Los Angeles, California
Frequently Asked Keratoconus Questions
Q. I have been diagnosed with keratoconus. Can my siblings or children also have this disease?
A. Dr. Khanna would have to do special exams to see if they have active keratoconus or a latent form called form fruste.
Q. Will insurance cover the cost of the surgery?
A. Some insurances may cover the cost. We can help you find out this information from your insurance.
Q. How much does Intacs cost?
A. The exact cost would depend on many factors. The following factors may influence the final cost- insurance, one eye or both eyes surgery, financing etc. The final costs may be discussed at the time of the visit.
Q. What is keratoconus?
A. Keratoconus is a degenerative condition of the eyes cornea, which is the clear front part. There is no inflammation in keratoconus, but the cornea gradually changes its curvature and bulges forward more. This distorts vision. Causes are not known, but keratoconus seems to occur throughout the world and it affects about one person per thousand. Usually keratoconus is diagnosed in adolescence and it intensifies through ones twenties and thirties.
Q. What are the symptoms of keratoconus?
A. At first keratoconus causes some blurriness of the vision. Many keratoconus sufferers then make an appointment with their eye doctor for new glasses. It may seem at this early stage as if nearsightedness is increasing, or farsightedness is increasing, or that astigmatism is increasing. In some cases only one eye is affected; in other cases, both eyes are affected. Also, one eye may be more severely affected than the other.
The classic symptom of keratoconus is ghost images. With ghosting, the main image will be somewhat blurry and it will be surrounded by vague duplicate images of varying blurriness.
As keratoconus starts progressing, more symptoms will occur:
• Night vision becomes difficult
• Blurriness will increase at all distances
• The eyes become more light-sensitive
• Eye strain becomes more common
• The eyes may become itchy
• Streaking or flaring appears around light sources
Generally however, there is no pain associated with these symptoms.
Q. Is there a cure for keratoconus?
No, there is no cure for keratoconus so far. But it can be well-managed as it progresses and the patient can continue to lead a normal life.
Q. How is keratoconus treated?
A. Keratoconus is first treated with glasses, and this approach will adequately correct the patients vision for a period of time. After a while, contact lenses are prescribed instead of glasses, and these contact lenses are designed specifically for keratoconus treatment. Traditionally, the contact lenses have been hard, but more recently a specialized soft lens has been developed, which are known as hydrophile lenses.
Hydrophile lenses bond with water. As keratoconus progresses and the corneal surface becomes more irregularly shaped, containing tiny dips, hydrophile lenses can hold tear fluid in these dips. This creates the effect of a more normal and smooth corneal surface.
• Some contact lenses are hybrid. They have a hard center which is gas-permeable to allow oxygen into the eye, and they have a soft skirt for greater comfort.
• For some patients the best option is a piggyback lens combination. With this arrangement, soft lenses are worn underneath rigid lenses. Each pair of lenses gives a certain amount of vision correction and their cumulative effect gives relatively clear vision. A lens fitter with specialized skill is required to implement this arrangement.
• Scleral lenses are a good option for some patients. Scleral lenses are larger, and they cover a portion of the white part of the eye, known as the sclera. Some patients find them uncomfortable but they are often preferred by an elderly patient who has reduced manual dexterity.
As keratoconus develops and becomes more severe, a corneal transplant may be necessary (also called a corneal graft). This would be because contact lenses may eventually cause corneal scarring, and as bulging progresses, the cornea can become too thin to adequately contain the eyes internal pressure. In this transplant surgery, a new cornea from a donor replaces the existing cornea. No blood type matching is necessary as the eyes cornea has no blood supply.
An alternative to corneal transplant surgery is the use of Intacs.
Q. What are Intacs?
A. Intacs are surgically implanted corneal ring segments. They are positioned on each side of the pupil, within the stromal layers (that is, beneath the corneal surface layer). Their effect is to flatten the cornea, and this compensates for the progressive bulging characteristic of keratoconus. An Intacs procedure is done with local anesthetic on an outpatient basis, and requires no removal of any eye tissue. It is a reversible procedure.
Q. I have been diagnosed with keratoconus. Could my siblings or children also have it?
A. Keratoconus causes are not well understood. Some studies have suggested that genetics may play a role in causing keratoconus, but other possible causes may be environmental or cellular. Dr. Khanna would have to examine your family members. They may not have any symptoms yet, but may have forme fruste keratoconus, which is a very mild and early stage of keratoconus. It is one of the counter-indications for LASIK.
Q. Will insurance cover the cost of the surgery?
A. Whether your insurance will cover the cost of the surgery will depend on who your insurer is and what text your policy contains. Our office can help you deal with your insurance company to get accurate information.
If you are wondering whether you might have keratoconus, or if you have a teenager who is having unexplained vision problems, please call or email us. We can schedule a consultation with Dr. Khanna at the Khanna Institute today.
If you are interested in keratoconus but are unsure which treatment is best for you, call or email to schedule your consultation with Dr. Khanna at the Khanna Institute today.