The end stage of keratoconus requires what is called a cornea transplant, to replace the cornea with a donated cornea from someone who's passed away and donated their eye.
Fortunately now, in the last five years, we've really changed the management of keratoconus to where we can prevent advancement from mild or moderate keratoconus to advanced keratoconus. With things like intacs, which are rings that are placed inside the cornea that provide structural support, they're essentially an under-wire for the cornea to change it from a cone to a sphere.
As well as the emerging technology of cross-linking, where we use a laser to stiffen the cornea and prevent weakening of the cornea. Ambati: It is a hereditary problem with what's called variable penetrance. So if you have a first degree relative with it you're at a higher risk for it.
Miller: And so if someone has a family history of keratoconus should they seek out an ophthalmological examination and a cornea scan? Ambati: I think that would be advisable if they have any significant near-sightedness or astigmatism. One of the things that we do at Moran Eye Center is to carefully screen patients coming in for potential LASIK or laser vision correction to make sure they don't have keratoconus or other cornea problems.
Miller: So just to be sure, if one has keratoconus does it always require a transplant or is there, as you said, variable stages of the development of the problem?
Ambati: It is definitely a spectrum of progression, and if we can catch it in the mild or moderate stage the goal would be to employ intacs, or cross-linking, or some of these other options to prevent the need for cornea transplant. Miller: Are there any other problems with the cornea? I notice since the cornea is the forward facing part to the environment, UV radiation, sunlight, does that affect the cornea more so than other parts of the eye such as the lens or retina?
Ambati: Certainly patients who are exposed to a lot of sunlight and UV light can develop pterygium, which is a growth on the surface of the cornea. Ambati: Indeed. And the UV radiation can also damage the back layer of the cornea, which is the endothelium. They can be helpful in improving the vision of people with very severe short-sightedness or those who have difficulty wearing glasses or contact lenses. Both types of implant are usually inserted under a local anaesthetic and you'll normally be able to return home the same day.
Each eye will usually be treated on separate occasions. Phakic lens implants may achieve better results than lens replacements in terms of improving vision on a long-term basis. But the technique carries a higher risk of complications, such as cataracts. Overall, most people will experience a significant improvement in their vision. A lens replacement may be more suitable for older adults with damage to their eyes or an eye condition other than short-sightedness, such as cataracts or glaucoma.
Also, as both techniques are relatively new, there's little information about whether they're safe or effective in the long term. Like all medical procedures, surgery to place artificial lens implants in the eyes carries a risk of complications. Posterior capsule opacification PCO is one of the most common complications of lens implant surgery. This is where part of the artificial lens becomes thickened and cloudy.
PCO usually occurs a few months or years after having surgery. Treatment for PCO can involve having laser surgery to remove the thickened part of the lens. You should talk to your doctor or surgeon about each procedure so you're fully aware of any risks involved. The younger they are when they start becoming short-sighted, generally the faster their vision deteriorates and the more severe it is in adulthood. But it may be slowed by treatments involving eye drops of a medication called atropine, or special contact lenses.
Research has shown that atropine eye drops can slow the progression of short-sightedness, but it can cause side effects at high strengths such as difficulty reading and sensitivity to bright light.
Orthokeratology and bifocal contact lenses may also slow down short-sight progression in children, but possibly not as much as the eye drops, and they carry small risks. Page last reviewed: 30 July Next review due: 30 July Corrective lenses Glasses Short-sightedness can usually be corrected using glasses made specifically to your prescription. The thickness and weight of the lenses you need will depend on how short-sighted you are. Contact lenses Contact lenses can also be used to correct vision in the same way as glasses.
Some opticians very occasionally use a technique called orthokeratology. Age-related changes in the eyes often begin in your late 30s to early 40s. Most of the potential vision issues that can come up for young adults are going to be related to eye strain or possible eye injuries. Eye strain can be the result of looking at screens and long-term exposure to blue light, such as that emitted by computers, smartphones, and television sets.
Often, young adults spend a lot of time looking at screens, and this can contribute to tired, irritated, and strained eyes. Digital eye strain, or computer vision syndrome CVS , can happen from prolonged screen time.
Most American adults spend around seven hours every day looking at a computer screen. This can cause CVS , which can include the following symptoms:. Eye strain from spending so much time looking at a screen can be minimized by following the rule. Every 20 minutes, look at least 20 feet away for about 20 seconds at a time. This can help to reduce symptoms of computer vision syndrome, as it allows your eyes time to relax and re-center.
Eye fatigue and strain are common in your 20s and 30s, as you likely spend a lot of time at the computer, on your smartphone, and watching tv. Exposure to blue light from these devices can be harmful to the eyes over time. Try and rest your eyes when they get dry, strained, and irritated. Take frequent breaks from your screen.
Reducing your exposure to blue light and screens for at least an hour or two before bed can help you to get more restful sleep as well. It can be tough to cope with worsening vision, particularly when it seems to happen earlier than expected. If your vision is worsening in your 20s, you might be struggling to adjust to that reality.
Even with decreased vision, you can still live an active life. Some modifications can help you adapt to worsening vision. The best thing you can do for your eyes to protect them as you age is to make good lifestyle choices , such as not smoking and eating a healthy and balanced diet.
While not everyone will experience the same symptoms, the following are common age-related vision changes:. If you have never needed eyeglasses or contact lenses to correct distance vision, then experiencing near vision problems after age 40 can be concerning and frustrating.
You may feel like you've abruptly lost the ability to read the newspaper or see the cell phone numbers. These changes in your focusing power have been occurring gradually since childhood. Now your eyes don't have enough focusing power to see clearly for reading and other close vision tasks. Losing this focusing ability for near vision, called presbyopia, occurs because the lens inside the eye becomes less flexible.
This flexibility allows the eye to change focus from objects that are far away to objects that are close. People with presbyopia have several options to regain clear near vision.
They include:. As you continue to age, presbyopia becomes more advanced. You may notice that you need to change your eyeglass or contact lens prescriptions more frequently than you used to. Around age 60, these changes in near vision should stop, and prescription changes should occur less frequently. Presbyopia can't be prevented or cured, but most people should be able to regain clear, comfortable near vision for all of their lifestyle needs.
This is also the time in life when your risk for developing a number of eye and vision problems increases. The following symptoms could be the early warning signs of a serious eye health problem:. Healthy eyes and good vision play a critical role in how infants and children learn to see. Preschoolers depend on their vision to learn tasks that will prepare them for school.
A child needs many abilities to succeed in school and good vision is key. Forgot username or password? You do not have access to this content. Join the AOA today! Eye Health for Life. Middle-aged adults will begin to notice slight changes in their vision which can progress over time.
Adults over 40 who have the following health or work issues may be particularly at risk for developing eye and vision problems: Chronic, systemic conditions such as diabetes or high blood pressure.
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