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Ojas Eye Hospital - Keratoconus Treatment
Keratoconus FAQ'S

Frequently Asked Questions About Keratoconus

What is keratoconus ?

Keratoconus is an abnormal protrusion of the cornea (bulging) associated with corneal thinning leading to distorted vision

Is keratoconus hereditary?

Keratoconus could be inherited at times, but is exaggerated with eye rubbing. Eye Rubbing is the sine qua non of Keratoconus.

Can abnormal sleeping posture lead to keratoconus ?

Yes, Sleeping on one side with head curved up within forearm could be a risk factor for keratoconus.

Is keratoconus reversible?

In mild to moderate case of keratoconus, the progression can be halted by a procedure called collagen cross linking with Riboflavin. In vision improvement glasses, contact special type of contact lenses can be tried.

In advanced cases, lamellar or full thickness corneal transplant may be done for vision improvement

Is it true that RGP will stop keratoconus from worsening ( Rigid gas permeable contacts )

This old tale is not true. When worn, the RGP lenses temporarily flatten the Non-structural epithelium (skin) of the cornea. To say that RGP contact lenses somehow stop keratoconus from progressing is like saying that wearing a baseball hat stops a child's skull from growing because keratoconus is a progressive disease, there must be some medical intervention to stop it, such as corneal crosslinking (C3R)

What are Intacs? Will they eliminate my need for contacts glasses?

To start, we must clarify that intacs are not like contact lenses. They are curved, clear plastic half-moon shaped segments that are inserted under the surface of the cornea to reduce the steepness of the cornea by reshaping it. They must be ordered and inserted by a trained Surgeon.

Should people with keratoconus be driving a motor vehicle?

Yes they definitely can as long as they meet the driving requirements.

How do we detect keratoconus ?

Corneal topography mapping of the cornea is the gold standard test to detect KC.

Will I go blind from keratoconus ?

keratoconus does not typically lead to complete blindness But the disease can degrade vision to a level when one will experience difficulty leading to a normal life.

Corneal Hydrops (extensive scarring) as well as contact lens intolerance can occur as the disease progresses and this may eventually need a cornea transplant. Hence early detection and timely management is necessary.

Collagen Cross Linking C3R FAQ

Is C3R painful?

No C3R is carried out under topical anaesthetic eye drops which makes the procedure pain-free.

Is C3R a permanent Solution for keratoconus ?

Yes C3R has more or less a permanent effect to halt the progression of keratoconus. C3R strengthens the interlinkages (bond) between the collagen strands with the corneal layers.

Will I have pain after C3R?

You might have mild pain and watering after the procedure. We apply a Bandage contact lens after doing the C3R for protection and symptomatic relief. This Bandage lens will be removed after 3days.

How many days rest do I need after C3R ?

You will need about 5-7 days’ rest after the procedure.

Will C3R have any other effect on the eye

No C3R does not penetrate beyond the corneal layers and has no other effect in the inside of the eye.

Will it have any effect on my glass number / or for my vision ?

It usually takes around 3-4 weeks for your glass number and vision to stabilise after C3R. There may be a mild change in the glass number after the C3R procedure.

When can I start wearing my contact lenses after C3R ?

You can usually start wearing your contact lenses around 3 weeks after the procedure.

How safe is C3R

C3R is considered to be a safe procedure, provided the recommended safeguards are observed. No sight threatening side effects are usually reported.

What is the device / machine used for C3R ?

For C3R, are needed Riboflavin ( Vit B2) diye and a special device to deliver UV-A light of specific wavelength of 365mm, at a controlled energy level of 3mw / sqcm .

Cornea Transplant FAQ

What is corneal transplant surgery?

The Cornea is the clear, round dome on the front of the eye. When it is diseased, it becomes cloudy or opaque. Corneal transplant is performed to remove the diseased cornea and to replace it with a healthy & clear cornea

How do you get New corneal tissue for transplantation?

Each city has multiple accredited eye banks registered with the Eye bank Association of India. Organ donors / kin of deceased consent to donating their eyes prior to passing.

What kinds of corneal transplant surgeries are there ?

There are 3 types

1. Full thickness / Penetrating keratoplasty (PKP) : The entire cornea is removed A full thickness healthy new cornea is then transplanted in its place and fixed in place with sutures.

2. Deep Anterior lamellar keratoplasty (DALK) : Only the front layers of the cornea are removed for conditions such as corneal scars, keratoconus.

3. Posterior lamellar keratoplasty / Descemet's Stripping Endothelial Keratoplasty / Descemet's (DSEK/DMEK) membrane endothelial keratoplasty. Only the Posterior / back layers are removed for conditions like fuchs endothelial dystrophy or pseudophakic bullous keratopathy.

What are the signs of tissue / graft rejection?

If you develop symptoms of vision loss, red eye, pain or sensitivity you must see your eye surgeon as soon as possible.

Can The transplanted cornea be saved after rejection ?

Yes If the rejection is caught (detected) by your specialist early on, aggressive treatment can save the cornea and preserve vision.

Who can perform corneal transplantation?

An ophthalmologist with additional sub speciality training in corneal transplantation performs these surgeries.

How long do I need to follow up and put eye drops?

After corneal transplantation surgery, regular visits to the clinic would be required, initially every 15 days and then 6 weekly, then 3 monthly, 6 Monthly, yearly and you will have to continue putting eye drops as advised at least for 2-3 years to ensure long graft survived.

A Centre of Excellence for Keratoconus Surgery in Mumbai, India.