Diagnosis and Treatments for Keratoconus

by Jun 6, 2023

Keratoconus is a progressive eye condition that affects the cornea. The term keratoconus comes from the Greek words “kerato” for cornea and “konos” for cone, which accurately describes the abnormality’s characteristic shape. The cornea of a healthy eye is supposed to be round and transparent. However, in the case of those with keratoconus, the cornea bulges outwards and acquires a cone-like shape, leading to distorted and blurry vision. A healthy cornea is vital for undistorted visual acuity as it bends light rays that pass through the eye. Additionally, a healthy cornea also protects the eye from harmful sources of light.

When is Keratoconus Diagnosed

Most cases of keratoconus are diagnosed in teenagers or young adults, typically between the ages of ten and twenty-five. However, the disease can also affect those outside of this age range. Though not specific to any race, ethnicity, or gender, genetics undoubtedly play a role in developing keratoconus. A familial history of the disease increases the likelihood of developing keratoconus, suggesting a potential genetic component. That said, keratoconus is still unpredictable and has no exact causes.

Diagnosing keratoconus requires comprehensive eye exams, including medical history. Subtle changes in vision may signal the onset of keratoconus, and a thorough eye examination will identify any abnormalities. Diagnosis typically involves a slit-lamp examination, where eye doctors use a special microscope and light to examine the cornea.


Stages of Keratoconus

Keratoconus is progressive, and vision disturbances get worse over time. In the early stages, a patient may not experience significant changes in the cornea’s shape and may require a comprehensive eye exam to detect its presence. As the disease progresses, the cornea takes on a cone-like shape, with the apex being the thinnest area of the cornea and the point of maximal convexity. The bending of light rays in the eye becomes more erratic, leading to blurry and distorted vision as the thinning progresses.


Treatments for Keratoconus

There is no cure for keratoconus, but various treatments can address the condition’s symptoms. Eyeglasses may not be effective in correcting vision, but scleral contacts and rigid corneal contacts may provide better results by accommodating the corneas’ irregular shape. In some cases, these contacts can improve the corneal shape, and stop the progression of the disease altogether. Additionally, corneal cross-linking (CXL) is a minimally invasive procedure that stops keratoconus progression. It is an epithelium-off procedure that involves the eye doctor placing riboflavin on the cornea and exposing it to UV light. This process creates new corneal bonds, making the cornea more rigid and reducing the progression of the disease. While CXL does not provide immediate visual improvement, it reduces the rate of disease progression and ensures that visual acuity is preserved.

Keratoconus patients that have had the disease for several years or are experiencing severe vision deterioration will most likely require a more interventionist approach. In these instances, implement an individualized treatment plan with a combination of contact lenses, CXL, or other refractive surgical options. The primary goal is to restore vision and prevent further deterioration of vision.

Our eye doctors at Neal Eye Group in Conshohocken, PA excel in the prescription of contact lenses, glasses and various eye diseases.  Call our optometrists at (610) 828-9701 or schedule an appointment online if you would like to learn more about keratoconus. Our optometrists provide the highest quality optometry services and eye exams in Conshohocken, Norristown, Plymouth Meeting, Lafayette Hill, and Philadelphia.


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