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World Keratoconus Day takes place on Nov. 10. According to Johns Hopkins Medicine, one in 2000 individuals are diagnosed with keratoconus – it is a condition that is often overlooked. This day brings awareness to the condition and is sponsored by the National Keratoconus Foundation, which was founded in 1986.

 We sat down with Dimitrios Karamichos, PhD, FARVO, Vice President for Research and Graduate Studies at UNT Health Fort Worth, and executive director at North Texas Eye Research Institute, to learn more about keratoconus – the early warning signs and what treatments are on the horizon for patients living with the condition.

“Keratoconus is a progressive eye condition, where the normally round, dome-shaped cornea (the clear, outermost layer of the eye) thins and begins to bulge outward into a cone shape,” Karamichos said. “The altered corneal structure and integrity prevent light from focusing correctly on the retina, leading to distorted and blurred vision and often nearsightedness.”

This condition is often diagnosed in adolescence and progresses at variable rates among individuals for unknown reasons slowly over the span of ten to twenty years. Some of the early warning signs are blurredvision, increased sensitivity to bright light and glare, seeing halos around lights, and difficulty with night driving. In most cases, keratoconus is diagnosed by an optometrist, but if worsening vision occurs, it is crucial to consult with an ophthalmologist.

The diagnosis of keratoconus has improved in recent years. “Doctors are catching keratoconus earlier now. Studies reveal a significant decrease in the mean age of diagnosis, primarily thanks to the widespread use of advanced corneal imaging techniques, such as tomography and topography,” Karamichos says. “This earlier detection is vital for effective management. We are observing an increase in prevalence because we can now diagnose more cases at earlier stages.” Karamichos also mentions that his lab is pioneering research on sex hormones – that keratoconus might have a systemic origin, rather than being localized just to the cornea. This is fueling new discoveries and discussions.

Treatment options for keratoconus are focused on two main goals – stopping the disease from progressing and improving vision. Keratoconus progression is halted using Corneal Collagen Cross-Linking , a procedure that stiffens the cornea by using riboflavin drops and UV light. In terms of vision correction, the primary solution is specialty contact lenses, which fit over the irregular cornea to provide clear sight that glasses alone cannot achieve. If the condition has progressed beyond those treatment options, surgical options, like Intracorneal Ring Segments or full or partial Corneal Transplant (Keratoplasty) may be necessary to restore functional vision.

“Research is in a non-stop hunt to find less invasive and more effective ways to treat keratoconus,” Karamichos said. “A few options include corneal regeneration, as a way to thicken and reshape the cornea, potentially stimulating the growth of healthy corneal cells, non-invasive therapies, like eye drops, to strengthen the cornea, Bowman Layer Onlay Grafting for advanced cases that involves transplanting the Bowman layer to flatten and stabilize the cornea, and utilizing artificial intelligence in treatment planning for optimal outcomes.”

For more information on NTERI, please visit our website to learn more about eye health and Karamichos’ research.

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