Keratoconus is a progressive eye disorder where the normally round cornea thins and begins to bulge into a cone-like shape. This abnormal shape prevents light from being focused correctly on the retina, resulting in distorted vision. The condition typically starts in adolescence or early adulthood and can worsen over time, leading to significant visual impairment if left untreated.


Symptoms of keratoconus may include:

  • Blurred or distorted vision
  • Increased sensitivity to light
  • Frequent changes in eyeglass prescriptions
  • Double vision in one eye

Causes & Risk Factors:

Causes of keratoconus may include:

  • Genetic factors: A family history of keratoconus can increase the likelihood of developing the condition.
  • Overexposure to ultraviolet rays: Excessive exposure to UV rays from the sun can contribute to corneal thinning.
  • Chronic eye rubbing: Frequently rubbing the eyes, especially with force, can weaken the corneal tissue.
  • Incorrectly fitted contact lenses: Poorly fitted contact lenses can exert undue pressure on the cornea, leading to structural changes.

These factors disrupt the normal structure of the cornea, resulting in its thinning and bulging into a cone-like shape, which impairs vision clarity. Watch the video below to learn more about keratoconus:

Testing & Diagnosis:

Testing and diagnosis of keratoconus typically involve:

  • Visual Acuity Testing: This assesses the clarity of vision at various distances using an eye chart, such as the Snellen chart, to determine how well the patient sees and if there are any distortions in their vision.
  • Corneal Topography: A detailed mapping of the cornea’s surface helps to detect irregularities and the cone-like bulging characteristic of keratoconus. It is the most effective test for diagnosing and monitoring the progression of the condition.
  • Pachymetry: This test measures the thickness of the cornea, which can help identify thinning that is typical of keratoconus.
  • Slit-Lamp Examination: Using a special microscope called a slit lamp, the eye doctor examines the cornea for signs of keratoconus, such as a conical shape, scarring, or stress lines (Vogt’s striae).
  • Keratometry: This test measures the curvature of the cornea’s surface. In keratoconus, the cornea’s shape becomes more conical, which can be detected through keratometry.

These tests and evaluations help our team accurately diagnose keratoconus and determine the most appropriate treatment options to improve vision and maintain corneal health.

Treatment Options

Some common treatment options for keratoconus include:

  • Prescription Eyeglasses or Soft Contact Lenses: In the early stages, corrective lenses can help improve vision by compensating for the irregular shape of the cornea.
  • Rigid Gas Permeable (RGP) Contact Lenses: These lenses provide a smooth refractive surface and are often prescribed when eyeglasses or soft contact lenses no longer provide adequate vision correction.
  • Scleral Lenses: These large-diameter lenses vault over the cornea and rest on the sclera, providing a smooth surface and clear vision while being more comfortable than RGP lenses for some patients.

The choice of treatment depends on factors such as the severity of keratoconus, the patient’s lifestyle, and personal preferences. Regular follow-up visits are essential to monitor the condition and adjust treatments as needed to maintain optimal visual acuity and corneal health. Watch the video below to learn more about how keratoconus is treated, and keep reading below to learn more about more advanced treatment options.

Corneal Collagen Cross-Linking

Corneal collagen cross-linking is a method to make the cornea stronger using a combination of riboflavin solution drops into the eye (a form of vitamin-B2) followed by the application of controlled ultraviolet (UV) light exposure for up to 30 minutes. This 2-step process has been shown to increase the cross-links in the cornea to provide strength and stability to the cornea. Only one treatment may be needed for some patients. This treatment may be covered by insurance.

Intacs® Corneal Implants

Another way to improve vision is to insert thin implants into the eyes to reshape the cornea. At Azul Vision, we may recommend Intacs corneal implants that use ring segments to push the cornea outward so the bulging shape is minimized. Only a small incision is needed to insert the rings into the layers of your cornea. These implants are virtually invisible in the eyes and you won’t be able to feel them.

Corneal Transplant

In severe cases, it may be necessary to have a corneal transplant. Your doctor will only recommend this treatment if your corneal damage from keratoconus is very severe. Keratoconus can be hereditary or it may be caused by an enzyme imbalance in the cornea. Click below to schedule an eye exam today! One of our eye care professionals can assess the situation and give treatment recommendations.

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