By Dr. Nadine Shelton
Keratoconus Eye Disease Background
A couple of weeks ago, I was checking the CBC app on my phone and came across a story about a lady in Ontario who had been diagnosed with Keratoconus. Ontario Health does not cover Collagen cross-linking corneal surgery (CXS) hence, sharing her story with the media. (http://www.cbc.ca/news/canada/ottawa/ottawa-woman-facing-blindness-pleads-with-province-to-cover-sight-saving-procedure-1.4594136). A few patients have asked me about it since then. Keratoconus, is a disease that causes a central thinning of the cornea, as a result causes the cornea to bulge out and form a cone like shaped. This change in shape causes the light rays to become out of focus and this distorts the vision. The cause is somewhat unknown but genetics does play a role as 1/10 people with Keratoconus have a parent with it too. It usually starts in the late teens to early 20s and the visual symptoms get worse over the next 10-20 years.
Diagnosis and Treatment of Keratoconus
Diagnosis by an optometrist and/or ophthalmologist, usually involves doing a map of the corneal surface with a special machine. Treatment options depend on your symptoms with most patients having a mild form and needing regular glasses correction updates. As the disease progresses, hard contact lenses may provide better vision as they create a more normal surface to focus the light rays. In more severe cases, an ophthalmologist may choose to use one of the following:
Intacts: small curved device that is implanted into the cornea to flatten the cone shaped curve of the keratoconus eye;
CXS: involves strengthening the cornea by using a special UV light and eye drops which causes it to flatten or stiffen and prevents it from bulging further. The UV light creates new collagen bonds and makes the surface more stable; and
Corneal transplant: replacement of the diseased cornea with a healthy donor cornea tissue.
Current reality in Manitoba
Manitoba Health does not cover CXS and in addition carries an associated cost of about $900 per eye. For more answers to your disease questions, please contact Dr. Nadine Shelton at nv eye care eye wear, 204-504-6863.