Keratoconus

Keratoconus is a condition of the cornea (the front window of the eye). The cornea suffers protrusion and thinning which causes reduced and distorted vision. The condition is thought to have an incidence of 1 in 2000 in the general population and as such is relatively common.

Keratoconus example where the eye bulges and vision is distorted

Causes

The underlying problem is weakness of the supporting collagen fibres in the cornea. This makes the cornea structurally and biomechanically “weak”. As a result, the cornea assumes a more conical shape, resulting in irregular astigmatism. Because the astigmatism is irregular rather than regular, the distortion is difficult to correct with contact lenses or glasses in the usual way especially in the more advanced stages of keratoconus.

Symptoms of Keratoconus

Symptoms of Keratoconus

The main symptom of keratoconus is blurred vision. As the condition often starts in the teen years, people often notice difficulty seeing the board in the first instance. In 20% of cases, the condition is progressive and those people will find their vision drops further over the years.

At some point, you will have an optician assessment and it is usually at this visit that it is discovered that your vision is not correctable with glasses. The optician then normally recommends a specialist opinion where the diagnosis is confirmed and you are able to start on the correct management.

It is quite common to have a mild form of the condition which doesn’t affect your quality of life and is able to be corrected with glasses. Sometimes the condition is diagnosed when you attend for laser vision correction. The detailed tests that are performed pick up any abnormalities in the cornea (front window of the eye) and if there is evidence of keratoconus, this may mean that laser vision correction is not suitable so other options with the specialist are discussed.

Eye surgeon examining patient for Keratoconus

Treatment options

Most people can be helped with contact lenses which often have to be specially designed to account for the irregular astigmatism. In milder forms of the disease, glasses may be sufficient. However, if glasses or contact lenses are not an option, there are now several techniques available to help with this condition including corneal collagen crosslinking, intra-corneal rings, crosslinking combined with laser remodelling and corneal transplantation.

A full assessment with one of our surgeons will establish which procedure is most suitable for you and likely to give you the best outcome.