KERATOCONUS OVERVIEW
Our goal is to prevent vision loss.
Keratoconus is a common type of corneal ectasia. It is a bilateral progressive corneal degeneration accompanied by corneal thinning. In later stages, the cornea takes on a conical shape, leading to irregular astigmatism that scatters incoming light and is difficult or impossible to correct. As a result, the patient experiences a loss of functional vision. Keratoconus is typically diagnosed in late teens to early twenties but is seen in children as young as 8 years old. Progression is unpredictable, but typically more rapid change occurs in younger patients. A recent study showed that 88 percent of pediatric cases progress within months and lead to loss of visual function.
Keratoconus is more common than previously recognized. Based on global epidemiological research, estimates of prevalence range from 1.2% in Australia to 4-5% in the Middle East to 8% in Africa, with geographic and ethnic variation. There are millions of patients at risk of vision loss if their keratoconus progresses without treatment.
Early Diagnosis is Key to Vision Preservation
No one knows the precise cause of keratoconus, but the etiology is multi-factorial. It begins with a weakness in the cornea, which covers the anterior segment of the eye and gives it shape. The first signs are thinning of the corneal layers and abnormalities in the posterior surface, which can only be seen using sophisticated instruments. When corneal weakness and thinning begins to cause distortions of the anterior surface, there is loss of vision.
The earliest diagnosis can be made with modern tomographic eye imaging equipment. These allow an ophthalmologist to view subtle changes in the shape at the front — and back — of the cornea. Many of the image processing tools used for evaluation were developed by Epion’s Chief Medical Officer, Dr. Michael Belin.
Early diagnosis and treatment can stop the progression of disease from robbing patients of their vision.
Disease-Modifying Intervention
Cross-linking is a chemical process that can strengthen the cornea and stop disease progress. It uses riboflavin (vitamin B2) and UV(A) light to cause chemical cross-links to form between proteins. This solidifies the structure of the cornea in the same way that natural processes do in a healthy eye. It has been shown to provide lasting stability in corneal shape and vision. The application of exogenous riboflavin and UVA poses challenges. Typically, an eye surgeon removes the epithelium, the outer layer of the cornea, to instill a drug containing riboflavin. This is called “Epi-Off” cross-linking. Like many surgeries, it is risky and painful.
Epion is developing a minimally invasive treatment for ectatic corneal disease that can bring early intervention to millions of patients globally. Our EpiSmart approach is a transformative cross-linking system designed to treat keratoconus without disrupting the epithelium, allowing for a rapid return to normal activities.