Keratoconus Management

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🌐 What is Keratoconus?

Keratoconus is a progressive eye disease where the normally round, dome-shaped cornea becomes thin and bulges outward into a cone-like shape. This irregular corneal shape distorts light entering the eye, causing blurred, distorted vision, glare, and sensitivity to light.

Keratoconus usually begins during adolescence or early adulthood and can progress over 5–15 years if left untreated. In advanced cases, it may lead to significant visual disability or even the need for corneal transplantation.

🔍 How Does Keratoconus Develop?

The exact cause of keratoconus is not fully understood, but a combination of genetic, environmental, and mechanical factors are believed to contribute:

• ✅ Genetics: Family history increases risk.
• ✅ Chronic eye rubbing: Often due to allergies or habitual behavior.
• ✅ Environmental stress: UV exposure and oxidative stress.
• ✅ Underlying conditions: Conditions like Down syndrome, Ehlers-Danlos, and connective tissue disorders.

The building blocks of cornea are collagen fibres that provide strength to the cornea. In keratoconus, collagen fibres are abnormal or reduced in number, resulting in weakness of cornea. These factors weaken the corneal integrity over time, resulting in a bulging, cone-like shape that affects vision clarity.

🧪 How is Keratoconus Diagnosed?

Early diagnosis of keratoconus is key to preventing progression and avoiding advanced complications. A patient of keratoconus often presents in young age (5 to 20 years) with repeated change in glass power, increasing cylindrical number and progressive blurring of vision even with glasses. A thorough clinical evaluation includes:

• ✅ Refraction: Frequent change of glasses, increasing astigmatism and vision not correctable to 6/6 even with glasses.
• ✅ Corneal Topography: Pentacam and corneal topography is the gold standard and maps the curvature of the cornea. Keratoconus shows a thin and ectatic cornea.
• ✅ Pachymetry: Measures corneal thickness.
• ✅ Slit-Lamp Examination: Detects signs of thinning, scarring, or Fleischer rings.
• ✅ Keratometry: Assesses curvature and astigmatism.

Visiting an experienced keratoconus specialist is crucial to ensure timely and accurate diagnosis. An early treatment can salvage the patient’s vision and prevent complications that occur with advanced form of diseases. Dr Vikas Veerwal is an expert in Keratoconus and has an experience of over 13 years working in this area. He has treated more than 500 cases of keratoconus. He customises the treatment in his patients to provide best possible outcome.

🩺 Treatment Options for Keratoconus in Indirapuram

Treatment depends on the severity and progression of the disease. Options range from non-surgical vision correction to advanced interventions.

1. C3R / CXL (Corneal Collagen Cross-Linking)

C3R (Corneal Collagen Cross-Linking) is a non-invasive procedure that strengthens the cornea using UV light and riboflavin (Vitamin B2), halting disease progression. During the procedure a special dye (riboflavin) is instilled over the cornea followed by exposure to concentrated UV light. This results in increasing the bonds between the collagen fibres, resulting in strengthening the cornea.

• ✅ Best for: Early to moderate stage keratoconus.
• ✅ Prevents further deterioration but does not improve vision.

💸 C3R cost in Indirapuram : ₹30,000 – ₹45,000 per eye

2. INTACS (Intracorneal Ring Segments)

INTACS are tiny semicircular plastic (PMMA) rings inserted into the cornea to flatten the cone and improve vision by reshaping the cornea.

• ✅ Best for: Moderate keratoconus with contact lens intolerance.
• ✅ Can delay or prevent corneal transplant and improve vision.
• ✅ Usually combined with collagen crosslinking.

💸 INTACS surgery cost in Indirapuram : ₹85,000 – ₹1,15,000 per eye

3. ICL (Implantable Collamer Lens)

ICL is a premium intraocular lens implanted behind the iris. It is ideal for patients with high myopia or astigmatism who are not LASIK candidates due to irregular corneas.

• ✅ Best for: Stable keratoconus with high refractive error.
• ✅ Delivers excellent unaided vision.

💸 ICL cost in Indirapuram : ₹80,000 – ₹90,000 per eye

4. Scleral Contact Lenses

Scleral lenses are large, gas-permeable lenses that vault over the cornea and rest on the sclera, providing a smooth optical surface for vision correction.