Our working hypothesis is that in keratoconus there are various factors (such as UVB, atopy/allergy, and mechanical eye rubbing) that can cause either oxidative damage or disruption of the cellular structure or function.
If the cells are irreversibly damaged, then they undergo apoptosis. If, however, the cells are only partially damaged, then the repair process is started with some increased activities of degradative enzymes, focal sites of wound healing and tissue remodeling. The goal of future research studies, in multiple laboratories in the US and abroad, is to understand the biochemical and molecular changes and possible genetic influences that occur in KC corneas. Intervention at one of these steps might be the key factor needed to block theprogression of keratoconus in the future.
Dr. Kenney is Professor and Director of Ophthalmology Research, Ophthalmology School of Medicine at the University of California-Irvine in Irvine, CA.