Keratoconus is an eye condition that affects the cornea, the clear, dome-shaped window at the front of the eye.
The cornea is responsible for focusing most of the light that enters the eye, allowing us to see clearly.
In keratoconus, the cornea gradually becomes thinner and weaker, causing it to bulge forward into a cone-like shape.
This change in shape alters the way light enters the eye, potentially leading to distorted or blurred vision.
While keratoconus is relatively uncommon, early detection and proper management are important to maintain good vision and prevent complications.
The exact cause of keratoconus is not fully understood, but researchers believe several factors may contribute:
Genetics:
Family history can play a role. If someone in your family has keratoconus, your risk may be higher.
Hormonal influences:
The condition is often first noticed during puberty and can progress during pregnancy, suggesting that hormones may affect corneal structure.
Connective tissue differences:
Some studies suggest that variations in collagen (the protein that gives the cornea strength and structure) may contribute.
Eye rubbing:
Frequent and forceful eye rubbing is strongly linked to keratoconus progression. Eye rubbing is often associated with conditions such as hay fever, eczema, or dry eyes.
Ill-fitting contact lenses can sometimes worsen the condition, which is why it is important to have contact lenses prescribed and fitted by a qualified optometrist.
Keratoconus can develop slowly, and symptoms may not be obvious at first. Some common signs include:
Because these symptoms can overlap with other eye conditions, a professional eye examination is the only way to confirm whether keratoconus is present.
If your optometrist suspects keratoconus, the most important test is a corneal topography scan. This is a painless test that creates a detailed map of the surface of the cornea, much like a geographical map showing hills and valleys.
The scan allows your optometrist to:
Regular monitoring is important, especially in younger patients, as keratoconus can progress more quickly during adolescence and early adulthood.
For most people, keratoconus does not lead to blindness. With appropriate care, fewer than 5% of patients ever require a corneal transplant. The condition often stabilises by the late 20s or early 30s.
Vision can usually be managed successfully with glasses or contact lenses, and newer treatments have made it possible to slow or stop progression in many cases.
The right treatment for keratoconus depends on its stage and severity. Management can be divided into non-surgical and surgical approaches.
Glasses:
Useful in the early stages, but often not enough on their own once the cornea becomes more irregular.
Rigid gas permeable contact lenses:
These small, firm lenses create a smooth surface in front of the cornea, improving vision significantly. They require specialist fitting to ensure comfort and safety.
Custom contact lenses:
Options such as scleral or hybrid lenses may be recommended in more advanced cases.
Corneal Collagen Cross-Linking (CXL):
This procedure has been available for around 15 years and is designed to strengthen the cornea. It involves applying vitamin B2 (riboflavin) eye drops and then exposing the cornea to controlled ultraviolet (UV) light.
This stimulates new bonds in the corneal collagen fibres, helping the cornea maintain its shape and halting further progression.
CXL is not a cure and does not reverse existing changes, but it can prevent keratoconus from worsening. The full benefit may take several months to a year to become clear.
Corneal transplant:
In severe cases where other options are no longer effective, a corneal transplant may be considered. However, advances in contact lens design and CXL have greatly reduced the number of people needing this procedure.
While being diagnosed with keratoconus can feel overwhelming at first, many people live well with the condition when it is properly managed. Regular check-ups, appropriate lenses, and avoiding habits such as eye rubbing can all make a big difference.
At Optometrist Parramatta, our team has extensive experience fitting contact lenses for keratoconus and working with patients to manage this condition over time.
If you are experiencing ongoing vision changes, frequent prescription updates, or symptoms such as ghosting and eye discomfort, an eye test can help determine the cause and guide your options.
Book an appointment with Optometrist Parramatta today to have your eyes checked and discuss whether keratoconus may be affecting your vision.
This content is for general information only and is not a substitute for professional eye care advice, diagnosis, or treatment. Always consult a qualified optometrist or healthcare professional regarding your individual circumstances.
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