Cornea is the clear, dome-shaped window at the front of your eye. It focuses light into your eye.

Keratoconus is a progressive disease, where the cornea thins out and bulges like a cone. The changed shape of the cornea brings light rays out of focus. As a result, the vision becomes blurry and distorted, making daily tasks like reading or driving difficult.

What Causes Keratoconus?

Doctors do not know for sure why people have keratoconus. In some cases, it appears to be genetic (passed down in families). About 1 out of 10 people with keratoconus have a parent who has it too. Keratoconus is also associated with:

    • Eye allergies
    • Excessive eye rubbing, and
    • Connective tissue disorders like Marfan syndrome and Ehlers-Danlos syndrome

Keratoconus Symptoms

Keratoconus often starts when people are in their late teens to early 20s. The vision symptoms slowly get worse over a period of about 10 to 20 years.

Keratoconus often affects both eyes, and can lead to very different vision between the two eyes. Symptoms can differ in each eye, and they can change over time.

In the early stages, keratoconus symptoms can include:

    • Mild blurring of vision
    • Slightly distorted vision, where straight lines look bent or wavy
    • Increased sensitivity to light and glare
    • Eye redness or swelling

Keratoconus Diagnosis

Keratoconus can be diagnosed through a routine eye exam. Your ophthalmologist will examine your cornea, and may measure its curvature. This helps show if there is a change in its shape. Your ophthalmologist may also map your cornea’s surface using a Corneal Topographer and also evaluate your corneal epithelium using OCT. This detailed image shows the condition of the cornea’s surface.

How Is Keratoconus Treated?

Keratoconus treatment depends on your symptoms. When your symptoms are mild, your vision can be corrected with eyeglasses. Later you may need to wear special contact lenses (scleral/mini-scleral/RGP/Rose K) to help keep vision in proper focus.

Here are other ways that your ophthalmologist might treat keratoconus:

  • Collagen cross-linking. Your ophthalmologist uses a special UV light and Riboflavin eye drops to strengthen the cornea. Doing this helps to flatten or stiffen your cornea, keeping it from bulging further.
  • Laser Based Collagen Cross Linkage. This includes latest procedures like TCAT (Topography guided Custom Laser Ablation) and TREK (Topography guided Removal of Corneal Epithelium). In TCAT, using excimer laser, irregular areas of the cornea are made regular along with removal of a small power, followed by collagen cross linkage. In TREK, the corneal epithelium is removed using excimer laser, followed by collagen cross linkage. 
  • Corneal transplant. When symptoms are severe, your ophthalmologist may suggest a corneal transplant. Your ophthalmologist replaces all or part of your diseased cornea with healthy donor cornea tissue.

Do not rub your eyes!

With keratoconus, try to avoid rubbing your eyes. This can damage thin corneal tissue and make your symptoms worse.

If you have itchy eyes that cause you to rub, speak to your ophthalmologist about medicines to control your allergies.