From the Guidelines
Yes, keratoconus in a 32-year-old can potentially be related to previous eye surgery or trauma, though these are considered secondary forms of the condition. Keratoconus is primarily characterized by progressive thinning and bulging of the cornea, causing distorted vision. While most cases are primary (genetic or idiopathic), eye trauma such as excessive eye rubbing, contact lens complications, or certain surgical procedures can damage corneal integrity and trigger or accelerate keratoconus development. Post-surgical keratoconus may occur following procedures like LASIK, PRK, or other corneal surgeries that alter corneal biomechanics, as noted in a study published in 2024 1.
Some key points to consider include:
- The etiology of corneal ectasia may include genetic factors, biochemical, and biomechanical factors, such as eye rubbing, as discussed in a study published in 2024 1.
- Corneal ectasia can occur after laser in-situ keratomileusis (LASIK), small incision lenticule extraction (SMILE), radial keratotomy (RK), and photorefractive keratectomy (PRK) in eyes with a pre-existing subclinical keratoconus, or even in eyes with no preoperative signs of keratoconus, as mentioned in a study published in 2024 1.
- If you're experiencing vision changes and have a history of eye surgery or trauma, it's essential to see a cornea specialist promptly for comprehensive evaluation including corneal topography and pachymetry.
- Treatment options depend on severity and may include specialized contact lenses, corneal crosslinking to stabilize progression, intracorneal ring segments, or in advanced cases, corneal transplantation, as recommended in a study published in 2019 1.
- Early diagnosis and intervention are crucial to preserve vision and prevent further corneal deterioration, as emphasized in a study published in 2024 1.
It is also important to note that patients with keratoconus should be counseled to avoid eye rubbing, whether they have a history of allergies or not, and that lifestyle changes, such as controlling chronic habits of abnormal rubbing, may help prevent progression of the disease, as suggested in a study published in 2024 1.
From the Research
Keratoconus and Previous Surgery or Trauma
- Keratoconus is a bilateral and asymmetric disease that results in progressive thinning and steeping of the cornea, leading to irregular astigmatism and decreased visual acuity 2.
- The condition normally develops in the second and third decades of life and progresses until the fourth decade 2.
- A 32-year-old patient with keratoconus may have developed the condition due to various factors, including a family history of keratoconus, eye rubbing, eczema, asthma, and allergy 2.
- Previous surgery or trauma may not be a direct cause of keratoconus, but it can exacerbate the condition or lead to the development of other corneal disorders, such as post-LASIK ectasia (PLE) 3.
- Corneal cross-linking (CXL) is a procedure that can be used to treat keratoconus and other ectatic corneal disorders, including PLE 3.
Risk Factors and Treatment
- Risk factors for developing keratoconus include a family history of the condition, eye rubbing, eczema, asthma, and allergy 2.
- Treatment for keratoconus varies depending on the severity and progression of the condition, and may include spectacles, contact lenses, or corneal surgery, such as CXL or intracorneal ring segments (ICRS) implantation 2, 4, 5.
- CXL has been shown to be effective in arresting the progression of keratoconus and improving visual acuity 4, 5, 3.
- ICRS implantation, with or without CXL, can also improve visual and topographic outcomes in patients with keratoconus 4, 5.