Understanding Keratoconus 

Keratoconus is a condition that affects the cornea, which is a clear, dome-shaped window that focuses light into your eye. Keratoconus occurs when the cornea thins out and bulges like a cone. The change in shape brings the light out of focus, resulting in blurry and distorted vision.  

Causes of Keratoconus:  

While the exact cause of keratoconus is not well known, it is believed to have a genetic component. Approximately 1 out of 10 people with keratoconus have a parent with the condition. Other factors may include:   

• Eye allergies  

• Excessive eye rubbing  

• Connective tissue disorders  

Symptoms and Diagnosis of Keratoconus  

Typically starting in late teens to early 20s, Keratoconus progresses over 10 to 20 years. It often affects both eyes, though the severity can differ between the two. Early symptoms may include:  

• Mild blurring 

• Slightly distorted vision  

• Increased sensitivity to light and glare  

• Eye redness or swelling  

In later stages, symptoms can include significantly blurred and distorted vision, increased nearsightedness, astigmatism, and difficulty and discomfort when wearing contact lenses.  

Keratoconus can be detected during a routine eye exam. Your primary eye doctor will examine the cornea and take measurements of its curvature to detect changes in shape. Corneal mapping can also provide a detailed image of the surface, helping to confirm the condition.  

Historical Treatments for Keratoconus  

In the past, treatment options for keratoconus were limited and/or involved invasive procedures. Often, eyeglasses or soft contacts were used just to correct the nearsightedness and astigmatism. As the condition progressed, doctors used the following methods:  

• Rigid Gas Permeable Contact Lenses: These lenses provide a smooth, stable surface to correct vision and act as a second surface for the eye. They compensate for the cornea’s irregularities and function as the eye’s new reflective surface.  

• Corneal Transplant: When all other treatments failed, a corneal transplant (keratoplasty) was used as a last resort. During this procedure, a damaged cornea was replaced with a healthy donor cornea. While generally effective, this procedure has a lengthy recovery period and a higher risk of infection and rejection.  

Modern Advancements in Keratoconus Treatment

In recent years, significant advancements have been made, offering less invasive options with promising outcomes.  

• Corneal Crosslinking (CXL): Corneal Crosslinking is a minimally invasive procedure that strengthens the corneal tissue to halt the progression of keratoconus. During CXL, drops are applied to the cornea, and then exposed to ultraviolent (UV) light. The UV light activates the drops creating bonds between collagen fibers in the cornea, increasing its strength and rigidity. This procedure can stabilize keratoconus and, in some cases, even improve shape and vision.  

• Advanced Laser Keratoplasty with Regional Segments (ALKRS): ALKRS is an innovative treatment that uses donor corneal tissue in a ring layer of the cornea. The donor tissue is cut to an exact size, allowing the surgeon to target the most irregular sections of the cornea. Unlike a full cornea transplant, ALKRS tissue is placed into a pocket within the natural cornea created by a laser during the procedure. The approach, often done in conjunction with Crosslinking, provides a more customized treatment with a faster recovery.  

What to Expect After Treatment 

Vision following keratoconus treatment can vary. Typically, one eye is operated on at a time, allowing patients to return to their normal activities within a few days. Glasses or contact lens prescriptions may change for a few months after the procedure, and the other eye is treated once the first eye is stabilized.  

Patients are advised to avoid submerging in water for two weeks to prevent contaminated water from getting into the eye. Additionally, controlling allergies, avoiding eye rubbing, and not sleeping on your face are essential to prevent keratoconus progression. 

Conclusion   

Keratoconus treatments have evolved dramatically, providing patients with more effective and less invasive options. Corneal Crosslinking and Advanced Laser Keratoplasty with Regional Segments represent significant advancements, offering new hope for those affected by this challenging condition. At Minnesota Eye Consultants, we are dedicated to staying at the forefront of these advancements, ensuring our patients receive the best possible care. If you are experiencing any symptoms of keratoconus or discomfort in your eyes, call Minnesota Eye Consultants to schedule an appointment at (952) 888-5800 or request an appointment.   

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Pickleball has gradually become America’s sweetheart, but the doctors at Minnesota Eye Consultants are seeing an increase in eye injuries as the sport gains popularity. Since a pickleball travels at approximately 40 mph, a close-range strike to the eye may result in a severe ocular injury. We spoke with two of our eye doctors about common eye injuries and safety measures to help protect you and your pickleball comrades from encountering a dangerous eye injury. Dr. David Hardten is a cornea, cataract, and refractive surgeon, and Dr. Jill Melicher is an oculoplastic and reconstructive surgeon. Read on to find out how to play this amazing sport safely.

What are the most common eye injuries associated with pickleball?

A direct hit by a pickleball to a certain area on the face could break the bones around the eye, potentially leading to double vision and other eye problems. Dr. Melicher has seen injuries ranging from cuts to the tissue around the eye and brow, to complete and permanent vision loss from a severe laceration to the eyeball itself. Other eye injuries include a cornea or sclera tear (the white outer tissue of the eye) and injury to the lens, iris, and retina.

What kind of surgeries are needed after pickleball injuries?

As you can imagine, many of the eye injuries we see may require surgery depending on the severity. Here are some of the injuries and procedures that have been performed at Minnesota Eye Consultants as a result of pickleball trauma:

• using sutures to repair eyelid and brow lacerations
• dislocation of the natural lens, often requiring a new lens and cataract extraction
• damage to the pupil, resulting in the need to suture the pupil smaller
• replacing a damaged iris with an artificial iris
• retinal detachment, leading to retinal surgery
• total loss of an eye, requiring surgical removal

What are the long-term effects of injuries sustained during sports like pickleball?

All the injuries and issues we’ve discussed could require a long-term need for eyecare. Another example would be an injury to the drainage system of the eye (trabecular meshwork); this may lead to glaucoma many years later.

Good News: Eye injuries can be prevented!

The good news is, when precautions are taken, eye injuries can be rarer than a pickleball player who doesn’t argue over line calls. Safety glasses are the name of the game – literally. Dr. Melicher advises players to wear polycarbonate safety glasses so they can have a great time while minimizing injury risk to the eye.

Safety glasses are very important in sports like pickleball, tennis, and racquetball. Any sport that involves a moving ball should have protective glasses. When an athlete is wearing safety glasses and protective eyewear, the trauma from a ball is translated to the bones around the eye rather than the eye itself, reducing the damage that can happen.

For all you enthusiasts, we’re not trying to rain on your pickleball parade, but we do want you to play it safe. Continue enjoying this amazing sport, but do it safely by wearing protective eyewear. The next time you pack your paddle for your pickleball game, grab your safety glasses too!

If you have a pickleball-related injury resulting in a change or decrease in your vision, please seek an evaluation with your eye care provider or call Minnesota Eye Consultants at (952) 888-5800.

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While some people may be familiar with various corneal conditions, many do not fully understand Keratoconus and the components linked to this cornea disorder. At Minnesota Eye Consultants, our cornea surgeons want to make sure that patients understand the symptoms, risk factors, treatment options, and other aspects connected to keratoconus. Read on to learn more!

What is Keratoconus?

Keratoconus (KCN) is a thinning disorder of the cornea in which the round, symmetrical shape of the cornea is distorted, and a cone-like bulge develops, resulting in significant vision problems. At certain times, objects may appear as though you’re looking through warped and distorted glass. The progression of Keratoconus is generally slow, and it sometimes stops progressing with age. However, Keratoconus doesn’t get better on its own if left untreated.

What are the Signs and Symptoms of Keratoconus?

The first indication of Keratoconus is a blurring and distortion of vision. In the early stages, this may be corrected with glasses. Eventually, vision cannot be completely corrected by glasses and contact lenses would be required. Scarring or swelling of the cornea may also develop as symptoms in later stages.

Who is affected by Keratoconus?

Keratoconus is not rare, and it has been estimated to affect vision in about 1 out of every 2,000 persons in a general population. It may also be present without symptoms in as many as 1 in 500 people. The disease usually shows up in young people in their teen years but can also be diagnosed in individuals that are older.  

Keratoconus has a genetic component and often runs in families. Other risk factors include allergies (which often lead to eye rubbing) and sleep apnea. With time, eye rubbing can worsen corneal thinning and increase irregular astigmatism. Patients with sleep apnea often sleep on their stomach or side to avoid snoring. Sleeping in this position can put pressure on the eyes which can also contribute to keratoconus progression. In general, the earlier in life someone has symptoms, the worse the disease eventually becomes.

What are the treatment options for Keratoconus?

Treatment options for keratoconus are directed toward two primary goals. The first goal is to halt the progression of the irregular curvature, and “lock in” your vision where it is today. This is accomplished with corneal crosslinking. The second goal of keratoconus treatment is to improve your quality of vision by neutralizing the astigmatism caused by irregular curvature. This is accomplished with specialty contact lenses, corneal inlays, or corneal transplants.

Corneal Crosslinking: Most patients diagnosed with keratoconus, regardless of severity, qualify for corneal crosslinking. Crosslinking is a technique that uses ultraviolet (UV) light and a photosensitizer called riboflavin (vitamin B2) to strengthen the cornea and is intended to reduce the progression of keratoconus. Watch video now.

Anterior Lamellar Keratoplasty with Regional Segments (ALKRS): ALKRS uses donor corneal tissue in a ring layer of the cornea. The donor tissue is cut to a specific size based on each patient’s pre-operative measurements. This allows the surgeon to target the most irregular sections of the cornea. As opposed to a full-thickness transplant, ALKRS tissue is placed into a pocket within the natural cornea created by a laser during the procedure.

ALKRS is primarily done in conjunction with collagen crosslinking. At Minnesota Eye Consultants, we often perform ALKRS and corneal crosslinking on the same day. The healing of ALKRS after the operation is rather quick and the recovery will likely be similar to a typical crosslinking recovery. Patients can expect some side effects such as light sensitivity, blurry vision, irritation, and mild discomfort.

What happens after the treatment?

Vision following the procedure is different for each patient. Because just one eye is operated on each time, the other eye isn’t affected, and most patients go back to work in a few days.

Glasses or contact lens prescriptions change for a few months after the procedure, and the other eye is typically done when the first eye has glasses or contacts that can work for the patient.

As with many corneal procedures, patients are advised to avoid saunas, pools, or hot tubs for two weeks to prevent contaminated water from getting into the eyes. All patients diagnosed with keratoconus are strongly encouraged to control allergies, avoid eye rubbing, and avoid sleeping on their faces to prevent progression.

If you’re experiencing any symptoms of keratoconus or having discomfort in your eyes, call Minnesota Eye Consultants at (952) 888-5800 to schedule an eye exam.

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At Minnesota Eye Consultants, we strive to provide excellent eye care to not only our patients, but our patients’ families as well. As a result of this relationship, we suggest that children and relatives of those diagnosed with Keratoconus be seen for an eye exam with their primary eye care provider. This disease is often thought of as a “young person’s disease” as it tends to be more prevalent in individuals in their teens and twenties and the progression often occurs more rapidly in younger generations. Keratoconus is a progressive disease and because of concern about the possible continued deterioration of vision over time, early detection and management is incredibly important.

If you or a family member has been diagnosed with Keratoconus, we’d like to encourage an appointment for your other relatives, especially the younger members of your family, for further screenings and closer corneal evaluation. We recommend you schedule this appointment with your regular family eye doctor. To find an Optometrist office near you, visit our Affiliated Doctors page. If you’d like to see one of the Doctors of Optometry at Minnesota Eye Consultants, we’d be happy to serve your family. Our scheduling specialists can be reached at 952-888-5800.

The post Did You Know Keratoconus is Hereditary? appeared first on Minnesota Eye Consultants.

Did you know that YOU have the power to build hope and restore sight by becoming an eye donor? Registering as an eye, organ and tissue donor is easy and will truly change the lives of others.

We have six corneal surgeons at Minnesota Eye Consultants who perform cornea transplants on a regular basis, bringing vision back to those in need. In fact, our surgeons perform more corneal transplants than any other group in Minnesota, including the academic institutions. We do about 400 surgeries a year, which is approximately half of the transplants done in the state.

What is the Cornea?
The cornea is the transparent front part of your eye, covering the iris (the colored part) and pupil (the black center). The cornea is often compared to the windshield of a car, as it’s the barrier between the inside of the eye and the outside world. Images enter your eye as light, then are transmitted and sent to your brain for processing. This is how you see.

Why would someone need a Cornea Transplant?
Cornea transplants are usually performed when patients lose vision as a result of an eye disease, infection, or an injury that causes scarring or a disruption in the vision. Fuchs’ Corneal Dystrophy and Keratoconus are two common reasons we perform cornea transplants.

Fuchs’ Corneal Dystrophy is a condition in which the “pumper cells” that line the endothelium begin to deteriorate and aren’t as effective at pumping liquid from the cells. This excess fluid in the cornea causes swelling, which leads to cloudy and blurry vision.

Keratoconus is a condition that causes the cornea to become thin, weak and misshapen. The cornea actually bulges outward, causing blurry vision and makes it very difficult to fit the patient for corrective contact lenses or even glasses.

What is a Corneal Transplant?
During a cornea transplant procedure, the damaged corneal tissue is removed and replaced with a healthy donor cornea. There are several different kinds of transplants, depending on the need of the patient. In some circumstances, only a small portion of the cornea is damaged, so a partial transplant can be performed (a DSEK or DMEK), offering a quicker recovery. Other patients require a full-thickness corneal transplant where the entire cornea is replaced.

Please consider giving the gift of sight by registering as an eye, organ or tissue donor. This selfless act will no doubt have a monumental impact on someone’s quality of vision (and life!).

For more information about eye, organ and tissue donations, please visit the Eye Bank Association of America. 

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18. The number of years Minnesota Eye Consultants has been involved with Artificial Iris research studies. We entered our most recent Artificial Iris study in 2013, with the CustomFlex® Artificial Iris however we began using Artificial Iris’ in 2000, as we were involved in a different study at that time. In 2010, we started using the now-approved CustomFlex® Artificial Iris using compassionate use process.

35. The number of eyes treated within just the most recent Artificial Iris research study at Minnesota Eye Consultants (2013-2018). Altogether, we’ve performed this procedure over 90 times since the year 2000, often under the compassionate use process.

11. The number of physician investigators at Minnesota Eye Consultants who have been involved in these essential Artificial Iris research studies. (Primary Investigator: Dr. David R. Hardten, Sub-Investigators: Drs. Thomas W. Samuelson, Elizabeth A. Davis, Sherman W. Reeves, Mark S. Hansen, Alyson L. Blakstad, Ahmad M. Fahmy, Mona M. Fahmy, Tara R. Barth, Johnna D. Hobbs and Mark R. Buboltz.)

0. The number of months until the U.S. Food and Drug Administration approves the CustomFlex® Artificial Iris. That’s right –  0. After approximately 20 years of being studied in the US, the CustomFlex® Artificial Iris has officially received the stamp of approval from the FDA. As a practice with a dedicated Research Department actively involved in Artificial Iris studies, we are ecstatic for this news and truly honored to have been part of this research for nearly the past two decades.

You might be wondering, “What is an Artificial Iris?”. It’s a prosthetic iris intended to replace a patient’s missing or damaged iris (the colored part of the eye). The iris plays an important part in our vision, adjusting incoming light as we change environments. An absent or partially functioning iris can cause extreme light sensitivity and glare, and even impact the sharpness of vision.

The newly approved device can be used on a variety of Iris defects (issues from a traumatic injury, for instance), but is often utilized by individuals with Aniridia (a disorder in which the iris is either partially or completely missing). Although rare, this can be devastating to those affected, both visually and cosmetically. The Artificial Iris not only offers these individuals improved vision by reducing light sensitivity and glare, but it also has the potential of cosmetically improving the appearance of the iris.

Each CustomFlex® Artificial Iris is 100% customized to the individual in need, and the details and care put into each prosthetic iris is truly remarkable. In addition to the size of the device being personalized, the colors within the CustomFlex® Artificial Iris are created to replicate those in the iris of the patient’s uninjured or unaffected eye (if one is present). The silicone CustomFlex® Artificial Iris is made in Germany and as you can imagine, takes quite a while to customize for the patient (approximately 2 months).

Although it often takes years after approval of a technology for insurance to cover devices (even when they are medically indicated), we couldn’t be more excited to be moving in the right direction.

For more information about the Artificial Iris, please contact our Research Department at (612) 813-3607 or read the full press release. 

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We keep these goals in mind each and every day as we set forth to care for our patients. Our hope is that you truly feel our warmth, determination and compassion at every step of your visit with us. We are forever grateful for our amazing patients and for the opportunity to serve our community members and beyond!

Listen to what some of our patients are saying about their experience with MN Eye, and we hope you feel the same about your visit with us.

Marilyn | Cornea Transplant Patient

Matt | LASIK Patient

Shari | Natural Lens Replacement Patient

Greg | Cataract Surgery + the Symfony Lens

The post VIDEO: Listen to What Our Patients Are Saying appeared first on Minnesota Eye Consultants.

Today, Kailee is happy to report that she’s celebrating 9 years of restored vision! It’s so touching to hear updates like this from our patients, and although we’re truly honored to be part of Kailee’s story, it’s important to remember the unnamed hero here – her cornea donor. A selfless individual agreed to donate his or her organs, ultimately resulting in renewed vision for this amazing young woman. To all the organ donors out there, both current and past, please accept our whole-hearted thank you for giving someone this life-changing gift of hope.

To learn more about eye donation, visit www.mnlionseyebank.org.

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