Denver and Cherry Creek, Colorado
Keratoconus (also called corneal ectasia) is a thinning and steepening of the cornea, the clear front surface of the eye. At Cherry Creek Eye Physicians and Surgeons in Denver, Colorado, Dr. Lewis has been treating people with both mild and severe keratoconus, and offers a wide array of choices.
Keratoconus usually starts during late adolescence, progressing until about age 40. At that point, it slows down and even stops altogether. The causes are unclear. It happens to both males and females, although slightly more often in females; and racial background seems only marginally related, with slightly more cases among those with an Asian heritage.
When keratoconus develops, the cornea becomes thinner, but not necessarily in an even fashion. Being thinner, the cornea starts to bulge forward, because the human eye is filled with fluids, and has a certain degree of internal pressure. As the cornea thins, it becomes less able to retain a firm front surface. Depending on where exactly it is becoming thinner, it might bulge centrally, or more often will bulge off-center. Each keratoconus case is individual, and each eye is unique, so that treatment must be highly customized.
- The most common symptom of corneal ectasia is seeing multiple images - two or three fainter duplicates of the main image.
- Most people with keratoconus are also nearsighted (myopic) and astigmatic (meaning that the cornea is not spherical in shape, but more oval, or otherwise irregular).
- Some people have only mild symptoms, correctable with glasses or soft contact lenses. Some are even unaware that they have a vision disorder at all. Others have severe sight impairment that can't be corrected with glasses or soft contacts.
When glasses and contacts are ineffective
When keratoconus becomes severe, there are some rigid contact lenses that are effective. Dr. Lewis offers a variety of them:
- Soper lenses -which come in a variety of sizes and strengths and are popular when the patient has a more steep and abrupt bulge (cone). The steeper it is, the wider the diameter will be of the Soper lens, so it can effectively vault the cone.
- VIP Cone natural lens
- SoftPerm lenses - which are rigid and breathable in the center, with a softer periphery. They can be a good choice for patients who have an off-center steepening, or who find they can't tolerate lenses that are 100% rigid.
- Rose KT lens - a custom-made lens for each eye, which is rigid and allows air, with its all-important oxygen, to pass through and ventilate the cornea.
- Soft K lens - which is a less rigid lens, for those who find rigid lenses too uncomfortable to wear.
Until recently, a corneal transplant was the other treatment for Keratoconus. But a newer alternative is Intacs. These are tiny slivers made of the same plastic used for intraocular lenses (implantable lenses used to treat cataracts and presbyopia in a procedure called a Clear Lens Exchange). They help to flatten the steepness in the cornea caused by Keratoconus.
Another possibility is Conductive Keratoplasty (CK). This procedure uses radiofrequency to strategically heat and shrink tiny parts of the collagen in the cornea. It's a treatment for farsightedness and presbyopia (middle-age vision), and can be effective for Keratoconus also.
At Cherry Creek Eye Physicians and Surgeons, P.C., we offer comprehensive vision care, and are always willing to answer questions. We believe in giving our patients as much information about their vision and possible treatments as they'd like to have. Please call or email us to set up a consultation. We look forward to meeting with you.