What is Keratoconus?
Keratoconus is a progressive eye condition in which the normally round cornea becomes thin and begins to bulge into a cone-like shape. This distortion causes blurry or distorted vision and can significantly affect a person’s ability to see clearly. The condition often develops during adolescence and may progress more quickly if it begins at a younger age or if there is frequent eye rubbing.
At Moorfields Eye Hospital Dubai and Abu Dhabi, our Keratoconus specialists use advanced diagnostic tools and personalised keratoconus treatment options for individuals, supporting long-term eye health and helping patients maintain the best possible vision.
What are the causes and risk factors of Keratoconus?
Keratoconus occurs when the cornea becomes more elastic and begins to thin, which causes it to bulge outward and lose its normal shape. Several factors may contribute to its development:
- Family history: The condition may be inherited, and individuals with a family member affected by keratoconus are at greater risk.
- Allergies and inflammation: Conditions such as hay fever, eczema, and asthma are commonly linked with keratoconus.
- Eye rubbing: Repeatedly rubbing the eyes can significantly accelerate the progression of keratoconus and is strongly discouraged.
Keratoconus affects approximately 1 in 2,000 people worldwide and is more commonly observed in the Middle East.
What are the symptoms of Keratoconus?
Keratoconus often presents with symptoms that vary in severity depending on the progression of the condition and these include:
- Blurry, distorted vision or double vision
- Seeing halos around lights
- Increased sensitivity to light
- Difficulty seeing at night.
- Frequent changes in eyeglass prescriptions
- Increased nearsightedness or astigmatism
Recognising the signs of keratoconus early is crucial for effective management. If left undiagnosed, the condition can progress to a stage where traditional corrective measures, such as eyeglasses or soft contact lenses, may no longer be sufficient.
How is Keratoconus Diagnosed?
Several diagnostic tests are used to confirm the presence of keratoconus and assess its severity. These include:
- Corneal Topography: This non-invasive imaging scan , maps the surface curvature of the cornea, revealing the characteristic cone-shaped irregularities
- Pachymetry: This test measures the thickness of the cornea, which is vital for detecting the progressive thinning that occurs in keratoconus.
- Slit-Lamp Examination: A detailed examination of the cornea using a slit-lamp microscope can reveal signs of keratoconus, such as corneal thinning and scarring.
- Keratometry: This test measures the curvature of the central cornea and helps in detecting abnormalities in its shape.
These tests aid in diagnosing keratoconus, monitoring its progression, and determining the most appropriate treatment options.
Keratoconus treatment options
Non-Surgical Treatments: Eyeglasses and Contact Lenses
In the early stages, vision can often be corrected with eyeglasses or soft contact lenses to provide clear vision.
- Eyeglasses or soft contact lenses: Suitable for mild cases.
- Rigid gas permeable (RGP) contact lenses: Help correct the irregular shape of the cornea as keratoconus progresses.
- Hybrid lenses: Combine the comfort of soft lenses with the clarity of rigid lenses, offering good vision and comfort for many patients.
Advanced Treatments: Corneal Cross-Linking and Surgery
- Corneal Collagen Cross-Linking with Riboflavin (CXL): This treatment strengthens the cornea using Vitamin B2, halting the progression of Keratoconus. The success of this treatment varies, but many patients experience a significant slowdown in the progression of the condition.
- Intracorneal Rings (Intacs & Ferrara): These rings are inserted into the cornea to modify its shape and improve vision. They are used when contact lenses are unsuitable and the cornea is relatively clear. Patients generally see improved vision and a more regular corneal shape post-procedure.
- Phototherapeutic Keratectomy (PTK) combined with corneal cross-linking: This procedure improves corneal surface irregularities when contact lenses are not tolerated..
- Corneal Transplants: Used in advanced stages with corneal scarring, the procedures vary from partial (Deep Anterior Lamellar Keratoplasty—DALK) to full-thickness grafts (Penetrating Keratoplasty—PK). The need for transplants is declining due to early diagnosis and successful early treatments like CXL.
Can Keratoconus be Prevented?
Although keratoconus cannot be entirely prevented, some measures may help slow its progression:
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- Avoid rubbing the eyes, especially during allergy flare-ups.
- Manage allergic eye conditions with appropriate treatments.
- Wear protective eyewear in dusty or windy environments to reduce the urge to rub the eyes.
Keratoconus treatment Specialists
Dr. Miguel Morcillo
Consultant Ophthalmologist in Cornea, Cataract and Refractive vision correction surgery
Dr. Miguel Morcillo is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive (Vision Correction – LASIK, LASEK, TransPRK) Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Miguel holds a Spanish Degree in Medicine from the Universitat de Valencia. He completed his Residency in Ophthalmology under the MIR (Medico Interno Residente) system of the Spanish Ministry of Health. He has more than 25 years of experience, most of which was attained in Spain. He also worked in Italy and finally moved to the UAE in 2017 and has been practising in the UAE since that time. Dr. Miguel started his career working with Clinica Baviera, the largest private ophthalmology group in Europe, in Madrid and Valencia. He helped develop many of the refractive treatments offered today, such as LASIK, LASEK, ICLs and multifocal IOLs, in addition to collaborations with other hospitals to provide high-quality cataract and refractive surgery to patients. Dr. Miguel trained in cornea surgery at NIIOS Eye Institute (Rotterdam) and, since then became an experienced educator for other surgeons in the fields of the anterior segment and refractive surgery.
He has been a member of “Surgical Eye Expeditions International” since 1999, an American non-government organisation that arranges eye camps worldwide. Dr. Miguel has assisted several eye charity camps in numerous countries of Africa, in addition to Peru, Panama and India, providing free eye care and performing surgeries to those who could not afford it in less developed areas.
His research efforts include surgical topics and outcomes such as Ultrathin LASIK, Keratoconus screening, ICLs, and multifocal IOLs, among others. He has presented various papers in national and international congresses and journals and organised educational courses on refractive surgery for peers and opticians.
He is a member of Sociedad Española de Oftalmologia (SEO), the Panamerican Association of Ophthalmology (PAAO) and the European Vitreoretinal Society (EVRS).
He is also the recipient of the Dr. P C Mahendra Memorial ACOIN International Award in India in recognition of his charitable work with people in need.
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Dr. Nadim Habash
Consultant Ophthalmologist in Cornea and Ocular Surface Diseases
Dr. Nadim Habash is an American Board-Certified Consultant Ophthalmologist specialising in Cornea, Ocular Surface Diseases, and General Ophthalmology at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Nadim undertook his speciality training at George Washington University in Washington D.C., U.S.A., where he also served as Chief Resident. He then acquired an additional Cornea and External Disease Fellowship at the University of Florida, Gainesville, U.S.A.
Dr. Nadim is a Diplomate of the American Board of Ophthalmology and a Fellow of the Royal College of Surgeons of Canada FRCS(C).
Over the past 40 years, Dr. Nadim has had extensive experience in Corneal transplantation and Anterior Segment Diseases in several countries, including the United States of America, the Kingdom of Saudi Arabia and the United Arab Emirates.
Dr. Nadim has worked and held leadership and academic positions in prestigious institutions, including the University of Ohio at Toledo, Ohio, U.S.A., the King Faisal Specialist Hospital and the King Khaled Eye Specialist Hospital in Saudi Arabia, and at the American Hospital Dubai, where he held key positions including Chief of Medical Staff, Assistant Chief Medical Officer and Director of Ophthalmology.
Dr. Nadim published several papers about Corneal transplantation, chaired many scientific conferences and symposia, and participated actively in teaching medical students and Ophthalmology residents.
Throughout his career, Dr. Nadim held memberships in several scientific organisations, including a fellowship of the American College of Surgeons, the American Academy of Ophthalmology membership, and many regional and local societies
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Dr. Osama Giledi
Consultant Ophthalmologist in Cataract, Cornea and Refractive Vision Correction SurgeryGCAA Approved Specialist Aeromedical Examiner
Associate Professor Of Ophthalmology (Adjunct)
Dr. Osama Giledi is a Consultant Ophthalmologist specialising in Cornea, Cataract and Refractive Surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
Dr. Osama is skilled in managing ocular surface problems, including severe dry eye and Stem cell deficiency. He performs small incision phacoemulsification for his cataract surgery and is experienced in using toric and multifocal premium intraocular lenses. Dr. Osama’s expertise in managing complex corneal conditions includes all types of modern corneal graft procedures, such as DALK and DSAEK. He has performed over 23,000 refractive surgeries, including Lasik, LASEK, Intralase LASIK and Trans PRK, and phakic IOLs. He delivers the latest treatment for keratoconus, including Intracorneal ring segments, corneal cross-linking and complex laser treatment.
Dr. Osama graduated from Libya and completed his ophthalmic training in the UK, attaining a Fellowship in Ophthalmology from The Royal College of Edinburgh in 1996. He completed two years of higher subspecialty training fellowship on the anterior segment, Cornea and refractive surgery in 2003 at the prestigious Corneoplastic Unit and Eye Bank at Queen Victoria Hospital, East Grinstead. He worked as a Consultant Ophthalmologist at the Centre for Sight London and the Corneoplastic Unit and Eye Bank at Queen Victoria Hospital. Dr Osama has 22 years of experience in the UK, providing services for anterior segment, Cornea, Refractive and cataract surgery.
In addition to his clinical commitments, Dr. Osama has extensive experience in teaching and training; he is a noted presenter at national and international meetings and has extensive research published in peer-reviewed scientific journals. He is a member of the Royal College Surgeons of Edinburgh, the United Kingdom & Ireland Society of Cataract and Refractive Surgeons, and the European Society of Cataract and Refractive Surgeons.
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Dr. Imad Hakim
Consultant Ophthalmologist in Cataract and Refractive vision correction surgery
Dr. Imad Hakim is a Consultant Ophthalmologist, specialised in Cataract and Refractive vision correction surgery at Moorfields Eye Hospital Dubai in Dubai Healthcare City.
He holds a graduate degree from the University of Aleppo in Syria, obtained in 2002. Dr. Hakim also holds a certificate in Ophthalmology from Ludwig Maximillian University of Munich, Germany. He undertook his sub specialty training in Cataract and Refractive surgery at Realeyes Eye Clinic in Munich, Germany.
His areas of expertise are in Femto laser assisted Cataract Surgery (FLACS), Refractive vision correction surgery (LASIK, LASEK, TransPRK, PTK, Implantable Contact Lenses ICLs, Multifocal Intraocular Lenses IOLs and Add-On IOL ), Keratoconus, Phototherapeutic Keratectomy (PTK) Laser Eye Surgery and General Ophthalmology.
He has more than 15 years of regional and international experience in countries including Germany and UAE.
In his career, he has practiced in leading medical institutions such as Realeyes Eye Clinic in Munich, Germany as well as American Hospital in Dubai, U.A.E.
He has published research papers on Cataracts and Retina in leading journals.
He is a member of the European Society of Cataract & Refractive Surgeons (ESCRS), The German Committee for Refractive Surgery (KRC), Commission of the German Ophthalmological Society (DOG) and Professional Association of German Ophthalmologists (BVA).
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Dr. Esmaeil Arbabi
Medical Director and Consultant Ophthalmologist in Corneal transplant, Cataract & Refractive Surgery
Dr. Esmaeil Mohammad Arbabi is a Consultant Ophthalmologist with excellent surgical experience including all types of corneal transplants (DMEK, DSAEK, PDEK, DALK, PKP), ocular surface reconstruction, complex cataract and laser refractive surgery.
Prior to joining Moorfields Eye Hospital Center, he was Consultant Ophthalmic Surgeon (Cornea, Cataract & Laser Refractive Surgery) and the Lead for Refractive Services at Royal Liverpool University Hospital, Liverpool, United Kingdom.
Dr. Esmaeil holds several prestigious degrees and certifications in the field of cataract and refractive surgery including MSc in Cataract and Refractive Surgery, Certificate in Laser and Refractive Surgery (CertLRS) from Royal College of Ophthalmologist and Fellow of European Board of Ophthalmology Subspecialty Diploma in Cataract and Refractive Surgery (FEBOS-CR).
He is a member of Royal College of Ophthalmologists, European Society of Cataract and Refractive Surgeons, European Board of Ophthalmology, UK Cross-Linking Consortium, EYE -LAW CHAMBERS - Medicolegal Expert and Expert, Association of Personal Injury Lawyers (APIL).
He is instrumental in high quality papers in various peer reviewed journals and numerous scientific and ophthalmology publications. He is also an examiner for the University of Leeds and the University of Liverpool and for the European Board of Ophthalmologist (FEBO exam).
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