OPHTHALMIC EDUCATION (18) Understanding Conical Cornea (Keratoconus) [Archives:2000/49/Health]

Mahfouth A Bamashmus
FRCSEd, FRCOphth
Consultant Ophthalmic Surgeon
Ibn-Al-Haitham Clinic
University of Science & Technology, Sanaa
What is Conical Cornea (Keratoconus)?
Keratoconus or conical cornea is a condition that affects the cornea (the transparent outer coat of the eye). The cornea becomes thin and starts to protrude giving the appearance of a cone. This leads to decrease in vision.
What are the causes of conical cornea?
No one knows exactly the cause of conical cornea. It is not a hereditary disease, but it can run in families. Patients with allergic eye disease especially vernal catarrh have more tendencies to develop conical cornea because of continuous rubbing of their eyes.
What are the symptoms of conical cornea?
Blurriness and distortion of vision is the earliest symptom.
The eye becomes sensitive to light.
Progressive reduction in vision over 5 10 years.
Vision can be lost suddenly because of some damage to the inner part of the cornea and that needs, weeks to months to heal. It usually leaves corneal scars.
The condition affects people in their second decade or early third decade. It progresses over 10 20 years then stops.
What is the treatment of conical cornea (keratoconus)?
1.Glasses are useful for the early cases.
2.Contact lenses especially the hard type is good for the moderate cases.
3.Corneal transplantation is the treatment for the severe cases.
What is a corneal transplantation?
In corneal transplantation, the diseased cornea is replaced with a healthy cornea obtained from a cadaver. The operation is not complicated but obtaining corneas is the major obstacle for these types of surgeries.
Unfortunately there is no Eye Bank in Yemen. It needs the effort of a large number of people in the community to establish an eye bank to help a large group of Yemeni patients that are blinded with eye diseases related to their corneas including conical cornea.
Are there any complications of corneal transplantation?
1.The main complication is the body rejecting the new cornea. With the new medications this risk is low.
2.Unfortunately the original disease can recur in the new cornea and this cannot be prevented.
Advice to patients affected with Conical Cornea:
1.If they have been diagnosed as having conical cornea they should wear their glasses or contact lenses.
2.If their glasses or contact lens are not doing the job they need a corneal graft and they need to travel abroad because of lack of corneas in Yemen
Routine eye exam by an eye specialist is very important.
It is your sight and your eyes need every care they deserve.
Reference: PAACO educational leaflets, Cairo.

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