Keratoconus Treatment in Calgary
What is Keratoconus?
Keratoconus is a progressive thinning of the central cornea (the clear front window of the eye). This thinning weakens the structural integrity of the cornea causing it to protrude forward like a cone. Typically, keratoconus (KC) first presents at the age of puberty and progresses over the next 10-20 years. Eventually, after age 40-45, progression usually halts as the fibers of the cornea become more stiff with age. Severity of the disorder varies from very mild irregular astigmatism, to severe thinning, protrusion and eventually scarring.
At Mission Eye Care, we are proud to offer Keratoconus treatment in Calgary – being a leading provider of both diagnosis and management of keratoconus (KC) for patients in both southern Alberta as well as our neighbouring provinces.
We offer non-surgical optical correction for those with keratoconus. Our doctors have advanced residency training in specialty scleral and hybrid contact lens designs that can restore sharp vision, read more about these lenses here.
How do I know if I have Keratoconus?
A study from the Netherlands shows that the prevalence (number of people living with KC) is 1 in 375 people. If we extrapolate that to the city of Calgary, with a population of 1.3 million people, there are expected to be about 4,000 people with KC within our city alone. The incidence (number of new cases per year) is 1 in 2000 people.
Patients with KC often have high astigmatism, and may suffer from blurry vision, even while wearing glasses. Haloes and starbursts at night are also commonly noticed with KC. At Mission Eye Care, we have the latest diagnostic equipment including topography, which measures the shape of the front of the cornea, and OCT, which measures the thickness of the cornea. Along with other measurements, we can detect the disease at a very early stage. “Normal” corneas should be of a regular, spherical shape, whereas orneas with KC typically show steepening of the inferior cornea, resulting in protrusion and thinning of the cornea over that area.
What causes Keratoconus?
The cause of KC is still unknown. There are associations between KC and atopy, Down’s syndrome, Leber’s congenital amaurosis, and Ehler’s Danlos/connective tissue disorders. A hereditary pattern has not been established, but positive family histories has been reported. Keratoconus incidence has been found to be four times greater in Asian patients compared to Caucasian patients, and the disease also is generally more severe in the Asian population. KC is associated with a history of chronic, circular, eye-rubbing with the palms or knuckles. For this reason, refraining from eye rubbing is always recommended for patients with keratoconus. http://www.charllaas.com/eye-rubbing-keratoconus
What are treatments for Keratoconus?
If keratoconus is newly diagnosed in someone under the age of 40, it is most likely that a referral will be made for a procedure called Corneal Crosslinking (CXL), which stabilizes the corneal fibers to give them more rigidity and prevent further progression. CXL does not improve vision on its own, however, some surgeons elect to also perform a laser correction procedure at the same time as CXL to both halt progression of KC and reshape the cornea to improve vision.
After CXL, vision usually corrects well with glasses or standard soft contact lenses, but in some cases, the corneal shape is still irregular. For these cases, specialty contact lenses have the potential to improve vision, in many cases, close to 20/20 vision can be regained with a properly fitted custom lens. These lenses are able to establish a spherical shape to the front of the eye, allowing light to focus properly onto the retina. At Mission Eye Care, our doctors have highly specialized and post graduate residency training in the fitting of these lenses. You can read more about these options here.
Some surgeons also offer INTACS (intrastromal corneal ring segment) to improve vision, although the results of this procedure vary, and many patients still require glasses or specialty contact lenses after the procedure. Rarely, progression of KC continues, causing corneal scarring or thinning of the cornea to such an extent that rupturing of the corneal layers may result. In these instances, keratoplasty (corneal transplant) is recommended. There are many different types of corneal transplants, the most common types for KC are a full-thickness transplant, or a partial transplant of only the anterior (front) layers of the cornea. Many patients will still require specialty contact lenses after transplantation.
Our clinic has long been one of the largest fitting centers for specialty lenses in Alberta. We invest in the latest tools and technology to provide world class care for our patients with keratoconus. We are also the only clinic in western Canada to have both the custom molded EyePrintPro prosthetic lenses and the new BostonSight lenses for advanced corneal disease. If you or someone you know may be affected by keratoconus, please contact us or book an appointment to discuss your unique needs.
