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