November 10 is WORLD KERATOCONUS DAY (WORLDKC DAY)

November 10 is WORLDKC Day! I tell my keratoconus patients about it and they were all surprised that there is such a day. It is not actually a celebration that they have keratoconus, but it is a good time to raise awareness about this disease.

Keratoconus is a condition where the cornea becomes thinner progressively over time. Although the real cause is unknown, it is often associated with atopic diseases, history of eye rubbing and may sometimes have a genetic role. Symptoms of keratoconus includes blurring of vision, light sensitivity, ghosting of vision and frequent need to change the prescription. When the central cornea is affected, patient will not be able to achieve 20/20 vision. The younger the patient is diagnosed, the more severe the keratoconus usually is. There is a higher percentage of incidence in Asians with both genders being affected equally. The incidence was estimated to be 1 in 2000, but recent data shows that this ratio seemed to be underestimating the actual incidence of the condition. Many patients are being diagnosed during the screening procedure for refractive surgery, thus numbers that are being revealed now surpasses the ratio of 1:2000. Keratoconus does not usually lead to blindness, but the effect on vision can really be debilitating.

In some cases, keratoconus can be dismissed by others to be blurring of vision due to lazy eyes; and the proper way to diagnose the condition is by getting a corneal map. The advanced technology of corneal topographers can detect even mild conditions, thus allowing earlier intervention such as corneal collagen cross linking which makes the corneal fibers stronger and resistant to thinning. Recently, laser refractive surgery, specifically photo refractive keratectomy (PRK) is combined with collagen cross linking to address both the corneal weakness and the blurring of vision due to the error of refraction. Oftentimes with mild conditions, glasses can still be effective, however as the condition progresses, contact lenses will be the management of choice. Some keratoconus patients would need to undergo corneal transplant, but many surgeries can now be prevented with the availability of specially designed contact lenses such as scleral lenses. In some cases, INTACs are prescribed to flatten the cornea, aiming to help improve the uncorrected vision of the patient, and when patient prefers to have better vision still, contact lenses can still be given.

I have seen patients and parents crying when after 10 or more so years, patient can see again. As an optometrist, it is indeed very rewarding to see these touching moments. Our task besides providing the best vision care for our keratoconus patients also includes creating awareness about the condition, hence the creation of this blog. Visit also worldkcday.com

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Can You Do Weight Lifting If You Have Keratoconus?

Many patients are asking if they can still do weight lifting since they have keratoconus. During weight lifting, in order to carry tons of weight, a powerlifter may utilise a breathing pattern which involves Valsalva manoeuvre. According to wikipedia, t he V alsalva manoeuvre is performed by moderately forceful attempted exhalation against closed airway, usually done by closing one's mouth, pinching one's nose shut while pressing out as if blowing up a balloon. Other situations where Valsava manoeuvre is done are during diving, hyperbaric oxygen therapy, air travel and sometimes even going to the restroom doing your number 1. According to Findley, Keating and Toscano (2003), the Valsalva manoeuvre is commonly used in powerlifting to stabilise the trunk during activities such as squat, deadlift, and bench press. So what happens to the cornea when Valsalva manoeuvre is done? A study by Drun et al (2017) recorded the measurements of the corneal curvature,

Can I Drink Alcoholic Beverages While Wearing Scleral Lenses?

Scleral lenses are fitted to patients with complicated prescriptions and irregular corneas. A common question I encountered is "Doc, is it safe to drink alcoholic beverages while I am wearing my scleral lenses?" . Looking into the different papers on the effects of alcoholic beverages on the eye, alcohol, similar to coffee and smoking, can induce some ocular dryness. Studies noted the presence of ethanol in tears of patients within 6 to 12 hours after drinking alcoholic beverages. The presence of ethanol in tears may cause increased evaporation rate, increased corneal staining, and decreased tear volume, leading to dry eyes. Unlike in soft contact lenses, the material of scleral lenses does not undergo dehydration. However, scleral lens wearers may still feel some symptoms of dryness. It is essential, though, to be sure to be still able to remove your lenses when you get home, clean and store them properly. We have one patient who was too drunk

How to Know If Your Keratoconus is Progressing?

Keratoconus typically starts at puberty and progresses until the third or fourth decade of life. At initial diagnosis, younger patients with the steepest corneal curvature (Kmax) of over 55 D have a significantly greater risk of progression. Keratoconus seen at this age is more aggressive, leading to more severe cases. Without any management, the corneal curvature becomes more conical in shape, which can cause worsening of vision, thinning and scarring of the cornea, and possible development of hydrops. However, it tends to stabilize after 20 years from the first diagnosis. To detect keratoconus progression, some corneal parameters need to be evaluated. WHAT THE EYE DOCTOR IS LOOKING FOR? -Increase maximum corneal refractive power (Kmax) by more than 1 Diopter within one year. -An increase in (corneal) myopia by more than 3 Diopter or astigmatism by more than 1.5 Diopter within one year. -An average corneal refractive power increase by more than 1.5 Diopter within one year. -A reduc

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