Everett Kinsey lecture. The elusive causes of keratoconus: a working hypothesis.

Abstract

Our hypothesis attempts to incorporate many of the recognized biochemical and molecular abnormalities found in the keratoconus corneas. Our hypothesis states: 1) there is abnormal processing of the free radicals and superoxides within the keratoconus corneas; 2) there is a build-up of destructive aldehydes or peroxynitrites within the corneas; 3) the cells that are damaged irreversibly undergo the process of apoptosis; and 4) the cells that are damaged reversibly undergo wound healing or repair. As part of the wound healing process, various degradative enzymes and wound healing factors are upregulated, which leads to focal areas of corneal thinning and fibrosis. Future studies will be directed to testthis working hypothesis and determine if these theories are valid.