What is keratoconus?

Arthur – what about this terrible word I learned – keratoconus?  

 Well, you aren’t obligated to know.  Keratoconus is a fairly rare disease where the cornea becomes thinner and takes on a conical shape, manifesting itself as various symptoms, including sudden changes in vision in one eye.  A normal and healthy cornea is round like a basketball, and keeps its shape thanks to tiny protein fibers.  When these fibers weaken, they can no longer support this roundness.  As a result, the cornea begins to gradually protrude and becomes like a cone, and that’s keratoconus.

 What’s the prognosis?

The cornea can change quickly or slowly, and those changes can stop suddenly or conversely continue for years.  In more difficult cases, stretched fibers can lead to serious damage of the cornea.  It’s also worthwhile to note that keratoconus is often inherited.  Therefore, with this kind of “family tradition”, you have to start checking a child’s vision after about 10 years old.  The disease begins in adolescence in the majority of cases, but also happens in people between 30 and 40.

Which symptoms should cause concern?

 An atypical shape of the cornea manifests as impaired vision.  Depending on different indicators, I will ask about the following symptoms during the examination:

• Sudden changes in vision, especially in one eye
• Objects are distorted both near and far
• Seeing halos around bright lights

This next word isn’t the most pleasant, like any other disease.  We have spoken about this problem more than once, but even my friends didn’t know anything about it – macular degeneration. 

 Well, that’s something they should know!  Macular degeneration is a disease that affects over 10 million of our fellow countrymen, and it’s the main cause in loss of vision among Americans older than 55.  Macular degeneration, as the name implies, is a degeneration of the macula itself, the part of the retina that is responsible for clear central vision, which is important for driving a car or reading.  There are two kinds – wet and dry.  Most often it is dry, but the wet has more serious consequences.  Dry is an early form of it.  Causes include age-related changes and a thinning of the macular tissues, pigment disturbances, or all these things at once.  The problem becomes obvious when the macula develops a yellow discoloration. About 10% of dry cases become wet.  With wet, new blood vessels start to grow under the retina, which leads to leakage of eye moisture and blood.  As a result, retinal cells can be damaged and begin to die, causing blind spots in central vision.

This next word isn’t the most pleasant, like any other disease.  We have spoken about this problem more than once, but even my friends didn’t know anything about it – macular degeneration. 

Well, that’s something they should know!  Macular degeneration is a disease that affects over 10 million of our fellow countrymen, and it’s the main cause in loss of vision among Americans older than 55.  Macular degeneration, as the name implies, is a degeneration of the macula itself, the part of the retina that is responsible for clear central vision, which is important for driving a car or reading.  There are two kinds – wet and dry.  Most often it is dry, but the wet has more serious consequences. Causes include age-related changes and a thinning of the macular tissues, pigment disturbances, or all these things at once.  The problem becomes obvious when the macula develops a yellow discoloration.  Gradual deterioration in vision is inherent to dry macular degeneration, which isn’t as much as if it was wet, but dry can develop into something more serious.  About 10% of dry cases become wet.  With wet, new blood vessels start to grow under the retina, which leads to leakage of eye moisture and blood.  As a result, retinal cells can be damaged and begin to die, causing blind spots in central vision.

Is it possible to not notice it’s happening?

Usually macular degeneration leads to a painless and gradual loss of vision.  Less often there’s a sudden loss.  Here are some early symptoms:

• visual distortion
• dark spots in central vision
• crooked central vision
• pale colors
• need a brighter light for reading
• hallucinatory geometric shapes or even people, but those are advanced cases

So hallucinations aren’t necessarily schizophrenia.  Now we turn to diabetic retinopathy.  Some of these are frightening words, so why don’t we call them something beautiful instead?

Diabetes is one of the main causes of blindness, so if you have it keep in mind that it can also affect vision.  Diabetic retinopathy, as understood from the name, affects the retina, and if the problem isn’t detected on time then there’s no escaping the consequences.  Small red dots, known as microaneurysms, are small bleedings in the eye that can lead to lack of bloodflow which in turn leads to the formation of blood vessels in the wrong places and can rupture the retina.

And it’s clear that the latter can affect eyesight. 

What’s more is that the disease can progress asymptomatically and remain unnoticed for a long time.  That’s why it’s necessary to check for it during a regular exam.

How do you treat it?

Laser options (photocoagulation) can be effective, although it doesn’t treat the actual disease.  But it can soften, pause, or even bring back good eyesight.  Without laser treatment or surgery, loss of vision will worsen until blindness, so it’s nothing to joke about.  So it’s important to catch the problem on time, especially as it develops quickly.  Remember, controlling blood sugar will prevent diabetic retinopathy.