Keratoconus is an inherited condition, in which the cornea, the clear dome of the front of the eye, thins and develops an irregular shape. In patients with keratoconus, the cornea loses is spherical shape, like a baseball, and develops a cone-like shape, like the tip of a football.
The cornea has 3 major parts, the outer skin (called the epithelium) the central structural portion (called the stroma), which is the scaffolding of the cornea, and provides the cornea it’s shape, and the endothelium, which prevents the cornea from becoming swollen.
Keratoconus is a disease of the corneal stroma. The stroma comprises over 85% of the cornea, and is made up of collagen, similar to the material on the tip of your nose. Some people are born with collagen fibers in the stroma that are less structurally sound, and the cornea weakens and thins over time.
Causes of Keratoconus
In the early stages of the condition, people will have changes in vision and need strong glasses to correct the astigmatism (a type of defocus in the eye) caused by keratoconus. As the condition progresses, the cornea becomes too irregular to use glasses, and special contact lenses, called rigid gas permeable (RGP) lenses are needed. However, these lenses are often quite uncomfortable in the eye.
Dr. Levinson specializes in the fitting of contact lenses for keratoconus, and we often use the SynergEyes hybrid contact lenses. Hybrid contact lenses have a rigid center, like an RGP, but they have a soft outer skirt, like a traditional soft contact lens, making these lenses much more comfortable.
Dr. Levinson is the only eye surgeon in Baltimore to be certified to fit the SynergEyes lenses and the only practice in the area to have all of the 5 different SynergEyes lens types.
Keratoconus is a progressive condition, and often starts in the teenage years. Until now, there was no treatment for keratoconus, and the cornea would continue to thin and vision would decrease. In the worst cases, the cornea would need to be removed, and a new cornea would be transplanted into the eye.
Dr. Levinson was involved in the early FDA studies on collagen cross linking (CXL) and has been perfoming CXL since 2012. Collagen cross linking uses UV light to stiffen the collagen fibers in the cornea. Collagen cross linking stops the progression of keratoconus in most patients. Read more about CXL here.
If you have keratoconus, feel free to call our office to make an appointment with Dr. Levinson.