Hydrops in Keratoconus

Heard about corneal hydrops? This is a not so common complication found in patients with advanced keratoconus. What exactly happens when you develop corneal hydrops? The normal average thickness of a cornea is about 550 microns. When we were studying, our professor often says that it is thinner than a credit card. So, a patient with keratoconus may have corneas thinner than 500 microns, the thinnest so far I have seen is about 200 some microns. Now, when the cornea continues to thin down, some layers may break, which can cause fluid from the internal environment to leak out. In hydrops, the Descemet's membrane, which is the 4th layer of the cornea, ruptures, when this happens, the aqueous fluid inside the eye may leak towards the stroma-- the 3rd corneal layer--- causing corneal swelling. You may develop blurring of vision, glare and pain. When this happens, you have to quickly go to your corneal specialist who will be managing the condition. Conservatively, acute hydrops are managed with the use of antibiotics, cycloplegics, hypertonic solution and bandage contact lenses. If managed on time, vision may recover. What happens to the cornea? Scar from the hydrops can be seen, and the area of the cornea may be flattened.

Recently, I just fitted a 14 year old patient who had corneal hydrops. When he came in, he was not able to recognise faces for his right eye, after fitting him with scleral lenses, his vision improved to 20/24, which is 3 lines away from the best 20/20 line.

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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?

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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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