Keratoconus

Keratoconus is a progressive eye condition in which the cornea (the clear, dome-shaped front surface of the eye) becomes thinner and gradually bulges outward into a cone-like shape. Because the cornea is responsible for bending light into focus, this irregular shape causes distorted, blurry vision that glasses and standard soft contacts often cannot correct.

Keratoconus typically begins in the teenage years to early adulthood but can appear at any age and may progress over time.

Causes

The exact cause of keratoconus is not fully understood, but several factors are believed to contribute:

• Genetics / family history
• Chronic eye rubbing (often related to allergies or dryness)
• Underlying conditions such as atopy, Down syndrome, or connective tissue disorders
• Corneal biochemical weakness leading to thinning over time
  

Risk Factors for KC

You may be more likely to develop keratoconus if you have:

• A parent or sibling with keratoconus
• Chronic allergies or itchy eyes
• A history of vigorous eye rubbing
• Asthma, eczema, or other atopic conditions
• Certain systemic connective-tissue disorders
• Early onset of rapidly changing prescriptions

Common Symptoms of KC

Patients with keratoconus may notice:

• Blurry or distorted vision
• Ghosting, halos, or shadows around objects
• Increased sensitivity to light and glare
• Difficulty seeing at night
• Frequent changes in glasses or soft contact lens prescriptions
• Eye strain, headaches, or visual fatigue
• Sudden worsening of vision (in advanced or acute cases)

Progression

Keratoconus is typically progressive, especially in younger patients. Over time, the cone may:

• Become steeper or more irregular
• Cause further thinning
• Lead to scarring
• Reduce vision even with glasses
• Require more specialized treatment
• Progression usually slows in the mid-30s to 40s, but not always. Consistent monitoring is key.

Diagnosis

Keratoconus is diagnosed through a combination of:

• Comprehensive eye exam
• Corneal topography (maps the shape of the cornea)
• Keratometry (measures curvature)
• OCT imaging
• Pachymetry (measures corneal thickness)

Advanced imaging allows detection of early or subtle forms, often before symptoms become obvious.

Treatment Options for KC

Keratoconus treatment is based on severity, rate of progression, and visual needs. Options include:

1. Eyeglasses and Soft Contact Lenses work well in early stages but typically become insufficient as the cornea becomes more irregular.

2. Corneal Cross-Linking (CXL): a procedure designed to halt or slow the progression of keratoconus by strengthening collagen fibers in the cornea.

• Helps preserve vision
• Most effective when done early
• Does not reverse existing distortion but prevents worsening

3. Specialty Contact Lenses

As keratoconus progresses, glasses and standard soft lenses often struggle to provide clear, stable vision. Specialty contact lenses, including RGP, hybrid, and custom soft lenses, can offer better clarity, but scleral lenses are widely considered the gold standard for moderate to advanced keratoconus.

Scleral lenses create a smooth, consistent optical surface that neutralizes the distortion caused by an irregular cornea. By vaulting over the cone and resting gently on the sclera, they deliver exceptional clarity, comfort, and all-day stability. For many patients, scleral lenses restore functional, reliable vision when other options can’t — often making them the most transformative solution for keratoconus-related vision loss.

4. Corneal Transplant: recommended only in advanced cases when scarring, extreme thinning, or poor vision cannot be corrected with lenses or other treatments.

Management & Prognosis

With early diagnosis and proper management, most keratoconus patients maintain good long-term vision. Ongoing care may include:

• Routine monitoring of corneal shape
• Adjustments in lens design
• Cross-linking if progression is detected
• Protecting the eyes from rubbing and allergies
• Regular follow-up exams to ensure optimal corneal health

When to Seek Care

You should schedule an exam if you experience:

• Rapid or frequent changes in prescription
• Increasing glare, halos, or distorted vision
• Trouble seeing at night
• Decreased vision that glasses no longer correct
• A family history of keratoconus
• Any sudden drop in vision (this may be an emergency)

Our expert doctors use advanced diagnostic technology to detect, monitor, and manage keratoconus at every stage. With their specialized training in complex corneal conditions, they design individualized treatment plans focused on preserving vision, restoring clarity, and safeguarding long-term corneal health.