Keratectasia - Causes, Symptoms, and Treatment

Introduction

Keratectasia is an eye disorder that can lead to vision impairment. The condition is characterized by progressive thinning of the cornea. The cornea controls the light entry and focuses that light into the retina. This helps in watching things. The condition can occur due to eye surgery complications such as laser-assisted in-situ keratomileusis (LASIK). Other factors that can lead to conditions such as genetic factors, corneal disease, and trauma to the eye. Keratectasia is also known as corneal ectasia. The conditions affect millions of people worldwide. Keratectasia begins in early adulthood. Daily check-ups can help the patient in relieving visual issues. The article discusses keratectasia, its types, causes, risk factors, symptoms, diagnosis, and treatment.

What Are the Types of Keratectasia?

Several types of keratectasia are as follows:

• Keratoconus: The commonest form of keratectasia. The cornea gets thinner and bulges out into a cone-like shape. The condition starts in the early childhood stage and progresses slowly with time.

• Post-LASIK Ectasia: It is a rare complication of LASIK surgery. The cornea bulges out and weakens, leading to distorted or blurred vision.

• Pellucid Marginal Degeneration: This is a rare condition in which the cornea is in a band-shaped pattern that leads to bulging of the cornea at the edge of the eye.

• Terrien Marginal Degeneration: The condition in which progressive cornea is thinning at the edge of the eye, leading to distorted or blurred vision.

• Keratoglobus: The entire eye bulges and thins out, causing a spherical or globular shape. This can lead to vision problems, which require a corneal transplant.

• Iatrogenic Keratectasia: This condition occurs due to certain eye surgeries such as LASIK or photorefractive keratectomy.

What Are the Causes of Keratectasia?

Eye surgeries such as LASIK remove too much tissue from the cornea, leading to refractive errors such as astigmatism (the curvature of the cornea is irregular). The cornea becomes thin and weak and does not hold normal eye pressure. The cornea bulges out. The most common form is keratoconus, in which the collagen fibers weaken, leading to irregular shape and structure. The inflammatory changes make the eye cone-like shape. It can lead to visual impairment. Contact lenses can lead to keratectasia. If the contact lens is placed incorrectly or if they are too soft or rigid, it can lead to the development of the condition. It can affect the shape of the eye and further vision problems. Corneal trauma is another possible cause of keratectasia.

What Are the Risk Factors of Keratectasia?

Keratectasia threat factors are as under:

• Age and Gender: The condition is more common in middle-aged men.

• Genetics: The condition can be transferred from the parents to the children.

• Eye Rubbing: Frequent eye rubbing due to an allergic reaction or dry eye can cause trauma to the eye.

• Corneal Surgery: Certain types of eye surgery, such as LASIK, can weaken the cornea and increase the risk of the condition.

• Connective Tissue Disorder: The disorders such as Marfan syndrome (a genetic disorder that affects the joints, skin, and blood vessels) and Ehlers-Danlos syndrome (a genetic disorder) increase the risk of keratectasia.

• Chronic Eye Inflammation: This is seen in autoimmune disorders that weaken the cornea with time.

• Hormonal Changes: Changes in hormones during pregnancy, puberty, or menopause may increase the risk of the condition.

What Are the Signs and Symptoms of Keratectasia?

The symptoms appear in people between the ages of 20 and 30. People with signs and symptoms are as under:

• Progressive vision loss or blurred vision.

• Increased sensitivity to light or glare.

• The shape of the cornea gets irregular, leading to distorted or double vision. The condition is known as astigmatism.

• Eye pain and discomfort.

• Headaches after reading or doing other tasks that need visual aids.

• Changes in contact lenses.

• Reduced corneal thickness.

• Watery eyes.

How Can Keratectasia Be Diagnosed?

A comprehensive eye examination and diagnostic tests can diagnose keratectasia. The eye doctor may ask for the onset of the symptoms or if a patient has any preexisting eyesight problems.

• Comprehensive Eye Examination: The healthcare provider may measure the eye pressure, check eye vision, and examine the front and back of the eye.

• Corneal Topography: The test may detect any abnormalities or irregularities. It also measures the shape of the cornea.

• Pachymetry: The test evaluates corneal thickness and identifies any indications of thinning or bulging of the cornea.

• Refraction Test: The test measures farsightedness, nearsightedness, and astigmatism.

• Slit-Lamp Examination: Bright light is used to see the cornea and eye lens.

How Can Keratectasia Be Managed?

The treatment of keratectasia depends on the severity of the condition. The possible treatment options are as follows:

• Corneal Cross-Linking: The minimally invasive procedure uses ultraviolet light and vitamin B2 drops to slow down the progression of the condition. It also strengthens the cornea. The surgeon may expose the cornea to ultraviolet light, remove the corneal epithelium, and apply Riboflavin drops. The procedure is effective and improves visual acuity.

• Intacs: These are small and crescent-shaped plastics that are inserted and implanted into the cornea. It helps in reshaping the cornea and reducing distortion. The procedure helps in reducing astigmatism in patients with the condition.

• Contact Lenses: Rigid gas-permeable contact lenses are provided to improve visual acuity. The contact lenses help reduce distortion and provide better vision to the patient.

• Corneal Transplantation: The doctor may provide corneal transplantation in a severe case of keratectasia. The procedure involves the replacement of the diseased cornea with a healthy cornea.

Conclusion

Keratectasia is an eye condition with bulging and cornea thinning, leading to decreased visual acuity. The disease can be caused due to LASIK surgery, an eye disorder, or any trauma to the eye. The eye doctor may diagnose the condition by comprehensive eye examinations and various diagnostic tests. Early diagnosis and treatment may prevent the further progression of the disease and decrease visual acuity. An individual may prevent the condition by wearing protective eyewear to avoid eye injury. Regular eye checks can prevent the progression of the condition. People should consult a family doctor or online doctor for regular eye check-ups.