Corneal Ectasia: Symptoms. Causes, Treatment

What are the symptoms of corneal ectasia?

Corneal ectasia is a rare condition that causes progressive thinning and bulging of the cornea, which can lead to vision distortion and other visual problems. The symptoms of corneal ectasia can include:

1. Blurred or distorted vision: This is often one of the first symptoms, and it may worsen over time.
2. Increased sensitivity to light (photophobia): Bright lights may cause discomfort or glare.
3. Ghosting or double vision: You may see multiple images of a single object.
4. Halos around lights: Lights may appear to have a halo or aura around them.
5. Astigmatism: Corneal irregularities can lead to astigmatism, causing blurry or distorted vision at all distances.
6. Eye strain or discomfort: You may experience eye pain, headaches, or general discomfort.
7. Difficulty with night vision: Night driving or low-light environments may be particularly challenging.

If you’re experiencing any of these symptoms, it’s important to see an eye care professional for a comprehensive eye exam and diagnosis.

What are the causes of corneal ectasia?

Corneal ectasia is primarily caused by weakening of the corneal structure, leading to progressive thinning and bulging of the cornea. The exact cause of this weakening is not always clear, but several factors and conditions are known to contribute to the development of corneal ectasia. These include:

1. LASIK or other corneal refractive surgeries: While rare, corneal ectasia can occur as a complication of LASIK or other corneal refractive surgeries, particularly when there is underlying corneal weakness that was not detected before surgery.
2. Keratoconus: This is a progressive eye condition where the cornea thins and bulges outward into a cone shape, leading to irregular astigmatism and visual distortion. Keratoconus is a major risk factor for developing corneal ectasia.
3. Genetics: There is evidence to suggest that genetics play a role in corneal ectasia, as it can sometimes run in families.
4. Chronic eye rubbing: Excessive rubbing of the eyes over time can weaken the corneal structure and potentially contribute to corneal ectasia.
5. Corneal thinning disorders: Certain conditions that cause corneal thinning, such as pellucid marginal degeneration, can increase the risk of corneal ectasia.
6. Eye conditions: Other eye conditions, such as high myopia (nearsightedness), can also be associated with corneal ectasia.

It’s important to note that while these factors are associated with corneal ectasia, the condition can sometimes occur without any known underlying cause. If you are at risk or experiencing symptoms, it’s important to have regular eye exams to monitor your eye health.

What is the treatment for corneal ectasia?

The treatment for corneal ectasia depends on the severity of the condition and its progression. Some common treatment options include:

1. Glasses or contact lenses: In the early stages, glasses or rigid gas permeable (RGP) contact lenses may be used to correct vision and provide better visual acuity by compensating for the corneal irregularities.
2. Corneal cross-linking (CXL): This is a procedure that involves applying riboflavin (vitamin B2) eye drops to the cornea and then exposing it to ultraviolet (UV) light. CXL is aimed at strengthening the cornea and slowing or halting the progression of ectasia.
3. Intrastromal corneal ring segments (ICRS): Also known as corneal implants or inserts, these are small plastic rings that are surgically placed in the cornea to help reshape it and improve vision.
4. Topography-guided conductive keratoplasty (CK): This is a non-invasive procedure that uses radiofrequency energy to reshape the cornea and improve visual acuity.
5. Corneal transplant: In advanced cases where other treatments are not effective, a corneal transplant (keratoplasty) may be necessary. During this procedure, a surgeon replaces the damaged corneal tissue with healthy donor tissue.
6. Scleral contact lenses: In some cases, specially designed scleral contact lenses that vault over the cornea and rest on the sclera (white part of the eye) can provide improved vision and comfort.

The choice of treatment depends on various factors, including the severity of the ectasia, the rate of progression, and the patient’s individual needs and preferences. It’s important to consult with an eye care professional to determine the most suitable treatment option for your specific case.

What is the difference between keratoconus and corneal ectasia?

Keratoconus and corneal ectasia are related conditions that involve thinning and bulging of the cornea, but they differ in their causes and associations:

1. Keratoconus: This is a progressive eye condition in which the cornea gradually thins and bulges outward into a cone shape. It typically begins in adolescence or early adulthood and can progress over several decades. Keratoconus is often associated with a family history of the condition and is sometimes linked to conditions like atopic dermatitis and allergic rhinitis.
2. Corneal Ectasia: Corneal ectasia is a broader term that refers to the general weakening and bulging of the cornea, which can occur due to various factors. While keratoconus is a form of corneal ectasia, not all corneal ectasia is classified as keratoconus. For example, corneal ectasia can occur as a complication of LASIK surgery in some cases.

In summary, keratoconus is a specific type of corneal ectasia characterized by progressive thinning and conical protrusion of the cornea, while corneal ectasia is a more general term that describes the weakening and bulging of the cornea, which can have various underlying causes.