Keratoconus and Your Treatment Options

What is keratoconus?

Keratoconus is a progressive eye condition in which the normally dome-shaped cornea thins over time causing an irregular conical shape that distorts vision. Symptoms are typically first noticed in the late teens or early 20’s and tend to progress slowly over the next 10-20 years. Keratoconus
is usually present in both eyes and occurs in approximately 1 in 2,000 people, though new reports are showing the condition may be more prevalent.

What causes keratoconus?

The exact cause of keratoconus is unknown. About 10% of people with keratoconus have a family history of the condition. Frequent eye rubbing (usually allergy-related) has also been associated with keratoconus and should be avoided.

What are the symptoms of keratoconus?

Depending on the rate of progression and severity, keratoconus can have mild to severe effects on your vision. Early symptoms of keratoconus may include: mild blurring or distortion of vision especially at night, light sensitivity, glare or halos, mild eye irritation, and eye strain. Symptoms of more advanced keratoconus may include: constant severe blurring or distortion of vision, increased nearsightedness or astigmatism, frequent eyeglass prescription changes, and intolerance to traditional contact lenses

How is keratoconus managed?

Regular annual examinations with your eye doctor ensures proper treatment recommendations to prevent vision loss. Patients with keratoconus should also have a topography/tomography scan of the cornea every 6-12 months to monitor for keratoconus progression and confirm stability. If instability is detected, scans may be done more frequently.

How is keratoconus treated?

With mild forms of keratoconus, glasses can sometimes provide acceptable vision, but in most cases, custom fitted contact lenses provide the best vision due to the irregularity of the cornea’s shape.

At Eye Clinics of Seattle, Dr. Charissa Young, OD, FAAO, FSLS specializes in fitting contact lenses for keratoconus, including custom soft, rigid/hard corneal and scleral contact lenses. Call our office to schedule your specialty contact lens consultation.

If keratoconus is diagnosed early, corneal collagen cross-linking (CXL) may prevent or delay the need for corneal transplants. CXL is a non-invasive treatment where riboflavin and ultraviolet light are applied to the cornea, strengthening the bonds to make the cornea more resilient to thinning. CXL can be repeated if needed. Glasses or contact lens correction is still required post-operatively. Your doctor can assess your candidacy at your examination.

In about 15% of cases, keratoconus has an aggressive course. Progressive corneal thinning can lead to scarring that deteriorates vision, necessitating surgical intervention. The primary surgical treatment for advanced keratoconus is a corneal transplant. While corneal transplants for keratoconus have a high success rate, there are still risks of infection or rejection. Glasses or contact lens correction is still required post-operatively.