What is Keratoconus?

Keratoconus is a progressive eye condition that affects the shape of the cornea - the clear, dome-shaped surface that covers the front of the eye. In individuals with keratoconus, the cornea thins and bulges into a cone-like shape, causing visual distortion and low vision.

The exact cause of keratoconus is unknown, but it is believed to be related to a combination of genetic and environmental factors. It typically develops during adolescence or early adulthood and affects both eyes, although it may progress at different rates in each eye.

Symptoms of keratoconus can include blurry or distorted vision, increased sensitivity to light and difficulty with night vision. Treatment options range from corrective lenses and rigid gas-permeable contact lenses. to more advanced options like corneal cross-linking - in which the cornea is strengthened with a special type of ultraviolet light and eyedrops. In severe cases, a corneal transplant may be necessary to restore vision.

 

"Keratoconus usually starts in your teens or 20s and generally worsens over time, finally becoming stable by the time you reach 40."

RNIB

How someone with Keratoconus might view the world  

Please note this is a simulation of Keratoconus, based on the anecdotal experiences of people who have the condition. This image is not the experience of everyone with Keratoconus and is for illustration purposes only.

Symptoms of Keratoconus

Keratoconus is a progressive eye condition that causes the cornea to thin and bulge outwards into a cone shape. This can result in distorted vision.

Some of the common symptoms of keratoconus include:

Blurred or distorted vision

Keratoconus can cause significant visual distortion, making it difficult to see clearly.

Sensitivity to light

People with keratoconus may experience increased sensitivity to light or glare, especially at night.

Eye strain

The strain on the eyes caused by the distortion of the cornea can result in eye strain, headaches, or discomfort.

Eye redness

Keratoconus can cause the eyes to become red and irritated, particularly if the person has been rubbing their eyes frequently.

Difficulty wearing contact lenses

As the cornea becomes more irregularly shaped, contact lenses may no longer fit comfortably or provide clear vision.

Seeing halos around lights

Keratoconus can cause halos or glare around lights, especially at night.

If you are experiencing any of these symptoms, seeing an ophthalmologist for an evaluation is important. Early diagnosis and treatment can help to manage the progression of the condition and preserve your vision.

"One in 10 keratoconus sufferers has a close family relative with the disorder."

American Optopmetric Association 

Diagnosis of Keratoconus

Keratoconus can be diagnosed through a comprehensive eye examination by an ophthalmologist. The diagnosis of keratoconus usually involves the following tests:

Visual acuity test

This test measures how well you can see at various distances.

Corneal topography

This test maps the shape of your cornea, which can help identify any irregularities or bulging that are indicative of keratoconus.

Slit-lamp examination

This test uses a special microscope called a slit lamp to examine the front of your eye, including the cornea, iris, and lens.

Pachymetr

This test measures the thickness of the cornea, which is often thinner in people with keratoconus.

Refraction test

This test determines the degree of short-sightedness (nearsightedness), long-sightedness (farsightedness), or astigmatism you have.

If keratoconus is suspected, your ophthalmologist may also order additional tests such as a corneal topography or a corneal tomography scan to help confirm the diagnosis. Early diagnosis and treatment can help to manage the progression of keratoconus and preserve your vision.

"Corneal Cross Linking (CXL) treatment is successful in more
than 90% of cases."

Moorfields Eye Hospital

Treatment of Keratoconus

Keratoconus is a condition in which the cornea of the eye becomes thin and weak, causing it to bulge outwards and take on a cone-like shape. This can lead to distorted vision, astigmatism, and other vision problems. While there is no cure for keratoconus, there are several treatments available that can help manage the symptoms and slow down the progression of the disease.

Contact lenses

For mild to moderate keratoconus, specially designed contact lenses called 'gas permeable' or 'rigid gas permeable' lenses may be recommended. These lenses can help correct the irregular shape of the cornea and improve vision.

Corneal cross-linking

Also known as CXL, this non-invasive procedure involves the application of a special solution and ultraviolet light to the cornea to strengthen its collagen fibres and slow down the progression of the disease.

Intacs

This is a surgical procedure in which small plastic inserts are placed in the cornea to help flatten its shape and improve vision.

Corneal transplant

In severe cases of keratoconus, a corneal transplant may be necessary. This involves replacing the damaged cornea with a healthy donor cornea.

It's important to note that the treatment plan for keratoconus will vary depending on the severity of the condition and the individual patient's needs. If you think you may have keratoconus, it's important to schedule an appointment with an opthalmologist for a thorough evaluation and to discuss treatment options.

Living with Keratoconus

Living with keratoconus can be challenging, but with proper treatment and management, many people can maintain good vision and lead normal lives.

Here are some tips for living with keratoconus:

Follow your treatment plan

It's important to work closely with your opthalmologist to develop a treatment plan that is tailored to your specific needs. Be sure to follow their recommendations for contact lenses, medication, or surgery, and attend all follow-up appointments.

Protect your eyes

Avoid rubbing your eyes, as this can further weaken the cornea and exacerbate the condition. Wear sunglasses or a hat with a brim to protect your eyes from UV rays, wind, and other environmental factors.

Use assistive technology

Assistive technology, including screen magnifiers, screen readers and accessible book readers and text-to-speech software, can help you navigate your daily life. These tools can make it easier to read, write, study and use technology.

Whatever your experience is with computers, Dolphin assistive technology can help. 

Manage your expectations

While treatment can improve vision, it may not completely restore it to normal. Be realistic about what you can expect from your treatment and work with your opthalmologist to set achievable goals.

Join a support group

Connecting with others who have keratoconus can be helpful and reassuring. Look for support groups in your area or online.

Be patient

Managing keratoconus can be a long-term process, so it's important to be patient and persistent in your treatment efforts.

Remember, everyone's experience with keratoconus is different, so it's important to work closely with your opthalmologist to develop a management plan that is right for you.