Understanding Keratoconus: Symptoms and Treatments

Written by Medicover Team and Medically Reviewed by Dr Manaswini Priya Varanasi , Ophthalmologists

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Keratoconus is a progressive eye disease characterized by the thinning and cone-like bulging of the cornea. This condition can significantly impair vision, making early diagnosis and effective management crucial.

In this comprehensive guide, we delve into the symptoms, causes, diagnosis, and various treatment options for keratoconus, including both conventional and alternative approaches.

Keratoconus, often abbreviated as KC, is a non-inflammatory eye condition where the normally round cornea becomes thin and develops a cone-like shape. This abnormal shape causes distorted vision, as the light entering the eye is deflected away from the retina.

What Are the Different Types of Keratoconus?

Keratoconus is classified based on the severity and progression of corneal thinning. Identifying the stage of the condition helps ophthalmologists choose the most appropriate treatment and monitor disease progression effectively.

Mild keratoconus: Slight corneal thinning with mild vision changes that are usually corrected with glasses or soft contact lenses.
Moderate keratoconus: Increased corneal irregularity causing blurred vision that often requires rigid gas-permeable or scleral contact lenses.
Advanced keratoconus: Significant corneal thinning and scarring with severe visual impairment that may require corneal cross-linking or corneal transplantation.

What Are the Symptoms of Keratoconus?

The symptoms of keratoconus can vary depending on the stage of the disease. Common early symptoms include:

Blurred or distorted vision
Increased sensitivity to light (photophobia)
Frequent changes in eyeglass prescriptions
Difficulty seeing at night

As the disease progresses, more severe symptoms may develop:

Noticeable visual distortion
Increased astigmatism
Double vision in one eye (monocular diplopia)

What Causes Keratoconus?

The exact cause of keratoconus remains uncertain, but several risk factors have been identified:

Genetics: A family history of keratoconus can increase the likelihood of developing the condition.
Environmental Factors: Chronic eye rubbing and exposure to ultraviolet rays can exacerbate the condition.
Associated Conditions: Keratoconus is often linked with systemic conditions such as Down syndrome, Ehlers-Danlos syndrome, and asthma.

When Should You See a Doctor for Keratoconus?

Consult an ophthalmologist if vision changes affect your daily activities or continue to worsen over time.

Persistent blurred or distorted vision
Frequent changes in eyeglass or contact lens prescription
Increased sensitivity to light (photophobia)
Difficulty seeing clearly at night
Double vision in one eye (monocular diplopia)
Sudden worsening of vision or eye discomfort

Early diagnosis helps slow disease progression, preserve vision, and improve treatment outcomes.

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How Is Keratoconus Diagnosed?

Early diagnosis is critical for effective management of keratoconus. Several diagnostic techniques are employed:

Corneal Topography: This non-invasive imaging technique maps the curvature of the cornea and can detect even subtle changes.
Pachymetry: Measures the thickness of the cornea and helps in assessing the progression of keratoconus.
Slit-Lamp Examination: Allows for a detailed examination of the cornea, revealing any abnormalities in shape and structure.
Keratometry: Measures the cornea's curvature to identify irregularities.

How Is Keratoconus Treated?

Treatment for keratoconus focuses on halting the progression of the disease and improving vision. The choice of treatment depends on the severity and progression of the condition.

Contact Lenses

For many patients with keratoconus, specially designed contact lenses can provide significant visual improvement:

Rigid Gas Permeable (RGP) Lenses: These lenses maintain their shape on the irregular cornea, providing clearer vision.
Scleral Lenses: Larger than traditional lenses, scleral lenses vault over the cornea and rest on the sclera, providing comfort and better vision.
Hybrid Lenses: Combine the clear vision of RGP lenses with the comfort of soft lenses.

Corneal Cross-Linking (C3R)

C3R treatment for keratoconus involves using riboflavin ( vitamin B2) and ultraviolet light to strengthen the collagen fibers in the cornea. This procedure can halt the progression of keratoconus and stabilize the cornea's shape.

Surgical Treatments

For advanced cases where non-surgical treatments are ineffective, surgical interventions may be necessary.

Intrastromal Corneal Ring Segments (ICRS)

ICRS involves implanting small, crescent-shaped rings into the cornea to flatten its shape and improve vision. This procedure can reduce nearsightedness and astigmatism, but it is not a cure for keratoconus.

Corneal Transplantation

In severe cases, a corneal transplant may be required. There are two main types:

Penetrating Keratoplasty (PK): Involves replacing the entire cornea with a donor cornea.
Deep Anterior Lamellar Keratoplasty (DALK): Only the front and middle layers of the cornea are replaced, preserving the inner endothelial layer.

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Can Keratoconus Be Prevented?

While it may not be possible to prevent keratoconus entirely, certain measures can help reduce the risk of progression:

Avoid Eye Rubbing: Chronic eye rubbing can exacerbate keratoconus and should be avoided.
Protect Eyes from UV Rays: Wearing sunglasses with UV protection can help safeguard the cornea from harmful ultraviolet rays.
Regular Eye Examinations: Routine check-ups with an eye care professional can help detect keratoconus early and monitor its progression.

What Is the Outlook for People with Keratoconus?

Managing keratoconus requires a multifaceted approach and ongoing care. Here are some tips for living with the condition:

Stay Informed: Educate yourself about keratoconus and stay updated on the latest treatments and research.
Follow Treatment Plans: Adhere to your prescribed treatment regimen and attend all follow-up appointments.
Join Support Groups: Connecting with others who have keratoconus can provide emotional support and practical advice.

Who Is at Risk of Developing Keratoconus?

Certain genetic, environmental, and medical factors can increase the risk of developing keratoconus. Recognizing these risk factors allows for earlier screening, diagnosis, and treatment to help preserve vision.