In a small number of cases, a patient may need to have surgery or a corneal transplant. Lenses can be custom fit so the patient has a more comfortable experience. Often this is the first treatment for mild cases. Custom scleral contact lenses may feel the most comfortable for those with keratoconus as they are wider and a scleral lens can vault over the dome of the eye. Rigid Gas Permeable (RGP) contact lenses are often used to treat both eye diseases. Rigid Gas Permeable Contact Lenses and Custom Scleral Contact Lenses It is a minimally invasive procedure that uses special eyedrops of Riboflavin (Vitamin B12) and a UV light. Treatments for Keratoconus and Pellucid Marginal DegenerationĬorneal cross-linking is a treatment that can halt the progression of both keratoconus and PMD. Keratoconus will typically show scarring while with PMD typically there is usually no scarring present. Neither eye condition usually causes pain. Keratoconus causes astigmatism reducing visual acuity. Both may have astigmatism (eyesight problem of blurriness) present with keratoconus patients also sometimes experiencing myopia. With both diseases, eyesight deterioration progresses. Symptoms of Keratoconus and Pellucid Marginal Degeneration The first signs are often a minor blurring of their vision. Patients with keratoconus are often diagnosed sooner as vision starts to deteriorate earlier. Keratoconus will start to plateau after around age 40 but PMD will continue to progress. PMD symptoms will typically start to show after age 30. Symptoms of Keratoconus are often diagnosed in the teenage years. Many patients will have had a history of allergies, hayfever, asthma, or eczema, possibly due to excessive rubbing of the eyes. Some studies have found that PMD might be more apparent in women. Keratoconus is more likely to occur in men. About 3% of cases with corneal ectasia resulted in a PMD diagnosis with the other 97% having keratoconus. Keratoconus is quite a rare disorder and PMD is an even more rare eye disorder. There is often no hereditary link, but if you have a first-degree relative with keratoconus, you are at higher risk than the general population of developing this eye disease. It is a bit more complicated with Keratoconus. There is no known hereditary link for those with PMD. If the cone shape is away from the cornea, a patient with keratoconus can often be confused to have PMD. In PMD, cornea thinning extends 1–2 mm away from the inferior limbus while in keratoconus, the thinning usually occurs in the paracentral region. The cornea of a patient with keratoconus is cone-shaped rather than the dome shape of a healthy eye. It is sometimes referred to as a “beer belly” configuration when you view it from the side. This shows as the thinning of the corneal band with the cornea protruding above the thinning. PMD shows severe inferior crescent-shaped thinning of the cornea. Treating and managing these eye disorders is different so it is important to have a keratoconus or PMD specialist working with you to get the proper diagnosis. There is some discussion of whether PMD is a form of keratoconus or its own eye disease entirely. It is possible for a person to have both eye conditions but this is quite rare. While they may have similar topographic features, they have slightly different cornea abnormalities. Keratoconus and Pellucid Marginal Degeneration (PMD) are both considered to be cornea ectatic disorders or corneal thinning disorders.
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