Ayurvedic Treatment for Keratoconus

Have you ever heard of keratoconus?  

If not, you are not alone. Keratoconus is a relatively rare eye condition that affects about 1 in 2,000 people. Keratoconus, derived from the Greek words “kerato” meaning cornea and “konos” meaning cone. It can cause blurry and distorted vision, sensitivity to light, and frequent changes in eyeglass prescription. In some cases, it can even lead to vision loss and the need for a cornea transplant. 

In this article, we will explain what keratoconus is, what causes it, how it is diagnosed, and what treatment options are available. We will also share some interesting facts and tips about living with keratoconus. 

What is keratoconus?

Keratoconus is a condition where the cornea, the clear front surface of the eye, becomes thin and bulges outwards into a cone shape. The cornea is responsible for refracting (bending) light rays that enter the eye and focusing them on the retina, the light-sensitive tissue at the back of the eye. When the cornea assumes an irregular shape, the light rays are not focused properly, resulting in blurry and distorted vision. Keratoconus may affect both eyes, but usually not equally. One eye may have more severe symptoms than the other. It generally begins to affect people between their late teens and early 20s and progresses over 10 to 20 years. The rate of progression varies from person to person. 

What causes keratoconus? 

The exact cause of keratoconus is not well known, although genetic and environmental factors are thought to be involved. Around 10% of people with keratoconus also have a parent with the condition. It is also more common in certain populations, such as people with Down syndrome. 

Some possible risk factors for developing keratoconus include:

Eye allergies and eye rubbing, which can worsen the condition. 
Eye injuries or infections. 
Chronic eye irritation or inflammation. 
Exposure to ultraviolet (UV) rays. 

How is keratoconus diagnosed? 
Keratoconus can be diagnosed by an ophthalmologist, through a routine eye exam. The ophthalmologist may use computerized corneal mapping to measure the shape and curvature of the cornea. Corneal mapping can also measure the thickness of the cornea, which is reduced in keratoconus. This type of testing can often detect early signs of keratoconus before the disease is visible. Slit-lamp examination, a test that involves directing a beam of light on the surface of the eye and using a microscope to view the eye, is also employed for diagnosing keratoconus.  

Other tests that may be done to diagnose keratoconus include: 

Refraction, a test that uses special lenses and equipment to measure your eyes and determine your eyeglass prescription. 
Keratometry, a test that involves focusing a circle of light on the cornea and measuring the reflection. This determines the basic shape of the cornea. 
Pachymetry, a test that measures the thickness of the cornea using ultrasound waves. 

Improving vision with keratoconus 
Improving vision depends on the severity of keratoconus. Some of the vision correction options for keratoconus include: 

Special contact lenses. For more advanced cases, special contact lenses, such as hybrid lenses, scleral lenses, or piggyback lenses, may be prescribed. These lenses provide better vision and comfort by creating a smooth surface over the irregular cornea. 
Corneal inserts. Another treatment option is corneal inserts, also known as intacs. These are small, curved devices that are surgically implanted into the cornea to flatten and reshape it. Intacs can improve vision and reduce the need for contact lenses. 
Corneal transplant. In some cases, a corneal transplant may be necessary if the vision loss is severe and cannot be corrected by other means. A corneal transplant involves replacing the damaged cornea with a healthy donor cornea. 

What are some tips for living with keratoconus? 
If you have keratoconus, here are some tips that can help you cope with the condition and improve your eye health: 

Have regular eye exams and follow your ophthalmologist’s recommendations for treatment and care. 
Avoid rubbing your eyes vigorously and avoid allergens such as pollen and dust. 
Wear sunglasses that block UV rays and protect your eyes from dust and wind. 
Use artificial tears or lubricating eye drops to relieve dryness and irritation. 
Clean and store your contact lenses properly and replace them as instructed. 
Seek immediate medical attention if you experience any signs of infection, inflammation, or rejection, such as redness, pain, discharge, or decreased vision. 

Ayurvedic View on Keratoconus and Its Management

In Ayurveda, there is no direct reference for keratoconus, but based on the symptoms, it can be considered as Timira, a Drshtigata Roga or disease that affects the vision. Timira is further classified into four types according to the involvement of Doshas: Vataja, Pittaja, Kaphaja, and Raktaja. Among these, vataja timira is the most relevant for keratoconus, as it is characterized by Vyaviddha Darsana (curved appearance of a straight line), Avila Darshana (blurred vision or hazy vision), Chandra, Deepadya Anekatvam (the luminous objects like moon, lamp appear to be multiple), and Kshina drushti (diminished vision).
According to Ayurveda, the cause of timira is the vitiation of both Vata Dosha, which is responsible for movement in the body, and Alochaka pitta, the sub-type of Pitta Dosha that governs vision. The factors that can aggravate vata dosha and affect the alochaka pitta are: 

Ruksha Ahara (dry food), Ati Laghu Ahara (light food), Vishama Ahara (irregular food), Ati Tikshna Ahara (too spicy food), Ati Katu Ahara (too pungent food), Ati Sita Ahara (too cold food), Ati Ushna Ahara (too hot food), Dushta Ahara (contaminated food), Adhyashana (overeating), Viruddha Ahara (incompatible food), Vishamashana (eating at improper time), Divaswapna (sleeping during the day), Ratri Jagarana (night awakening), Cinta (worry), Soka (grief), Krodha (anger), Bhaya (fear), Ati Vyayama (excessive exercise), Ati Abhyanga (excessive oil massage), Ati Snana (excessive bathing), Ati Chakshushya Karma (excessive eye strain), Dhumapana (smoking), Madyapana (alcohol consumption), Anjana (eye cosmetics), and Netra Abhighata (eye injury).  

These factors can lead to the weakening and thinning of the cornea, resulting in the formation of a cone-like shape. This causes the light rays to be refracted irregularly, and impair the vision. 

The aim of ayurvedic management of keratoconus is to balance both Vata Dosha and Alochaka Pitta, and to strengthen and nourish the cornea. The general principles of treatment are: 

Nidana Parivarjana (avoidance of causative factors) 
Shodhana (purification therapy) 
Shamana (palliative therapy) 
Rasayana (rejuvenation therapy) 
Chakshushya (eye tonic) drugs 

Nidana Parivarjana is the first and foremost step in the treatment of any disease in Ayurveda. It involves avoiding or minimizing the factors that can aggravate Doshas and harm the cornea. Some of the measures that can be taken are: 

Avoiding dry, light, irregular, spicy, pungent, cold, hot, contaminated, incompatible, or excessive food 
Avoiding daytime sleeping, night awakening, worry, grief, anger, fear, excessive exercise, excessive oil massage, excessive bathing, excessive eye strain, smoking, alcohol consumption, eye cosmetics, eye injury, and eye diseases.
 
Shodhana is the process of eliminating the accumulated toxins and impurities from the body, and restoring the normal functioning of the doshas and the tissues. Shodhana can be done by various methods, such as vamana (emesis), virechana (purgation), basti (enema), nasya (nasal administration), and raktamokshana (bloodletting). The choice of the method depends on the condition and constitution of the patient, and the advice of the ayurvedic physician. 

Shamana is the process of pacifying the aggravated Doshas and alleviating the symptoms of the disease. Shamana can be done by various methods, such as Ahara (diet), Vihara (lifestyle), and Aushadha (medicine). The choice of the method depends on the condition and constitution of the patient, and the advice of the ayurvedic physician. For keratoconus, the most suitable methods of Samana are local ocular therapeutics, which include Pindi, Bidalaka, Netra Prakshalana, and Tarpana. These methods can directly act on the eye and provide relief from the symptoms, as well as prevent the progression of the disease. 

Rasayana is the process of rejuvenating the body and mind, and enhancing immunity and vitality. Rasayana can be done by various methods, such as Ahara (diet), Vihara (lifestyle), and Aushadha (medicine). The choice of the method depends on the condition and constitution of the patient, and the advice of the ayurvedic physician.  

Pathya or compatible diet and lifestyle during and after management of keratoconus includes the following: 

Eating fresh, wholesome, nourishing, and balanced food at proper time and in proper quantity 
Following a regular and healthy daily routine (dinacharya) and seasonal routine (ritucharya) 
Practicing eye hygiene and eye care 
Protecting the eyes from dust, wind, sun, and other harmful factors 

Conclusion 

Keratoconus is a challenging eye condition that can affect the vision and the quality of life of those who have it. Modern medicine offers various treatment options to correct the vision and slow the progression of the disease, but they may have some limitations, complications, or side effects. Ayurveda, on the other hand, offers a holistic and natural approach to manage keratoconus, by balancing the vata dosha and alochaka pitta, and strengthening and nourishing the cornea. Ayurveda also emphasizes the importance of avoiding the causative factors, following a healthy diet and lifestyle, and taking chakshushya (eye tonic) drugs to prevent and treat keratoconus.

FAQ 

Q : Can keratoconus lead to vision loss or blindness, and are there any complications associated with the condition?  
A : In severe cases, keratoconus can lead to significant vision loss or legal blindness, particularly if left untreated. Complications may include corneal scarring, hydrops (acute corneal swelling), and irregular astigmatism, which can severely impact visual function.  

Q : Is keratoconus genetic?
A : In most cases, keratoconus is not inherited

Q : Does Keratoconus Cause Eye Pain?
A : Keratoconus doesn’t always cause eye pain. However, its symptoms can cause discomfort and other problems. The most common symptoms of Keratoconus include astigmatism, degrading vision quality, and corneal thinning, bulging, or rounding. 

Q : Will certain activities, such as sports or long hours in front of the computer, hasten the progression of keratoconus? 
A: There is no evidence that any physical or visual activity has any effect on the progression of keratoconus. The exception is eye rubbing where the trauma caused by rubbing the eye can damage the cornea which may cause the condition to advance more rapidly. 

Q : Can keratoconus affect my eligibility for certain activities, such as driving or contact sports, and are there any precautions I should take? 
A : Yes, keratoconus can potentially affect eligibility for certain activities, particularly those that require good visual acuity and depth perception, such as driving or contact sports. However, the impact varies depending on the severity of the condition .

Q : What is the best contact lens for keratoconus?
A: There is no single lens type or brand that works for every keratoconus patient. In the early stages, conventional soft lenses can work remarkably well. As keratoconus progresses, gas permeable (GP) lenses work best for the majority of patients. 

Q : Can laser eye surgery fix keratoconus? 
A : Keratoconus is a degenerative disease that thins the cornea and causes an abnormal shape, which cannot be rectified with laser eye surgery.

Q : Can Stage 3 keratoconus be cured? 
A : Stage 3 is the most advanced. You will likely have substantial corneal thinning and scarring at this stage. We may use corneal ring segments and corneal transplants (penetrating keratoplasty) to treat the keratoconus.