Keratoconus
Early detection protects your vision
What is keratoconus?
Keratoconus is an eye condition in which the normally round, clear front surface of the eye (the cornea) gradually becomes thinner and bulges outward into a cone-like shape. This change can cause blurred and distorted vision.
Keratoconus usually begins during the teenage years or early adulthood and may progress over time.
Common symptoms
- Blurred or distorted vision
- Reduced quality of vision even with glasses
- Frequent changes in spectacle prescription
- Increased sensitivity to light and glare
- Difficulty seeing or driving at night
- Multiple images or Ghosting
- Contact lens intolerance
- Eye strain and headaches
Causes and risk factors
The exact cause of keratoconus is not fully understood, but several factors may increase the risk:
Risk factors
- Family history of keratoconus
- Chronic eye rubbing
- Allergies causing itchy eyes
- Certain genetic conditions
- Connective tissue disorders
The disease usually affects both eyes, although one eye may be more severely affected than the other.
Why eye rubbing matters
Frequent or vigorous eye rubbing may contribute to the progression of keratoconus; it is important to seek treatment for allergies or itching and to avoid eye rubbing.
How is keratoconus diagnosed?
A comprehensive eye examination that includes
- Vision testing
- Refraction (spectacle power assessment)
- Slit-lamp examination
Corneal imaging
Specialised scans create detailed maps of the cornea and help detect keratoconus at an early stage.
Common tests include
- Corneal topography
- Corneal tomography
- Pachymetry (corneal thickness measurement)
Early diagnosis is important because treatment can help prevent progression and deterioration of vision.
Treatment options
Treatment depends on the severity and progression of the condition.
1. Spectacles: suitable for mild, nonprogressive keratoconus
2. Specialised contact lenses: when spectacles no longer provide adequate or good quality vision. These lenses provide a smoother optical surface and often improve vision significantly
- Rigid gas permeable (RGP) lenses
- Hybrid lenses
- Scleral lenses
3. Corneal collagen cross-linking (CXL)
Cross-linking is the only proven treatment to slow or halt disease progression.
Benefits:
- Strengthens the cornea
- Helps prevent worsening
- May postpone or avoid the need for future surgery
Advanced treatment options
For advanced keratoconus, your doctor may recommend:
Intracorneal ring segments (ICRS)
Small synthetic implants are placed within the cornea to improve its shape and therefore vision.
Also improves contact lens fitting in some cases
Corneal transplantation
Involves replacing the diseased cornea with a healthy donor cornea
Reserved for advanced cases when vision cannot be improved with other treatment modalities
Can be avoided with early diagnosis and timely cross-linking
Can keratoconus cause blindness?
Keratoconus rarely causes complete blindness. With modern treatments and regular monitoring, most patients maintain useful vision throughout their lives.
Is keratoconus hereditary?
It can run in families, so family members may benefit from eye examinations if keratoconus is diagnosed.
Can keratoconus be cured?
There is currently no cure, but effective treatments can improve vision and slow or stop progression.
Living with keratoconus
Keratoconus is a progressive eye disease that needs regular follow-up with an ophthalmologist
Protect your vision
- Avoid rubbing your eyes
- Seek medical advice for allergies and itchy eyes
- Follow contact lens care instructions carefully
- Report any sudden changes in vision immediately