Keratoconus, Cross linking, Intacs
Keratoconus expert Dr. Khanna – will be holding Free patient seminars across southern california in Januarary and Feburary 2011.
The seminars will discuss the disease of keratoconus and treatment options including the latest on intacs and crosslinkage therapies.
Please register
Rajesh Khanna, MD is a Beverly Hills Cornea Surgeon and Board certified by American Board of Ophthalmology.
Indications for Intacs
1. Must be 21 years of age or older
2.progressive deterioration in vision not able to be improved with contact lenses or spectacles.
3.Clear central cornea
4.Central corneal thickness of 450 microns or more
5.corneal transplantation is the only other option.
Los Angeles keratoconus expert dr. Khanna advises other surgeons to follow these indications.
Keratoconus (KC) is a bilateral, non-inflammatory, and progredient corneal ectasia that mostly occurs as a sporadic disorder, but it has long been recognized that a significant minority of patients also exhibit a family history. In Los Angeles in recent years several candidate genes such as VSX1 and SOD1 have been proposed, and some disease-causing mutations have been identified. Keratoconus research in united states has also focused on collagen genes, especially those that are differentially expressed in KC cornea. Alterations in COL4A3 and COL4A4 genes may be responsible for decreases in collagen types I and III, a feature often detected in Los angeles keratoconus.
Hi ,
My name is D, I am Tanzanian student , studying in US.
I was reffered to you by National keratoconus foundation in California. I contacted them because I have a brother (23 years old) In Tanzania, East Africa who was diagnosed with Keratoconus last year. He has not been able to get treatment in my country and he is loosing his vision.
I was looking for ways for him to come here in US to receive Corneal transplant.
The problem is my family can not afford medical expenses and I am looking for Medical financial Assistance for him.
I am emailing you to ask you for the following informations:
1)Do you help people outside to come to US for treatments?
2) If Yes, which procedures should I follow?
3)If No, Do you have any information on organisations or hospitals around US t hat help keratoconus patients financially to get treatment(- Who can not afford medical expenses)
I have been searching for help, his sight is getting worse and It is sad that he is young and has no help around.
I am thanking you for reading this and looking forward to hear from you. My cell number is
Sincerely,
What causes keratoconus?
The causes of this condition are still unknown despite our familiarity with this disease. There have been many studies and there have been many theories.
One proposal suggests that orange county keratoconus depends on a defect in the development and genetic (about 7% of patients have relatives with keratoconus). This suggests that the consequence of an abnormality in growth, essentially a birth defect. Another is that Keratoconus is a degenerative condition. A third postulated that keratoconus is secondary to other diseases. A less accepted theory suggests it may be of endocrine origin.
The actual incidence of orange county keratoconus is not known. It is one of the most common afflictions of the eye but it is by no means a rare disease. Is estimated to occur once in every two thousand people. Usually the disease occurs in young people at puberty. It is found everywhere in the world without follow any geographical pattern, cultural or social acquaintance. Several sources suggest that keratoconus probably arises from a number of different factors: genetic, environmental or cell phone, no one can form the trigger that will initiate the disease. There are also doctors who associate the scratching keratoconus eyes. Often the patient has allergic rhinitis associated with keratoconus, which causes the eyes itch often. This can cause thinning of the cornea due to mechanical removal of epithelial cells.
The visual distortion experienced by the patients come from two sources, one being the irregular deformation of the surface of the cornea, and other scars formed at points of high curvature exposed. These factors act together to form regions on the cornea which projects an image into different regions of the retina and cause the symptoms of monocular diplopia or monocular poliplopia. The effect can worsen in low light because the pupil tends to dilate in order to receive more light, and thus further exposing the irregularities of the cornea. Scars seem to be an aspect of the degradation of the cornea, however, a large multi-center study conducted (Clek STUDY – Collaborative Longitudinal Evaluation of Keratoconus Study) suggests that the abrasion caused by contact lenses may increase the tendency of this finding on one factor above two, or more than double the chance of occurrence.
Recent studies have shown that orange county keratoconus corneas show signs of increased activity of proteases, a class of enzymes that break part of the collagen fibers in the corneal stroma, with a simultaneous significant reduction of the action of protease inhibitors. Other studies have suggested that the reduction of activity by the enzyme aldehyde dehydrogenase may be responsible for the creation of free radicals and oxidant species in the cornea. It is quite likely that whatever the pathogenic process, the damage caused by activities in the cornea resulting in reduction of its ultrasound pachymetry and weakening their resistance biomechanics.
A genetic predisposition for keratoconus has been observed, with the disease manifesting itself in certain families, and reported incidences of concordance in identical twins. The frequency of occurrence in close relatives is not clearly defined, although it is known that the incidence is considerably higher than in the general population, and studies have obtained estimates ranging between 6% and 19%. The gene responsible for keratoconus has not been identified: two large studies involving isolated communities homogenéticas contrary has indicated as causes of genetic disease mapped to chromosomes 16q and 20q. However, most genetic studies agree on a model autosome dominant hereditary. Keratoconus is also diagnosed more often in people with Down syndrome, although the reasons for this link have not yet been determined. Keratoconus has been associated with atopic diseases. including asthma, allergies and eczema, and it is not uncommon for many or some of these diseases affect a person. Studies suggest that rubbing the eyes vigorously may contribute to the progression of keratoconus, and patients should be discouraged from this practice.
Symptoms
People with early keratoconus in los angeles typically report a small blur his vision and seek a professional in search of contact lenses for driving or reading. In early stages, the symptoms of keratoconus may be the same as any other refractive defect the eye. As the disease progresses, vision deteriorates, sometimes rapidly. Visual acuity becomes impaired at all distances and night vision is often quite poor. Some people have vision in one eye that is markedly worse than in the other eye. Some develop photophobia (sensitivity to bright light), eye strain by forcing the eyes while reading or itching in the eye. [2] However, there is usually little or no sensation of pain.
The classic symptom of keratoconus in Los Angeles is the perception of multiple ghost images, known as monocular polyopia. This effect is most clearly observed in a field of view with high contrast, as a point of light in a dark environment. Instead of seeing only one point, a person with Orange County keratoconus sees many images of that point, spread out in very irregular pattern. This pattern typically does not change every day, but usually during the time it takes new forms. In some cases the patient may present with monocular diplopia in this case is the presence of double image, not multiple.
Some patients also reported traces of light reflections and distortion (Lens Flare) around light sources. Some have even reported moving images against each other following their heartbeats.
The first sign of Los Angles keratoconus is blurred vision at first can be corrected with eyeglasses. Since it is a progressive disease, will require frequent changes in the formula of glasses. The thinning of the cornea progresses slowly over 5-10 years and then tends to stop. Occasionally it is rapidly progressive and advanced stages the patient may experience sudden blurred vision in one eye. This is called Acute Hydrops “and is due to the sudden entry of fluid into the cornea thinned. This hydrops improves with time, taking weeks or months to disappear. In advanced cases superficial scarring at the apex of the cornea resulting in further decrease in vision.
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Los Angeles Keratoconus