Senior optometrist Léonard Kollros has published a paper in Contact Lens and Anterior Eye that shows that keratoconus progression continues in older patients – and that corneal cross-linking (CXL) can still be used to successfully arrest its progression. In the case series, five eyes from four patients with progressive keratoconus, aged at least 48 years old, were followed regularly after initial diagnosis. The rate of progression was measured using corneal topography, in which the maximum steepness values (Kmax) of their cornea was measured. These values were found to be 1.4 diopters at 6 months and 14.6 diopters after 14 months. All patients eventually received corneal cross-linking, with one patient requiring two procedures to successfully stabilise their cornea.
As keratoconus progression continues in older adults, the study highlights the importance of regular follow-up examinations for patients with keratoconus, even in their fifth and sixth decades of life. While the probability of progression declines after the age of 40, it never becomes zero, and regular monitoring can help detect and treat progression before it causes significant vision loss. Corneal cross-linking has been shown to be an effective treatment for arresting the progression of keratoconus, and this study adds to the growing body of evidence supporting its use in patients of all ages.
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Reference
- Kollros L, Torres-Netto EA, Rodriguez-Villalobos C, Hafezi N, Hillen M, Lu, N, Hafezi F. Progressive keratoconus in patients older than 48 years. Contact Lens Anterior Eye (2022). Epub Ahead of Print.
About Keratoconus
Keratoconus is a progressive eye condition in which the cornea, the clear outer layer of the eye, becomes thin and cone-shaped. This can cause the cornea to bulge outward, leading to blurred and distorted vision. Keratoconus usually develops in people between the ages of 10 and 25, and it can affect one or both eyes. It is most common in people with certain risk factors, such as a family history of the condition, chronic eye rubbing, and certain eye disorders. Symptoms of keratoconus include distorted vision, increased sensitivity to light, and the need for frequent changes in eyeglass or contact lens prescriptions. Treatment options for keratoconus include eyeglasses or contact lenses, corneal cross-linking, and corneal transplantation. The study published by Kollros et al. show that keratoconus can still affect older people, and regular check-ups should still be performed to detect this, as the paper, describing corneal cross-linking for keratoconus in patients over 48 years demonstrably shows.
