Advancements in Diagnostics and Treatments for Keratoconus in Russia: A Comprehensive Overview

Keratoconus is a progressive eye disorder that affects the cornea, the clear front surface of the eye. It is characterized by the thinning and bulging of the cornea into a cone shape, resulting in distorted vision. This condition typically begins during adolescence or early adulthood and gradually worsens over time. Although the exact cause of keratoconus is unknown, it is believed to involve a combination of genetic and environmental factors.

One of the primary symptoms of keratoconus is blurry or distorted vision, often accompanied by an increased sensitivity to light and glare. As the cornea becomes more irregular in shape, it causes astigmatism, making it difficult to focus on objects. Additionally, keratoconus can induce nearsightedness or double vision, creating further visual disturbances.

In diagnosing keratoconus, several diagnostic methods are used. These methods help in identifying the shape and condition of the cornea, which is typically affected in keratoconus.

• Corneal topography: This non-invasive imaging technique provides a detailed map of the cornea's shape and curvature. Topography helps identify irregularities in the cornea's surface and determines the severity of keratoconus.

• Slit-lamp examination: An ophthalmologist uses a biomicroscope with a slit-shaped beam of light to examine the cornea's surface. By assessing the cornea's shape, thickness, clarity, and presence of any corneal scarring, the ophthalmologist can diagnose keratoconus.

• Optical coherence tomography (OCT): This imaging technique uses light waves to create cross-sectional images of the cornea. OCT is useful in measuring the corneal thickness and identifying abnormalities within different layers of the cornea, including any thinning characteristic of keratoconus.

• Retinoscopy: It measures how light reflects off the retina to assess the refractive error, including astigmatism caused by keratoconus. By analyzing how light bends as it enters the eye, an ophthalmologist can determine the presence and extent of irregular corneal shape.

• Pachymetry: Corneal pachymetry measures the thickness of the cornea. People with keratoconus usually have thinner corneas compared to healthy individuals. This test helps determine the cornea's thinning and the progression of keratoconus.

• Keratometry: Keratometry measures the cornea's curvature and helps identify astigmatism. It is particularly useful in quantifying the changes in corneal shape caused by keratoconus.

• Endothelial cell count: This test measures the number and condition of the cells on the inner layer of the cornea. Changes in cell count can indicate keratoconus and assess the cornea's overall health.

Early detection through these methods allows for timely intervention and appropriate management strategies for keratoconus patients.

In Russia, there are several treatment options available for keratoconus aimed at improving visual clarity and halting the progression of the disease. One commonly used method is the use of rigid gas permeable (RGP) contact lenses. These lenses are designed to provide a smooth surface over the irregular cornea, allowing light to properly enter the eye and correct vision. RGP lenses can greatly improve visual acuity in mild to moderate cases of keratoconus.

In more advanced cases, Russian medicine offers various surgical interventions for keratoconus. One such procedure is corneal collagen cross-linking (CXL), which involves applying a combination of riboflavin (vitamin B2) and ultraviolet (UV) light to the cornea. This procedure strengthens and stabilizes the cornea by increasing the collagen cross-links, ultimately preventing further thinning and bulging.

Additionally, in cases where keratoconus has significantly progressed, and vision cannot be adequately corrected with contact lenses, corneal transplantation may be necessary. Russian medicine has a wealth of experience in performing corneal transplantation.

Early detection and diagnosis of the disease is essential for successful treatment. Fyodorov Eye Microsurgery Federal State Institution provides an opportunity to perform diagnostics on advanced instruments by experienced ophthalmologists who are able to effectively identify and treat such diseases effectively.