While nearsightedness and astigmatism are familiar terms, most people may be puzzled by keratoconus. Yet these conditions share a connection, as keratoconus often manifests as rapidly worsening myopia and irregular astigmatism. In ophthalmology clinics, patients frequently report declining vision and astigmatism but struggle to find suitable glasses at optical stores.Only after examination do they receive a diagnosis of keratoconus.
Li Dong (pseudonym), a resident of Binyang County, Nanning City, visited the hospital due to severe vision loss and astigmatism. Li Dong recalled that his work required frequent computer and smartphone use. When his vision became blurry, he initially attributed it to eye strain from insufficient sleep, assuming more rest would resolve the issue.but his vision continued to deteriorate over time. He finally sought treatment at Nanning Aier Eye Hospital, where he was diagnosed with keratoconus. Unfortunately, his right eye had progressed to an advanced stage, requiring a corneal transplant. Fortunately, his left eye was still in the early stages and could be managed with corneal collagen cross-linking surgery to slow progression.
Rapid Vision Decline in Adolescents: Be Alert to Keratoconus
The cornea is the transparent tissue covering the front of the eyeball. Keratoconus is a common blinding eye disease characterized by thinning of the central and paracentral corneal stroma, with the central apex protruding into a cone-shaped deformation.Dr. Huang Minghai, Director of the Cornea and Ocular Surface Department at Nanning Aier Eye Hospital, notes that keratoconus predominantly occurs during adolescence, with individuals aged 10 to 25 being the primary affected group.
The primary clinical symptoms of keratoconus involve visual changes, leading to high irregular astigmatism and persistent vision deterioration:
1. Rapid vision decline with rapidly increasing prescription even after glasses correction;
2. Significant irregular astigmatism where contact lenses provide limited visual improvement;
3. Severe vision loss where no corrective lenses can restore normal vision.
Early detection and control prevent advanced corneal transplantation surgery.
Keratoconus progresses through latent, initial, advanced, and late stages. Treatment approaches vary by stage.Dr. Huang Minghai notes that while early-stage keratoconus can be corrected with eyeglasses or rigid gas-permeable (RGP) contact lenses, studies indicate these cannot effectively halt disease progression. Currently, corneal cross-linking is an ideal treatment for early-stage keratoconus, successfully preventing progression in the vast majority of cases.In contrast, advanced-stage keratoconus necessitates corneal transplantation. This procedure not only offers no guarantee of improved vision post-surgery but also carries risks of corneal graft rejection. 【Corneal Transplantation】 Dr. Huang Minghai notes that in clinical practice, many patients present at the hospital only after keratoconus has progressed to its advanced stage.Had the condition been detected years earlier and treated promptly with corneal collagen cross-linking, progression to the advanced stage requiring transplantation might have been avoided. Therefore, adolescents experiencing vision loss or irregular astigmatism that does not respond well to eyeglass correction should undergo ophthalmic examination to confirm whether they have keratoconus. Early-to-mid-stage diagnosis allows for timely treatment with corneal collagen cross-linking.
Corneal Collagen Cross-Linking: The Future Trend in Keratoconus Treatment
According to Dr. Huang Minghai, corneal collagen cross-linking uses riboflavin as a photosensitizer. By applying 365nm ultraviolet light to specific areas of the cornea, it stimulates collagen fiber cross-linking to enhance corneal rigidity and resistance.Currently, this therapy is recognized as the only effective treatment for progressive keratoconus. It not only halts or slows corneal expansion in keratoconus but also offers hope for treating conditions like keratitis and refractory corneal ulcers.The introduction of this therapy in Guangxi is welcome news for keratoconus patients, enabling early-to-mid-stage disease control and preventing progression to advanced stages that necessitate corneal transplantation. 【Corneal Collagen Cross-Linking Equipment】 Although corneal collagen cross-linking therapy has been practiced internationally for years, few hospitals in China currently offer this treatment.Nanning Aier Eye Hospital has recently performed successful corneal collagen cross-linking surgery on nine patients with keratoconus. The application of this technology in Guangxi will provide new treatment options for patients in the early to mid-stages of keratoconus. Hospital Address: No. 126 Xiuling Road, Xixiangtang District, Nanning City, Guangxi (Nanning Aier Eye Hospital)