What is keratoconus?

Keratoconus is a disease of the cornea (the clear window at the front of the eye), which becomes gradually thinned. The cornea can then start to very gradually bulge forward, causing the normally regular, smooth shape of the cornea to become irregular and cone shaped. This produces blurring and distortion of vision.

The rate of change is very variable. Generally, the later the onset of the condition, the more slowly it progresses, and the earlier it stabilizes. The rate of progression can also vary between each eye, for example one eye may be quite badly affected, while the other shows little or even no changes at all.

What causes keratoconus?

The exact cause is not known. Most patients do not have a family history of the condition. It is known to be associated with certain conditions, particularly asthma and eczema, and some skin & joint diseases, but many patients are healthy. Eye-rubbing is known to worsen the condition, and should be avoided.

What treatment will I need?

In the early stages of the condition, the symptoms of slightly reduced vision can be corrected with spectacles. If the condition progresses or is more marked, rigid gas-permeable contact lenses are used to restore the vision, often with very good results. In many patients, spectacles or contact lenses are all that will be required, although these will need to be up-dated from time to time.

All contact lens wear does carry some risk of complications, so it is important to follow the advice given by your contact lens practitioner, and to attend for regular appointments as and when requested.

In some patients the thinning and distortion of the cornea can get slowly worse over time. This becomes less likely after the age of 30. If this happens, it is possible to treat some patients with an ultraviolet light treatment called “corneal cross-linking”. This treatment involves ultraviolet light therapy directed at your eye for up to 30 minutes, and can help slow or prevent worsening of the condition. If you would benefit from this treatment, your doctor will discuss this with you.

A minority of patients find their vision continues to slowly deteriorate even with contact lenses, or find increasing difficulty managing with contact lenses. These patients may require a ‘corneal transplant’ operation to restore their vision. If you need to have a corneal transplant, this option will be fully explained and discussed with you, by the doctor in the eye clinic.

Should I get my children’s eyes checked?

Although keratoconus can run in families, most patients do not have a family history of the condition. Specific screening for keratoconus is therefore not necessary. Regular eye tests for children are recommended, regardless of a history of keratoconus.

 Will I go blind?

Keratoconus does not cause complete blindness. It is difficult to predict how rapidly the condition will progress in any one individual, but most patients with keratoconus do not require surgery. Although contact lenses do not halt or alter the progression of the disease, they do provide a very good level of vision to enable most patients to continue with their normal daily lives.