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Is there a link between Keratoconus and Sleep Apnea?

If you’re sleepy during the day, you may attribute that to vision problems associated with keratoconus. But studies have found that people with keratoconus are at a higher rate of having Sleep Apnea than patients without keratoconus.

What is Keratoconus?

Having keratoconus means the cornea starts to thin and bulge into a cone shape. People with this eye disorder will often have decreased vision, blurry vision, and sensitivity to light and glare. This eye disorder generally worsens over time.

Those with a family history of keratoconus are at higher risk for developing it themselves. Individuals with Down syndrome, Marfan syndrome, or a congenital disorder are also known to develop Keratoconus. 

What is Obstructive Sleep Apnea?

If you stop breathing involuntarily briefly while sleeping, you may have sleep apnea. This can happen hundreds of times during your sleep without waking you so you don’t even notice it.

There are three types of sleep apnea provided on the Sleep Foundation website:

  • Obstructive Sleep Apnea (OSA): OSA occurs when the airway at the back of the throat becomes physically blocked. That obstruction causes temporary lapses in the breath.
  • Central Sleep Apnea (CSA): CSA happens because there is a problem with the brain’s system for controlling muscles involved in respiration, leading to slower and shallower breathing. This is a rare form of sleep apnea.
  • Mixed Sleep Apnea: When a person has both OSA and CSA at the same time, it is referred to as mixed sleep apnea or complex sleep apnea.

Obstructive Sleep Apnea is a common sleep disorder that affects children and adults. Obesity, having a large neck, a family history, or excessive drug and alcohol use, can all lead to an increased risk of developing or having OSA. 

Research on Keratoconus and OSA

A 2018 study published in Cornea, found that “OSA was 10 to 20 times more prevalent among patients with KCN than the rate reported for the general population.”

This 2019 study reviewed five studies on the association between keratoconus and OSA and found there is a correlation.

Researchers aren’t entirely sure why there is a link between keratoconus and OSA, but multiple studies have found this to be the case. 

Do I have OSA?

Most studies use the Berlin Questionnaire to determine the risk level for sleep apnea. If you’re curious how you would score, you can take the Berlin Questionnaire here to see what your risk factor is. Of course, you should always seek a qualified medical diagnosis and treatment.

Patients with Keratoconus Should Speak to Their Doctor About OSA

If you have keratoconus, consider discussing sleep apnea with your primary care physician. 

Patients with keratoconus may attribute their sleepiness to their corneal disorder. Knowing they are at higher risk for having sleep apnea may allow them to seek a medical diagnosis sooner to receive treatment.

Do I have Keratoconus?

Early detection of keratoconus may give you more treatment options for managing this cornea condition. Our Albuquerque office specializes in keratoconus diagnosis and management and we have technology available that can help us detect keratoconus sooner than other eye care clinics. There is no cure for keratoconus but it can be managed and corneal crosslinking can slow the progression.

If there is a family history of keratoconus, or you’re experiencing poor or blurry vision, make an appointment with our eye doctors so we can create a treatment plan for you.

Photo by RODNAE Productions from Pexels

Corneal Crosslinking: What to Expect

Corneal crosslinking or corneal collagen crosslinking (CXL) is a minimally invasive procedure that can halt or slow the progression of eye conditions such as keratoconus and pellucid marginal degeneration. Corneal collagen crosslinking, using riboflavin and UV light, received FDA approval on April 18, 2016. This is the only treatment that can prevent the condition from progressing. Doctors at Eyes of New Mexico Family Optometry and Contact Lenses can determine if you’re a good candidate for this procedure.

If you’re a candidate for corneal crosslinking, as discussed with your optometrist, it can be exciting to have a method that can keep your eyesight from getting worse. It is also normal to feel some anxiety over the procedure. Here’s what you can expect from your corneal crosslinking procedure.

Preparing for Corneal Crosslinking

Typically, we will treat only one eye at a time. The other eye will have the procedure after several weeks or months. 

Depending on the contact lenses you wear, your doctor may advise you to not wear your lenses for about two weeks before the procedure. 

The Day of Your Corneal Crosslinking Procedure

  • Don’t wear eye makeup, perfume or aftershave.
  • Bring a pair of sunglasses with you to wear after the procedure.
  • Do not have vitamin C before or after the procedure (including in foods high in vitamin C like orange juice).
  • If you’d like, bring a pair of headphones to listen to music or podcasts during the procedure.

During the Procedure 

  1. Your doctor will place drops in your eyes to numb them.
  2. You will then lie back while the procedure is being done. Your eyelid will be kept open during the procedure using a special tool. Riboflavin (Vitamin B12) eyedrops are then applied to your eye. These drops will allow your cornea to better absorb light and will take about 30 minutes to soak into your cornea.
  3. A UV light is then applied for up to 30 minutes and you’ll look into the light.
  4. Your doctor will place a contact lens in your eye to help with healing.
  5. The whole procedure will take about 60-90 minutes. You shouldn’t feel any pain.

After the Procedure

  • You won’t be able to drive. Please make arrangements for someone to pick you up to take you home. Expect to not be able to drive for about a week following the procedure.
  • You may experience some sensitivity to light. Bring a pair of sunglasses with you to wear afterwards and continue wearing while you’re healing.
  • You will be given a prescription for eyedrops to prevent infection. Carefully follow instructions for using them.
  • You may experience some discomfort for a few days. Cold compresses and ice packs may help.
  • For the first few hours you may want to keep your eyes closed and rest. It’s best not to plan any other events for the day.
  • Contact us if the contact lens falls out and don’t try to put it back in. It will be removed at your post-procedure appointment.
  • Don’t rub your eyes for at least 5 days following your procedure. Keep your eyes from coming into any contact with water. Also avoid wearing makeup.
  • Avoid computer screens, television and reading for the first 24-48 hours.
  • Contact your doctor if you experience severe or worsening pain.

It can take several weeks for your eyes to heal and your vision may not be fully functioning during that time. Most people will return to work about a week after corneal crosslinking, but you may choose to take more time. After your doctor has given you approval, you can return to wearing your glasses or contact lenses you wore before the procedure. During this period, you may notice your vision improving, worsening or changing. It should stabilize after about 3 months.

For the 2-4 weeks following your procedure

  • Avoid dusty, smoky environments for the first two weeks.
  • Put off that vacation for at least a month after the procedure and avoid flying.
  • Avoid sun exposure.
  • Stay away from swimming pools and chlorinated water.
  • Avoid makeup for at least 2 weeks.
  • After 3-6 months, you may need new glasses or contact lenses as your vision prescription may have changed.

Doctors at Eyes of New Mexico Family Optometry and Contact Lenses are experienced with corneal crosslinking and assessing patients for the procedure. If you suffer from keratoconus or pellucid marginal degeneration, or your family has a history of these conditions, contact our office for a consultation. We can treat children and adults using corneal crosslinking. Call 505-828-3937 or schedule an appointment online.

Do You Have Keratoconus?

What is Keratoconus?

Keratoconus is an eye disease where the cornea of the eye will gradually thin and bulge, shifting into the shape of a cone. It is sometimes referred to as irregular astigmatism. People with keratoconus suffer from poor vision. At Eyes of NM Family Optometry and Contact Lenses, we can diagnose and treat keratoconus.

Who is at Risk?

The disease typically starts in the teenage years or early twenties. Over the next 10 to 20 years, patients diagnosed with keratoconus can expect the disease to get worse. The rate of progression of the disease is not the same in everyone.

There are no known causes of keratoconus, nor is it known why certain people get the disease. Family history, Down syndrome, Marfan syndrome, congenital disorders and vigorous eye rubbing are some of the risk factors. If one of your parents had keratoconus, eyes should be checked every year starting at age 10 for the disease.

Inflammation from allergies or asthma can break down the tissue of the cornea and is also a risk. Environmental factors can include excessive exposure to ultraviolet rays from the sign, continuous poorly fitted contact lenses and chronic eye irritation.

What are the Symptoms?

Those that suffer from keratoconus have blurry vision, possibly cloudy vision and may have a sensitivity to light and glare. This may cause difficulty with driving at night. Progressive nearsightedness may also develop.

Symptoms can change as the disease progresses and changes can be sudden or gradual. It can affect one or both eyes. It is important that you don’t rub your eyes. If this is something you’re finding yourself doing, make sure you talk to us.

How We Treat Keratoconus

Optometrists at Eyes of New Mexico are specialists in treating keratoconus. Our optometrists will look for signs of keratoconus during your routine eye health exam. To diagnose it, we will measure the shape of your cornea. In the early stages it may look like any other refractive error like that of blurred vision. It is easier to detect as the disease worsens.

Eyes of NM Family Optometry and Contact Lenses in Albuquerque has the latest technology to detect and diagnose this disease sooner. With such a progressive disease, this provides a tremendous advantage to our patients that is not available at all clinics.

Glasses, Custom Scleral Contact Lenses or Custom Rigid Gas Permeable Lenses

Initially, glasses may be prescribed for the treatment of keratoconus. Glasses and the prescription may change often. As the disease advances, your prescription may change to custom scleral contact lenses or custom rigid gas permeable lenses. We will custom-fit you for scleral contact lenses or rigid gas permeable lenses if appropriate for your specific situation.

Corneal Cross-Linking

The only effective treatment that can halt the progression of keratoconus is corneal cross-linking. It is a relatively new procedure and will be performed in the office by our qualified eye doctors. We will use special eye drop medication and ultraviolet light from a special machine to create stronger, more stable corneal tissues. Talk to the doctors at Eyes of NM Family Optometry and Contact Lenses to find out if you’re a good candidate for a corneal collagen cross-linking procedure.

Surgery or Cornea Transplant

Eventually, patients with keratoconus may need surgery or even a cornea transplant. We will be able to guide you through this process and refer you if surgery is needed.

As keratoconus is a progressive disease, monitoring and maintaining your eye health is extremely important. Changes to vision can occur frequently and rapidly and it is important to have a keratoconus specialist near you that you see regularly.

Specialists for Keratoconus

We can diagnose your condition and find the right treatment option for your comfort level and the stage of your progression. Our New Mexico eye doctors are able to help you at any stage of your diagnosis of Keratoconus. If you’ve suffered from an extreme change of vision, have a family history of keratoconus or feel you may be at risk, book an appointment with us in our Albuquerque clinic today.