Keratoconus - What Is It?

Hi,

I am Dr. Aditi Manudhane, Ophthalmologist and mai cataract, cornea and refractive surgeon hun. Aaj hum baat karenge keratoconus ke baare mein. Sabse pehle aap ko ye samjhna hoga ki keratoconus kya bimari hai. Kerato means cornea yanike humari kali putli hoti hai, oconus means tricone. Is bimari mein humari normal cornea uska aakar dheere dheere tricone ho jata hai. Ye bimari 10-15 years ke bachon mein shuru hoti hai aur 30-40 years ke logon mein bhi paayi jaa sakti hai. Keratoconus humare India mein bohut hi common hai. Iske kya karan ho sakte hain? Aapne dekha hoga ki bohut se logon ka number sthir nahi hota hai aur cylindrical number badalte rehta hai. Sabse pehla sign ki is patient ko keratoconus ki bimari hai ye humein kaise pata chalti hai. Agar number baar baar badal raha hai toh hum shak kkar sakte hain ki aise patient ko keratoconus ki bimari ho. Dusra common factor hai eye rubbing. Jo bache constantly aankhon ko rub karte hain ya fir baar baar allergy ki bimari hoti hai toh ye bada risk factor hai is bimari ke liya.

Jis bache ka number 1 se jyada ho aur baar baar badal raha ho, aise humein doubt hota hai ki ye bimari ho. Inki screening bohut jaruri hai. Ab mai aap ko btaungi ki is bimari ko diagnose kaise karte hain. Is bimari ko pakdane ke liya corneal topography ki jaanch ki jaati hai. Ismein humein putli ki motayi pata chal jaati hai aur uska curvature pata chal jaata hai. Ye isliya kiya jaata hai kyuki bimai jitni jaldi pakdi jaaye uska ilaj utna jaldi possible and successful hota hai. Aur bimari ko hum stabilize kar jaate hain. Jaise jaise bimari advance hot hai, iska treatment utna hi complicated ho jaata hai. Isliya jaruri hai ki bimari ko hum time se diagnose karen. Agar kisi patient ko keratoconus diagnose hota hai aur uski cornea ki motayi 400 microne se jyada hoti hai to hum ek parkriya karte hain jise cornea collagen crosslinking kehte hain. Ye treatment bimari ko apni jgha pe rok sakti hai. Is se cornea strong ho jaati hai and aage chal ke patla hone se ruk jaati hai. Is bimari ko yahi roka jaa sakta hai. Putli ki motayi agar 400 se kam hai toh hum cornea collagen crosslinking nahi kar sakte. Ek dusri parkriya bhi hoti hai jise hum intacs kehte hain.

Is mein plastic ki rings hoti hain. Jise hum laser ke through cornea min daal dete hain. Is se tricone ko flatten kiya jaa sakta hai. Patient ke number ko thoda kam kiya jaa sakta hai. Tisra option hai contact lens ka. Jab humne cornea collagen crosslinking kar di and bimari ko rok diya, toh patient ko achi vision dene ke liya specs ya fir contact lenses use karne pad sakte hain. Aise patients ke liya contact lenses ke bohut different options hote hain. Inhe hum RGP lenses advise karte hain. Jarurat padne par mini sclera lens bhi advise karte hain. Especially un cases mein jinmein cylindrical power bohut jyada ho. Aise in patients ki vision improve kar jaati hai. Advance cases mein agar cornea ke thickness 400 se kam ho jaati hai toh aise patients mein humein corneal transplant ki jarurat padti hai. Ye transplant bhi 2 types ke hote hain. Ek hai penetrating keratoplasty and 2nd is deep anterior lamellar keratoplasty. Keratoconus mein transplant ke options bohut ache hote hain. Deep anterior lamellar keratoplasty mein aage ke layers jo effect hue hain unhein replace karte hain. Last mein mai ye kehna chahungi ki aagr kisi ka bhi high cylindrical power hai aur vo stable nahi hai, badhta jaa raha hai toh is bimati ko rule out karna bohut jaruri hai. Kyuki jitna jaldi is bimari ko pakda jaaye uthna hi acha hai. Aur agar advance stage pe pata chale toh uske treatment option utne hi complicated hain.

Thank You!