Keratoconous diagnosed.

[youmeetus]

Hi my sibling recently (for a month now) felt difficutly in reading subtitles on TV. he is 32 yrs.  till his last last eye check up in 2004 he had 6/6 vision. he went for a fresh eye check up this week. doctor was surprised to find -1.75 cylindrical in Right eye and -2.5cylindrical in left eye. he does not wear glasses or was having any discomfort until a month back. his eyes were dialated and rechecked. the reading was constant. he under went topography which showed keratoconus! Doctors are surprised and have conveyed keratoconous in its early stage. he is due for an orbscan shortly. My concern is 1) how was he so asymtomatic with such a cylindrical number? shall we believe this disease has manifested itself so progressively in a months time? 2)is orbscan final diagnostic method for keratoconous ? 3) what should be line of treatment? he has been advised to wear glasses for now .4)we have been told about corneal collagen crosslinking with riboflavin (c3r) would it be a wise decision to go for c3r immediately? 5) what are the complications of this procedure? 6)how succesful is c3R in arresting the disease.7) will this procedure reduce the cone and  restore his vision or just prevent further damage? 9) will this disease hamper his career and life?  

[youmeetus]

Dear Dr. Feldman, thank you for your inputs.
I am from India. I have the following concerns. I will profoundly appreciate your feedback on this.
My sibling has just been diagnosed, from orb scan disease is at mild to moderate level. shall we wait to obeserve the rate of progression before undergoing this treatment Or immediate action is required?.
What are the side effects of this procedure?
What is the prognosis of Keratoconous after Collagan crosslinking procedure?
What are the chances of loss of vision in future even after C3R?
what is the success rate in this procedure?Can we expect cylindrical power to reduce and cone to flatten after the treatment? patient has RE : 1.75x15 (6/6)  and 2.25X150 (6/6) in LE.
how complicate is this procedure for a corneal specialist? what should be the minimun gap between the two eyes for this procedure?

[Sandy Feldman, MD, MS]

Dear youmeetus,

Keratoconus is disease in which the cornea thins and causes changes to the refractive error.  You do not mention where you are located.  In the U.S., collagen cross linking is still experimental and for eyes in which the keratoconus is progressing.  International data looks promising.  

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California