What Is Keratoconus?
Eric D. Donnenfeld, MD, FAAO

Keratoconus is an eye disease characterized by progressive thinning of the cornea, which then begins to bulge into a cone-like shape. As keratoconus advances, the abnormally shaped cornea deflects light as it enters the eye, thereby causing distorted vision. Keratoconus may lead to severe vision impairment.

Keratoconus generally develops during adolescence or the early 20s. The rate of progression varies from one person to another. In fact, individuals who have a mild case of keratoconus may not be diagnosed until years later.

Eric Donnenfeld, MD, FAAO, is a nationally recognized corneal diseases specialist and uses the most advanced treatments, including advanced corneal transplant surgery and corneal collagen cross-linking, to treat keratoconus patients in New York, New Jersey and Connecticut.

Signs and Symptoms of Keratoconus

Keratoconus is often difficult to detect until it progresses significantly and the cornea's abnormal shape becomes obvious. However, there are some signs and symptoms associated with keratoconus that can be detected early on; these include:

  • Progressive nearsightedness
  • Irregular astigmatism
  • Frequent changes in eyeglass prescription
  • Distorted and blurred vision
  • Glare and light sensitivity

What Causes Keratoconus?

Keratoconus-related weakening of the cornea can be caused by many factors, including an imbalance of enzymes within the cornea. Keratoconus often affects more than one person in the same family, in which case it is caused by genetic factors. Other causes that may lead to keratoconus include:

  • Chronic eye irritation
  • Allergic eye disease
  • Eye rubbing
  • Complications following laser eye surgery

Keratoconus Diagnosis

Several tests and technologies can be used to diagnose keratoconus, including eye refraction, slit-lamp examination, keratometry and computerized corneal mapping. Dr. Donnenfeld uses the most advanced diagnostic equipment available to accurately diagnose keratoconus, determine the severity of the disease and develop an effective treatment plan for each patient.

Keratoconus Treatment Options

Initial treatment of keratoconus is aimed at preserving the patient's vision. This is accomplished through the use of glasses in mild cases. As the disease progresses, special contact lenses, such as rigid gas permeable contact lenses or scleral contact lenses, may be required. Surgical treatments include corneal inserts (Intacs), which Dr. Donnenfeld performs with the aid of a femtosecond laser. While these treatments allow most keratoconus patients to retain functional vision for a period of time, sadly, they do little to slow the progression of keratoconus. In its advanced stages, keratoconus causes corneal thinning and scarring, eventually requiring corneal transplant surgery. Dr. Donnenfeld is the Surgical Director of the Lions Eye Bank for Long Island. He and his partners perform the most corneal transplants on Long Island and throughout the Tri-State area.

Fortunately, in early 2008 the FDA began clinical trials for a new procedure called corneal collagen cross-linking (CXL). This procedure, performed by a few highly skilled eye surgeons, including Dr. Donnenfeld, offers keratoconus patients hope of achieving long-term relief from this devastating eye disease. Corneal cross-linking is the only treatment that stops the progression of keratoconus without the need for corneal transplant surgery.

Read more about corneal-cross linking.

For more information on your treatment options, please schedule a consultation with Dr. Donnenfeld. In addition to performing keratoconus treatments, Dr. Donnenfeld is also recognized as a leading Long Island laser eye surgery and cataract surgeon.

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