What would it be like to have a degenerative disease of the cornea? Ultimately resulting in the need for a corneal transplant, keratoconus (KC) breaks down and thins the corneal tissue until vision is impacted in major ways.

1. by Gary G. Abud, Jr. Pictures courtesy of www.kcvision.org Keratoconus

2. Keratoconus KC is a progressive and degenerative disease of the cornea Vision is affected in several ways simultaneously, including ghosting, blurring, double vision, and a haloing effect Both genetic factors and mechanical strain have been hypothesized to lead to the disease Course of treatment varies from mild KC (glasses) to moderate KC (special contact lenses) to severe KC (transplantation of cornea, in part or whole)

3. What Keratoconus (KC) Does to the Cornea

4. A Normally Seen (20/20) Parking Sign

5. Parking Sign: Mild Keratoconus

6. Parking Sign: Advanced Keratoconus

7. Keratoconus Causes Double Vision

8. The Eye Chart

9. Slight Image Distortion with Mild KC

10. Normal View of Building without Glare

11. Glare: Mild Keratoconus

12. Glare: Moderate Keratoconus

13. Glare: Advanced Keratoconus

14. KC Causes A Halo Effect Around Night Lights

15. Keratoconus Makes Night Driving Difficult

16. Sometimes Night Driving is Impossible

17. The Moon Seen Normally

18. Double Vision: Moderate Keratoconus

19. Double Vision: Advanced Keratoconus

20. A Clear Image of a Navy Plane

21. “Ghosting” of Image: Very Mild KC

22. “Ghosting” of Image: Mild KC

23. “Ghosting” of Image: Moderate KC

24. “Ghosting” of Image: Advanced KC

25. “Ghosting” of Image: Very Advanced KC

27. Glasses can help in early stages

28. Hard contact lenses must be worn as KC progresses, but then lens fitting is difficult

29. Eventually, the only alternative is surgerya cornea transplant Glare Ghosting Distortion Halo Effect Double Vision Poor Night Vision

30. A Cornea Transplant Can Replace the Diseased Keratoconus Cornea, but Recovering Useful Vision Takes Time

31. Cornea Transplant Vision: 2 Days After

32. Cornea Transplant Vision: 1 Month After

33. Cornea Transplant Vision: 2 Months After

34. Cornea Transplant Vision: 4 Months After

35. Cornea Transplant Vision: 6 Months After

36. The Clear Image

37. Treatment Success The success of any form of treatment depends on the progression of the disease Corneal transplantation, although highly successful, is reserved for the more severe cases The transplanted cornea, once fully healed, can give rise to vastly improved vision compared to pre-transplantation keratoconus vision Many new techniques in transplantation and contact lens fitting make treating keratoconus much more manageable

38. G. Abud 2011 Keratoconus