Itchy eyes, change in spectacles may indicate progressive visual disorder

Pune: Frequent change in spectacles prescription coupled with itchy eyes may not necessarily be a sign of a studious student, it may instead hint at a bigger problem.

This is exactly what happened with 23-year-old IT professional Sudhir, who had bouts of itchy eyes ever since he was 14-year-old and was sighted rubbing them more often than not.

After following up with an eye surgeon initially, Sudhir switched over to consulting optometrist at optical shops and kept on changing his spectacles on their advice for five years. However, when the problem persisted, he consulted another eye surgeon, who diagnosed him with keratoconus, a commonest corneal thinning disorder of young age where cornea becomes progressively thinner, resulting in the deteriorated vision over time.

“When he approached us a month ago, Sudhir complained of poor vision in the right eye and mild to moderate loss of vision in the left eye,” eye-surgeon Vardhaman Kankariya of Asian Eye Hospital told TOI.

Upon scanning, Kankariya found that the right corner of Sudhir’s eye had become extremely thin and could not maintain its shape — a case of severe keratoconus. Sudhir had to undergo advanced corneal transplant in the right eye. Fortunately, as his left eye was diagnosed in time, a corneal collagen cross-linking laser treatment stabilized the disease.

Largely, the disorder is picked up late. “This is because early corneal thinning and change of corneal shape cannot be picked up on routine eye examination,” Kankariya said.

Besides, young patients tend go to optical shops for eye check-ups, so comprehensive examination is often not done at regular intervals. “The disease is fairly common and we see at least 10 new patients every week. It is common in patients with history of eye-rubbing (those who suffer from eye allergies) as it makes the cornea go thinner,” Kankariya added.

There is also genetic predilection. “Once diagnosed, we study the patient’s family. Often, the patient’s siblings are seen to have keratoconus features. We perform over 50 corneal transplants for severe keratoconus every year, which is a huge concern as we have shortage of corneal donors in India,” he said.

Kankariya has researched and innovated two new laser treatment protocols, called as Cretan protocol and Athens protocol, with his mentor professor George Kymionis from Greece. “These new treatments have improved visual outcomes and are implemented all over the world,” eye surgeon Swapnil Rathod said.

Sharing the view, eye surgeon Rajesh Sinha (cornea department) of All India Institute of Medical Science, said, “The condition is often missed because of lack of current generation equipment in eye hospitals that are needed to diagnose it.”

Keratoconus requires the advanced corneal imaging technology Pentacam, which gives very precise thickness and corneal curvature map. It diagnoses and confirms corneal thinning and shape changes in early keratoconus as well as stages the disease.