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    Eye Health and Keratoconus

    Can Keratoconus Damage Vision?

    The changes to the cornea can make it impossible for the eye to focus without eyeglasses or contact lenses. In fact, a corneal transplant may be needed to restore vision if the condition is severe.

    Laser vision correction surgery -- LASIK - is dangerous for people with keratoconus because it can further weaken the cornea and make vision worse. Anyone with even a small degree of keratoconus should not have LASIK surgery.

    How Is Keratoconus Diagnosed?

    Keratoconus changes vision in two ways:

    • As the cornea changes from a ball shape to a cone shape, the smooth surface becomes wavy. This is called irregular astigmatism.
    • As the front of the cornea expands, vision becomes more nearsighted. That is only up close objects can be seen clearly. Anything too far away will look like a blur.

    An eye doctor may notice symptoms during an eye exam. You may also mention symptoms that could be caused by keratoconus. These include:

    • Sudden change of vision in just one eye
    • Double vision when looking with just one eye
    • Objects both near and far looking distorted
    • Bright lights looking like they have halos around them
    • Lights streaking
    • Seeing triple ghost images
    • Being uncomfortable driving due to blurry vision

    To be sure you have keratoconus, your doctor needs to measure the shape of the cornea. There are several different ways this can be done.

    The most common way is called ‘cornea topography,’ which snaps a photo of the cornea and analyzes it in seconds. Children of parents with keratoconus should have a cornea topography done every year starting at age 10 to monitor the cornea.

    How Is Keratoconus Treated?

    Treatment usually starts with new eyeglasses. If eyeglasses don't provide adequate vision, then contact lenses, usually rigid gas permeable contact lenses, may be recommended. With mild cases, new eyeglasses can usually make vision clear again. Eventually, though, it will probably be necessary to use contact lenses or seek other treatments to strengthen the cornea and improve vision.

    A specialized procedure called PTK can smooth out the scar and improve contact lens comfort.

    A treatment called cornea collagen crosslinking is often effective to help prevent progression. Intacs are implants that are placed under the surface of the cornea to reduce the cone shape and improve vision.

    A last resort is a cornea transplant. This involves removing the center of the cornea and replacing it with a donor cornea that is stitched into place. You usually need contact lenses afterwards.

    WebMD Medical Reference

    Reviewed by Brian S. Boxer Wachler, MD on May 04, 2015
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