• Is excessive reading and screen time harmful to my keratconus?


    Question:

    I’m a 23-year-old woman from India. I had no problem with my vision until very recently when the local doctors diagnosed my left eye as having keratoconus. I have been asked to use contact lenses as a primary means to deal with keratoconus. I want to know how serious is this disease and whether or not it can be slowed by wearing contact lenses. Can corneal transplantation be avoided? Is there any necessary precaution that I must take to prevent its progression? I need to spend a lot of time in front of the computer and on books. Is that harmful?


    Answer:

    Keratoconus is a condition where the cornea becomes thin and develops a cone-like shape. It is usually progressive in early life and stabilizes in someone’s 20’s and 30’s. Some people are more likely to develop keratoconus due to a weakness in collagen (material that makes up the cornea) integrity. It has also been associated with conditions where people excessively rub their eyes. Depending on how advanced the disease progresses, vision effects range from no impairment to severe scarring, distortion, and legal blindness. Spending a lot of time in front of the computer or reading books should not affect the progression of keratoconus.

    Fortunately, there are a variety of treatment options for keratoconus that divide into two categories. The first objective is to stop the disease from getting worse. This is done by treating associated conditions such as allergies to prevent rubbing of the eyes. Collagen cross linking is a treatment that has shown very promising results in stopping progression of keratoconus and in some cases even reversing the corneal distortion.

    The second goal is vision rehabilitation. The purpose of the non-surgical treatments is not to prevent the disease, but instead allow a patient to see clearer despite the distortion. In early stages of keratoconus, glasses and soft contact lenses can be used to minimize the amount of astigmatism. Rigid gas permeable lenses are can also help normalize vision at this stage.

    The main surgical procedures are Intacs, which are plastic rings inserted into the cornea that flatten the cone, and corneal transplantation, where the abnormal corneal shape is removed in its entirety and replaced with a normal cornea. Corneal transplants are the last resort as there is significant recovery time and follow-up care required. Most patients are treated with contact lenses and only in rare cases does the disease become significant enough to require a corneal transplant.


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