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Fluctuating visual acuity first sign of possible astigmatism
Visual disturbances are not only associated with significant limitations in everyday life, they can also point to serious diseases such as a stroke. Likewise, eye diseases are to be mentioned as possible triggers, but today these can be successfully treated in many cases. One of these diseases is the deformation of the cornea, in the worst case a blindness of those affected. Early diagnosis and treatment is strongly advised.
The pathological deformation of the cornea (called keratoconus) is a widespread picture of the condition, which results in considerable impairment of visual acuity. While in a healthy eye the cornea lies flat on the eyeball and lens, "in keratoconus, there is an increasingly conical deformation and thinning of the cornea", explains Dr. med. Stefan Lang, Specialist at the Department of Ophthalmology of the University Medical Center Freiburg. The eyesight of those affected will be significantly reduced.
Deformation of the cornea causes significant vision impairment and, in the worst case, can lead to blindness. (Image: vicu9 / fotolia.com) Symptoms of astigmatism
The deformation of the cornea leads to a strongly fluctuating visual acuity, a distorted perception of the environment or even corneal tears and a consequent corneal clouding, which in the worst case can lead to blindness, so the announcement of the Freiburg University Hospital. The onset of disease usually lies in puberty, but it may take a while until a corresponding diagnosis is made.
In the long term mostly both eyes affected
In the course of the disease, "at first usually only an increasing myopia and astigmatism, which is why the glasses are often changed," explains Dr. med. Long. If corneal curvature is suspected, the cornea can be precisely measured by means of keratometry. It often shows initially only one eye affected, but in most cases, the second eye deteriorate over time, the ophthalmologist continues.
Course individually very different
The speed and severity of the disease varies greatly from patient to patient, reports the expert. In particular, in younger patients with a high risk of disease progression, a very close-knit care by experienced doctors is required to be able to intervene promptly. Because the treatment must be adjusted continuously.
Various possible treatment approaches
Initially, the deteriorating visual acuity can usually be compensated by a pair of glasses, but this does not stop the increasing deformation of the cornea. By dimensionally stable contact lenses this deformation can be counteracted. Also, a networking treatment may be useful to stop the progression of the disease or at least slow down, reports the Freiburg University Hospital. For this purpose, the so-called cross-linking is used, in which the soft cornea is treated with UV rays to achieve a stiffening and thus a slower deformation.
In the worst case, a corneal transplant is required
If the deformation is already very advanced, a corneal transplantation (keratoplasty) can restore vision very well, the Freiburg expert continues. A cornea transplantation shows a very good prognosis in patients with keratoconus and could last for many years Long. "Nevertheless, the lifetime of a transplant can be limited by rejection reactions or a new deformation," explains the ophthalmologist.
Causes not clarified conclusively
To further improve the therapy, according to Dr. med. Lang researched new treatment approaches worldwide, such as further development of the cross-linking procedure or optimized corneal transplantation. "We are working hard to improve the treatment to help patients as well as possible," says Dr. Long. Further work is also needed to investigate the causes of the disease, as so far the genesis has not been conclusively clarified and new treatment options could open up here. So far only known is that "in addition to genetic factors and possible environmental influences certain diseases, such as atopic dermatitis, favor a keratoconus," said the Freiburg ophthalmologist. In the case of an astigmatism of the cornea, it could also be aggravated by frequent eye rubbing. (Fp)