Diagnose and manage keratoconus, including options such as specialty contact lenses.

Understanding Keratoconus


Keratoconus is a progressive eye condition characterized by the thinning and bulging of the cornea, the clear front surface of the eye. This distortion can lead to blurry vision, light sensitivity, and visual distortion, affecting an individual’s quality of life. Diagnosing keratoconus early is crucial, as prompt treatment can help manage its symptoms and halt its progression. This guide offers a concise introduction to the diagnostic processes and the various treatment options available, helping patients navigate their journey towards clearer vision and better eye health. Whether you’re new to this diagnosis or looking for the latest interventions, understanding keratoconus is the first step towards optimal eye care.


Symptoms of Keratoconus:
If you or someone you know is experiencing any of the following symptoms, it may be indicative of keratoconus:
  • Blurred or distorted vision
  • Increased sensitivity to light
  • Difficulty driving at night
  • Sudden worsening or clouding of vision
  • Frequent changes in eyeglass prescription
Who Does Keratoconus Affect?
Keratoconus often begins in the teen years to early 20s, but it can start at any age. Its progression can be fast or slow, and can affect one or both eyes. Several factors can contribute to the onset or progression, including:
  • Genetics: It can run in families.
  • Environmental factors: Frequent eye rubbing and exposure to ultraviolet rays.
  • Associated conditions: Allergies, eczema, and connective tissue disorders.
How is Keratoconus Diagnosed?
Early detection is vital. Ophthalmologists can diagnose keratoconus using:
  • Eye examination: Reviewing the patient’s medical and family history.
  • Refraction test: Determines the prescription for eyeglasses or contact lenses.
  • Slit-lamp examination: Inspects the cornea and other eye areas.
  • Keratometry: Measures the shape of the cornea.
  • Corneal topography: Provides a detailed shape map of the cornea.
  • Pachymetry: Measures the cornea’s thickness.
Available Treatments for Keratoconus:
The goal of treatment is to improve vision and halt the disease’s progression. Depending on its severity, several treatments are available:
  • Eyeglasses or soft contact lenses: For mild cases.
  • Hard contact lenses: Provides a smoother surface to correct vision issues.
  • Piggyback lenses: Wearing both soft and hard lenses for comfort and clarity.
  • Hybrid lenses: A mix of hard and soft lenses.
  • Scleral lenses: Cover a larger portion of the sclera or white part of the eye.
  • Intacs: Surgical implants to reshape the cornea.
  • Collagen cross-linking: A procedure to strengthen the corneal tissue.
  • Corneal transplant: Recommended for severe cases where other treatments don’t help.

Specialty Contact Lenses for Keratoconus


Keratoconus can lead to irregular astigmatism, where the cornea becomes uneven. This irregularity makes it challenging for regular eyeglasses and standard contact lenses to provide clear vision. Specialty contact lenses are designed to address this unique shape, offering clearer vision and increased comfort for those with keratoconus.


Rigid Gas Permeable (RGP) Lenses:

What are they? RGP lenses are made of a semi-rigid material that allows oxygen to pass through to the eye.

How do they work? The rigid nature of these lenses helps to create a smooth refractive surface, compensating for the irregular cornea shape. The lens vaults over the cornea, supported by a thin layer of tear fluid between the cornea and the lens, which aids in comfort and vision correction.

Hybrid Lenses:

What are they? Hybrid lenses combine the features of hard and soft lenses. They have a rigid center to correct vision and a soft lens skirt for improved comfort.

How do they work? The rigid center provides a clear line of sight by covering the cone-shaped cornea, while the soft skirt ensures the lens is centered and comfortable.

Piggybacking Lenses:

What are they? This involves wearing two lenses on one eye: a soft contact lens underneath a rigid gas permeable lens.

How do they work? The soft lens acts as a cushioning base for the RGP lens. This system can provide the clear vision benefits of RGPs while offering the comfort of soft lenses, especially for those who find it challenging to wear RGPs alone.


Scleral and Semi-Scleral Lenses:

What are they? These are larger diameter lenses that sit on the sclera (the white part of the eye) rather than just the cornea.

How do they work? They vault over the entire corneal surface, ensuring that there’s no direct contact with the cone-shaped cornea. The space between the back surface of the lens and the cornea is filled with a saline solution, which provides comfort and ensures consistent vision.


Which Lens is Right for You?

Choosing the best lens depends on the shape and severity of your keratoconus, as well as your personal comfort and vision requirements. It’s essential to work closely with an eye care professional specializing in fitting contact lenses for keratoconus. They can evaluate your needs, provide tailored recommendations, and ensure a proper fit for optimal vision and comfort.

Regular Check-ups Are Essential

Your cornea can change shape as keratoconus progresses, which means you might need adjustments in your contact lens prescription or type over time. Regular appointments with your eye doctor ensure that you’re always getting the best vision correction possible.


Frequently Asked Questions (FAQs) Keratoconus

Keratoconus is a progressive eye condition in which the normally round cornea thins and begins to bulge into a cone-like shape, leading to vision distortion.

The exact cause remains unknown, but it is believed to be a combination of genetic, environmental, and hormonal factors. Frequent eye rubbing and certain conditions like allergies and eczema can also contribute.

It’s diagnosed through a comprehensive eye exam which can include keratometry (to measure the shape of the cornea), corneal topography, and pachymetry (to measure corneal thickness).

While keratoconus can significantly impair vision, it rarely leads to complete blindness. However, if left untreated, it can progress to a point where vision is severely compromised.

Treatment options range from eyeglasses and specialty contact lenses for mild cases to surgical interventions like corneal crosslinking and corneal transplants for more severe cases.

There is a genetic component to keratoconus, and it can run in families. However, not everyone with a family history will develop the condition.

While there’s no cure for keratoconus, its progression can be halted or slowed with treatments like corneal crosslinking. The goal is to stabilize the cornea and improve vision.

Keratoconus affects approximately 1 in 2,000 people globally. Its onset typically begins in the late teens to early twenties.

Yes, many people with keratoconus wear contact lenses. Specialty lenses like rigid gas permeable (RGP), hybrid, and scleral lenses are designed to fit the irregular shape of a keratoconic cornea.

Keratoconus typically affects both eyes, though it might progress at different rates in each eye, leading to varying degrees of vision impairment.