Keratoconus (Cornea diseases)
Keratoconus (Cornea diseases)
The eye affects many diseases, and the degree of its impact on vision varies, but the keratoconus is the most affecting those of clarity of vision; a rapid deterioration characterizes it. That causes the glasses to change quickly without success, so if the surgical intervention is not quick, the situation may reach a lack of vision. In our time, many options appeared before doctors regarding keratoconus, depending on the stage of the disease from light to medium to severe.
The corneal implant is available in an era in which there are femtosecond technology and others. Still, it should be emphasized here that time is an essential and vital factor when diagnosing keratoconus disease. If the intervention is early, then stopping the deterioration is possible.
But we are blessed with good news for you, which is that the rate of recovery in keratoconus surgeries reaches between 90 and 95%. Still, the difficulty is that the keratoconus has different forms from one patient to another. Therefore, the surgical procedure and the diagnosis are different, and thus the method used is Surgeons are also different.
In this article, we explain the causes and symptoms of keratoconus, diagnosis, and methods of treatment, as well as other diseases that can affect the cornea, affect the degree of vision, its symptoms, and available methods of treatment. We see so that we do not lose sight, and for correct medical information, read this article.
Corneal and ocular surface diseases:
The diseases that affect the cornea are divided into hereditary diseases, diseases that do not have a genetic origin, and the genetic disorders that affect the cornea affect one or more parts of the cornea; the origin of this is the accumulated substances that envelop the cornea, and these genetic diseases affect both eyes.
First: The genetic diseases that affect the cornea:
Keratoconus: This disease is the most common disease that affects the cornea in terms of prevalence and spread. It is a thinning that occurs gradually in the cornea, and its thickness decreases. It stands out in a conical shape instead of the natural one, which is similar to the dome, and the effects of the keratoconus:
Eye allergy to glare and light.
The vision is not clear.
The incidence of keratoconus is mostly due to a group of genetic, environmental, and hormonal factors that interact in the cornea.
Other diseases of the cornea and ocular surface (basal atrophy): This disease occurs as a result of the abnormal growth of the basal membrane, and this growth form folds in the tissues of the cornea. These folds are formed in the form of continents drawn on the map, or in the form of fingerprint-like lines in the center of the cornea.
Fox's dystrophy: A disease of the cornea that is caused by a gradual deterioration of the cells in the lining of the cornea; These cells function to maintain balance in the corneal fluid, causing blurred vision, glare, and discomfort in the eye. Because of the death of the cells of the lining of the cornea, this disease affects women and affects them more than it affects men, as it affects both eyes.
Retinal dystrophy: Sediments that occur in the cornea, resulting in reduced vision.
Second: Corneal and ocular surface diseases
Those have no genetic origin:
Optical herpes disease:
The infection with genital herpes causes ulcers of white color on the surface of the cornea or eyelid. The inflammation resulting from this infection may reach the deep layers of the cornea, the disease develops to flesh keratitis, and the virus that causes this disease is transmitted to the eye by sex.
After a few years of chickenpox infection, the herpes sperm virus has infected the nerve cells. This virus activates and transmits through the nerve fibers, affects the cornea and results in keratoconus.
The pterygium is caused by prolonged exposure to sunlight. What makes ultraviolet rays a critical factor in their appearance, and pterygium is a disease that grows slowly along with longevity, which is a triangle of pink tissue on the cornea.
Iridocorneal endothelial syndrome:
The cause of this syndrome is the movement of the endothelial cells from the cornea to the iris, and this disease causes a significant change in the shape of the iris, causes swelling of the cornea, and produces blue water, and affects one eye.
The cornea is the transparent part of the eye, through which vision occurs. The state of the keratoconus is the disease in which the cornea transforms from the shape of the dome, which is its natural form, to the shape of the cone, or protrusion forward. The cornea takes the form of keratoconus in its weak state and being thicker, and therefore cannot maintain its natural way. People with eye diseases (retinitis or hereditary vision loss) are the most susceptible groups to this disease, as well as those with certain genetic disorders; Such as osteoporosis, Down syndrome, Turner syndrome, and others.
What are the causes of keratoconus disease?
Genetic causes usually cause keratoconus.
Rubbing the eyes can usually lead to keratoconus.
Inside the eye, there are proteins fibers called collagen and these fibers help stabilize the cornea, and the cornea is converted to the keratoconus when those fibers weaken.
A keratoconus is produced when the levels of antioxidants that protect the cornea from damage decrease.
What are the symptoms of keratoconus?
The keratoconus is a significant reason for accelerating glasses change; Symptoms include poor vision, and sometimes it may cause blindness.
Patients with keratoconus cannot tolerate light, and see halos around bright lights when viewed.
When a patient with a keratoconus has closed eyes and looks at the other; It sees two things one.
Blurring of vision, especially at night, is a symptom of keratoconus.
Complications of keratoconus:
Low vision due to scratches or bumps (scars) in the affected area.
Eye fluids accumulate in the keratoconus, in what is known as corneal hydrophobia, and this symptom causes visual impairment and vision problems (this is a rare symptom).
Keratoconus may affect the balance of the body, mostly due to the different size of the lenses, so you should see a doctor. To check other organs responsible for the body's balance, if the problem is not in the glasses.
How to diagnose cone keratologists?
The cornea can be examined in several ways. To indicate whether or not there is keratoconus disease:
First: Through the two devices:
(Keratometer & Corneal topography)
These two devices draw corneal images; like maps drawn to heights, the more inconsistent it appears, it appears in red.
Second: Examination of the corneal topography:
This diagnosis is made by constructing a topographical image of the surface of the cornea after its imaging, and if the patient has a keratoconus. Gestures will appear on the surface of the cornea in orange.
Third: Examination of corneal thickness:
This examination is carried out to know the thickness of the cornea through ultrasound. Each person of ours has a different thickness of the cornea than the other.
The standard corneal thickness in people without keratoconus or corneal diseases is an average of 530 microns. When infected with keratoconus, its width is less than 500 microns. If the keratoconus stage is severe, the corneal thickness is less than 400 microns.
Fourth: When examining glasses:
When examining the glasses, a person may be suspected to have keratoconus; He is then asked to go to find out.
Fifth: Upon detection in advanced cases of keratoconus, fine parallel lines may appear in the inner part of the cornea.
How to treat keratoconus:
To know the treatment of keratoconus, keratoconus can be divided into three stages:
The first stage (light or simple):
In this case, the patient's eyesight is useful when using medical glasses, and when performing a fixation, the condition of the cornea continues for several years without deterioration.
The surgeon removes the cells lining the anterior corneal surface.
The surgeon puts drops of a substance called Riboflavin on the surface of the keratoconus.
The surgeon sheds UV radiation on the cornea; to strengthen the corneal tissue; where the ultraviolet rays increase the bonding of collagen fibers in the cornea.
Second stage: intermediate:
At this point, the vision is not clear with the use of medical glasses, and surgeons take a different course of treatment for keratoconus as follows:
Using a femtosecond laser, the doctor implants tiny rings in the cornea bark.
The previous procedure leads to the treatment of convex and herringbone of keratoconus.
The doctor fixes the cornea with ultraviolet radiation and a drop (Riboflavin).
The third stage: severe conical cornea:
This is the last stage in which there is severe convexity in the cornea, as well as darks. Doctors, in this case, resort to what is known as (patching the cornea), which is divided into two parts:
The first section: a complete corneal transplant: In this section, the doctor replaces the cornea from one of the deceased donors, free of any defect in the cornea.
The second section: Partial corneal transplant: in which the keratoconus is treated by replacing the surface layers of the cornea, and at the same time, maintaining the inner cells of the cornea, and this procedure significantly reduces the patient's immune system rejection of the transplanted cells.
How to protect yourself from keratoconus?
Avoid rubbing the eyes by allergy sufferers.
Do not take medications that have not been prescribed by your doctor, even if the counselor recommends someone with the same patient condition.
Avoiding eye irritants protects against keratoconus.
A protective presence when swimming or any other sport; Eye protection is critical.
Visiting the ophthalmologist regularly, and examining the eye periodically, if a family member has the disease, after the age of ten years.
Keratoconus and Lasik:
The defect in the cornea, which is the keratoconus, results in what is known as irregular astigmatism, unlike the other type of astigmatism that can be treated with contact lenses or medical glasses, or corrected using LASIK. Here there is no relationship between the keratoconus and LASIK.
Mainly dealing with the eye aims to preserve it, not improve vision quality and visual acuity; because keratoconus has no treatment with LASIK. Because LASIK treats visible defects, these are: myopia, astigmatism, farsightedness, and nearsightedness, not physiological abnormalities, but rather LASIK can worsen the situation with keratoconus. Because the LASIK procedure requires the removal of part of the cornea, this threatens the blind keratoconus.
What are the causes of Corneal Ulcer?
There are many causes of corneal ulcers, but the leading cause of them is associated with infection, such as:
Inflammation with the herpes virus, a viral infection that frequently causes eye ulcers.
Schucococcus keratitis, an amoebic infection, can be a cause of blindness, but it is a rare infection, and occasionally occurs in patients who wear contact lenses.
Corneal ulcers can be caused by fungal corneal inflammation, and this plant-based infection can occur in people with weakened immunity.
There are other causes for corneal ulcers:
The patient's wearing non-sterile contact lenses. Thus people who use soft contact lenses that have expired, or those that are not reusable again, especially during the night, can be considered the most susceptible to corneal ulcers.
Vitamin A deficiency.
Dry eyes can lead to corneal ulcers.
Symptoms of a corneal ulcer:
A person with a corneal ulcer suffers from an increase in tears.
The person has eye pain.
A person with a corneal ulcer feels blurred.
Eye inflammation is a symptom of corneal ulcers.
The presence of secretions in the eye, pus.
A person with a corneal ulcer has a white patch on the cornea, which appears when examined in front of a mirror.
Eyelid swelling is a symptom of this disease.
Feeling of a foreign body in the eye.
The patient's sensitivity to light and his inability to open his eyes in the light are signs of a corneal ulcer.
How does a doctor diagnose corneal ulcers?
The only test that a doctor can diagnose a corneal ulcer is a fluorescent eye dye test, as follows:
The doctor uses a thin piece of blotting paper; to put a drop of an orange tint on it.
The doctor slightly touches the surface of the eye with blotting paper; to transfer the dye to the eye.
The doctor shines a special violet light on the eye with a microscope; to find damaged areas in the cornea.
Damaged areas of the cornea appear green, after highlighting them violet.
To check the cause of the eye infection with bacteria, viruses, or fungi; the doctor numbs the eye with a single drop, then gently scrapes the sore to get a sample from it, then examines it.
What is the treatment of corneal ulcers?
After performing a corneal examination, the doctor prescribes the appropriate anti-bacterial, antifungal, and antifungal medication. If the eye is infected with a tumor or inflammation, the doctor will prescribe to you individual drops called corticosteroid drops. The patient is prohibited during the following treatment period: using makeup, wearing contact lenses, and touching the eye; if not, it is necessary to use other medicines.
If the corneal ulcer is severe, the doctor will resort to a cornea transplant from a donor, but it is a process that has its risks; like:
Possibility of infection.
The body may reject the new (donated) corneal tissue.
Cataracts have occurred.
Swelling of the cornea.
Glaucoma (blue water or ocular hypertension).
How to prevent corneal ulcers:
You should not sleep when a person wears contact lenses, or get rid of them before bed.
It is essential to clean and sterilize the lenses before wearing them.
Hands should be washed before touching the eyes; because neglecting, this transmits the infection.
To get rid of foreign bodies that enter the eye or remove them, the eyes are washed with water.
Visiting the doctor when feeling any of the symptoms of infection and treating them early before they cause corneal ulcers.