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Keratoconus is caused by weakening of the cornea. This weakening
causes the outward protrusion and thinning of the cornea. It can
be thought of as a subtle hernia of the cornea due to the weakness
in the corneal tissue.
The cause of the weakening is due to an imbalance of enzymes within
the cornea itself that leads to high levels of damaging "reactive
species" chemicals. Different types of reactive species include
superoxides, hydrogen peroxide, and nitric oxide. These substances
essentially are free radicals that cause oxidative damage to the
cornea.
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| Reactive species (free radicals) accumulate |
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The reactive species cause weakness |
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The weakness causes the cornea to herniate which leads
to keratoconus |
Research suggests that patients with keratoconus
cannot clear away the normal amount of reactive species that are
normally produced. The reason for poor clearance is that the good
enzymes (Catalase and Superoxide dismutase) are not functioning
properly which leads to the toxic accumulation of the reactive species
and eventual damage in the cornea from the buildup of reactive species.
There are some genetic reasons explaining why the good enzymes
do not function properly. Non-genetic sources can also increase
the reactive species. Such sources include ultraviolet light sun
exposure, eye rubbing, poorly fit contact lenses, and chronic eye
irritation. All these cause an increase in reactive species (free
radicals).
For these reasons, we recommend that all patients with keratoconus
protect their eyes by wearing 100% UV blocking sunglasses with the
wrap-around design. The wrap-around design minimizes light coming
in from the sides. It's also important to avoid eye-rubbing and
have a comfortable contact lens fit if contacts are being worn.
The only method to increase corneal strength is with the C3-R®
treatment.
Keratoconus is the thinning and bulging of the cornea.
Treatments include Intacs®,
C3-R®, cornea
collagen cross linking, and if keratoconus
progresses to a serious level, cornea transplantation. Dr Brian
Boxer Wachler is a specialist in keratoconus
evaluation and treatment.
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