Keratoconus is a progressive eye condition in which the normally round, dome-shaped cornea gradually thins and begins to bulge outward into a cone-like shape. This irregular corneal geometry distorts the way light enters the eye, causing progressively worsening blurred and distorted vision that glasses and standard soft contact lenses cannot adequately correct. Keratoconus typically appears in the late teens to early 20s and may progress for one to two decades before stabilizing.

Recognizing the Signs of Keratoconus

  • Progressive blurring and distortion of vision that changes frequently
  • Increased sensitivity to glare and light, particularly at night
  • Ghosting or multiple images from one eye
  • Frequent prescription changes that still don't produce clear vision
  • Eye rubbing — a risk factor that can accelerate corneal thinning

Diagnosis

Keratoconus is diagnosed through corneal topography, which creates a detailed map of the corneal surface shape. Early or subclinical keratoconus can be detected before vision is significantly affected, which is why topography screening is important for patients with unusual refractive patterns or a family history of the condition.

Treatment Options by Stage

  • Glasses and soft contact lenses — Effective only in very early, mild keratoconus when the corneal shape is still fairly regular
  • Specialty contact lenses — The primary treatment for moderate to advanced keratoconus. Rigid gas-permeable (RGP), hybrid, and scleral lenses vault over the irregular cornea and create a smooth, uniform optical surface, restoring functional vision
  • Corneal cross-linking (CXL) — The only treatment that halts keratoconus progression. A minimally invasive procedure using riboflavin (vitamin B2) drops and UV light to strengthen the collagen bonds within the cornea. It doesn't reverse existing distortion but prevents further worsening
  • Intacs corneal implants — Small plastic ring segments inserted into the cornea to flatten and regularize its shape, improving the fit of contact lenses
  • Corneal transplant (PKP or DALK) — Reserved for advanced cases where contact lenses can no longer provide adequate vision; outcomes are generally very good

Our team has extensive experience fitting specialty lenses for keratoconus patients and coordinating cross-linking referrals when indicated. If you've been told you have keratoconus or suspect you might, contact us to schedule a comprehensive evaluation.