Keratoconus

The cause of keratoconus isn’t fully understood, but genetics may play a part as it does run in some families.

Keratoconus is known to be associated with eye rubbing. Allergic eye conditions and keratoconus are frequently seen together.

Early symptoms of keratoconus include:

• blurred vision – even when you're wearing glasses or contact lenses
• distorted vision – where objects can look warped
• increased sensitivity to light and glare.

Both eyes can be affected, but you may have different symptoms in each eye.

Later (usually over several months to years) you may experience:

• increased blurriness and distorted vision
• altered refraction (focus error) especially increasing astigmatism (a condition where your eye is oval shaped instead of evenly rounded), meaning your glasses can lose their helpfulness more quickly than usual
• not being able to wear regular contact lenses because they don’t fit properly anymore.

Keratoconus can occasionally change rapidly when your cornea becomes very thin. See a doctor immediately if you have any of these symptoms or signs:

• Sudden onset of severely blurred vision.
• Severe light sensitivity, redness and pain.

If you’re concerned that you might have keratoconus, it’s important to see your healthcare provider or an optometrist for an eye examination. They will do some initial tests and can help work out what's causing your vision to be blurry.

After these tests, you may need more detailed testing by an optometrist and/or an eye surgeon (ophthalmologist). This may include a corneal topography test to assess the shape of your cornea and look for swelling or scarring.

Read more about eye examinations.

Treatment of keratoconus depends on its stage and severity.

Visual enhancement with glasses or contact lenses

Usually, your vision can be corrected using glasses or contact lenses. There are different types of contact lenses that your optometrist can advise you about. A government subsidy may be available to help with the costs of contact lenses. Ask your eye specialist for more information about this.

Surgery

Sometimes surgery may be recommended if your keratoconus is progressing. A procedure called corneal cross-linking is available to slow down or stop its progression. If your condition is severe, and your vision doesn’t improve sufficiently with visual aids, corneal transplant surgery may be of benefit. This has been used successfully for many years and can restore significant visual function. Your eye specialist will recommend the best procedure for you.

If you have keratoconus it's most important to avoid rubbing your eyes. Rubbing can damage your cornea and make your symptoms worse. It is therefore critical to have your allergies controlled. Talk to your healthcare provider about medicines to control allergies.

Apps reviewed by Healthify

You may find it useful to look at some visual impairment apps. 

Most people with keratoconus have better vision with contact lens treatment.

Although corneal transplant is generally successful, there is a significant risk involved. If you are privileged to be offered a corneal transplant, you must follow the recommended care and attend all future appointments to ensure long term success and maintenance of your vision. The post-operative recovery can take some time and you may still need to wear glasses or contact lenses to optimise your vision afterwards.

Laser refractive surgery for vision correction is contraindicated for people with keratoconus.