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Possible Link Between Keratoconus and Accutane
Anthony wrote:
I am 18 years old. I started taking accutane 4 months ago. Today I was told that I have the symptomes of Keratoconus. Do you think that it is caused by the accutane? I've never complained about my vision before taking accutane and nobody in my family has Keratoconus. Since Keratoconus was just discovered, do you think if I stop the accutane, my cornea will be fine? Thanks
Dr Henry Smit's response:
Dear Anthony
There does not appear to a link between the use of Accutane and the development of keratoconus (KC). Keratoconus, as you may already know, is an non-inflammatory condition of the eye that causes thinning and steepening or “coning” of the cornea (the front optical surface of the eye). The symptoms of KC usually first appear in the second decade of life, and this coincides with the time that Accutane is most frequently prescribed – as a treatment for acne. Although a small number of patients who take Accutane have keratoconus, there is little evidence to suggest that using Accutane has caused the keratoconus.
In the majority of cases, KC causes blurred vision that is difficult to correct with eyeglasses. Rigid gas permeable contact lenses sometimes provide better vision than spectacles alone. The condition may progress for 10 to 20 or more years and, in many cases, stabilizes in middle age.
The exact cause of KC remains a mystery. Some people may have a genetic predisposition to develop the disease, but according the National Keratoconus Foundation (American) “there is less than a one in ten chance that a blood relative of a keratoconic patient will have keratoconus. Eye rubbing (either from poorly fitting contact lenses or from the patient rubbing their eyes in response to an allergic reaction) appears to be more significant contributing factor than genetics alone, but even this factor is not universally accepted as causative.”
Based on my clinical experience, keratoconus usually develops slowly, and patients most often have measurable signs of the disease for some time before the symptoms are noticeable. As you have only been on Accutane for 4 months, it appears most likely that your development of the symptoms of keratoconus while on Accutane, was a coincidence. If your Accutane is effectively treating the condition for which it was prescribed, having keratoconus does not appear to be a contraindication for continuing the medication.
On the bright side, there is a treatment called “corneal cross-linking” which is often effective in stabilizing keratoconic corneas. You may want to discuss with your optometrist if you are a suitable candidate for this procedure.
Best of luck,
Dr. Henry Smit
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