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Conditions

Keratoconus

A progressive eye condition where the cornea, the clear, dome-shaped front surface of the eye, thins and bulges into a cone-like shape causing distorted and blurred vision.
On this page:
What is?
Symptoms
CAUSES
TREATMENTS

What is Keratoconus?

Keratoconus is an eye condition that affects the shape of the cornea and causes distorted vision. The cornea is a thin transparent layer in the front of the eye — usually, it is a regular spherical shape, but in people with keratoconus it bulges outwards into a cone. The condition is progressive meaning it gets worse over time — as the cornea changes shape and becomes thinner the symptoms become more severe. Treating keratoconus early is the best way to limit symptoms and stop the condition from progressing.
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Symptoms

Keratoconus can be difficult to distinguish from other kinds of visual impairment. Many people with the condition will often change their prescriptions while trying to figure out the cause.

Common symptoms of Keratoconus include:

  • Blurred or distorted vision
  • Light sensitivity
  • Ghosting or double vision
This last symptom is often common at night when bright lights can create a variety of visual distortions.
The condition affects both eyes, but usually with different severity. Optometrists diagnose keratoconus by identifying irregularity in the shape of the cornea. There are a range of tests that can achieve this including Corneal Mapping and Keratometry, which may be performed during an eye exam.

Causes

Keratoconus is a progressive eye condition in which the cornea thins and bulges outward in a cone-like shape, leading to visual distortion and decreased vision. The exact cause of keratoconus is not fully understood, but several factors may contribute to its development, including:
There is evidence to suggest that genetic factors play a role in the development of keratoconus. The condition is more common in individuals with a family history of keratoconus.
The cornea is the clear, dome-shaped outer layer of the eye that helps to focus light. In keratoconus, the cornea becomes progressively thinner and weaker, leading to the characteristic bulging and distortion.
Chronic eye rubbing, especially in susceptible individuals, can contribute to the progression of keratoconus. This is why avoiding eye rubbing is often recommended for individuals with keratoconus.
Factors such as allergies, chronic eye irritation, and UV light exposure may also play a role in the development of keratoconus.
Some studies suggest that hormonal changes, such as those occurring during puberty or pregnancy, may influence the progression of keratoconus.
Keratoconus is more common in individuals with certain connective tissue disorders, such as Ehlers-Danlos syndrome or Marfan syndrome.
Previous eye injuries or surgeries can sometimes lead to the development of keratoconus.
While the exact cause of keratoconus is not always clear, early detection and management are important to slow the progression of the condition and preserve vision. Treatment options for keratoconus may include eyeglasses, contact lenses, corneal collagen cross-linking, and in severe cases, corneal transplant surgery.

Treatments

Keratoconus affects people in different ways, so treatment varies from patient to patient. For those with mild symptoms, glasses or contact lenses are often sufficient to correct vision. In other cases, surgery may be necessary to slow down or stop the progression of the condition.

Corneal cross-linking

Corneal cross-linking (CXL) is a kind of laser eye surgery which can be used to treat keratoconus to make the tissues stronger in the cornea. It’s called “cross-linking” because the treatment adds bonds between the collagen fibres in the eye which work like support beams to help the cornea stay stable. CXL is only available where the corneal shape is continuing to deteriorate. If the cornea is too thin it could be unsafe to perform this procedure.

Intacs

These tiny rings are inserted within the tissue allowing its shape to be stabilised.

Corneal transplant

In the most serious cases, a corneal transplant may be necessary to restore vision. Replacing corneal tissue with that of a donor is a more complex procedure and has greater risks.

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