What is Keratoconus?
Keratoconus is a progressive eye condition where the normally round cornea thins and begins to bulge into a cone-like shape. This cone shape deflects light as it disrupts the visual pathway on its way to the light-sensitive retina, causing distorted vision.
For many patients, this diagnosis comes as a shock. You may have just gone in for a regular eye exam, thinking you needed a stronger prescription, only to be told you have a degenerative corneal disease. The good news is that modern medicine has transformed keratoconus from a potentially blinding condition into a manageable one.
Key Symptoms to Watch For
- Fluctuating Vision: Your prescription seems to change every time you visit the eye doctor.
- Halos and Glare: Driving at night becomes difficult due to "starbursts" around lights.
- Ghosting: Seeing double or triple images, especially with high-contrast text.
- Sensitivity to Light: Squinting more often, even indoors.
What Causes It?
While the exact cause is still being researched, we know it is a combination of genetics and environmental factors:
- Genetics: About 1 in 10 patients have a parent who also has the condition.
- Eye Rubbing: Chronic, vigorous eye rubbing is the #1 risk factor for accelerating the disease. It physically breaks down the collagen fibers in the cornea.
- Allergies: Often linked to eye rubbing, chronic allergies can contribute to the cycle of damage.
Treatment Options: The Modern Hierarchy
1. Corneal Cross-Linking (CXL)
This is the only treatment that stops the progression. It uses UV light and Vitamin B2 (Riboflavin) to stiffen the cornea. It does not fix your vision, but it prevents it from getting worse.
2. Scleral Lenses
The "Gold Standard" for vision restoration. Unlike regular contacts that sit on the sensitive cornea, scleral lenses vault over it, resting on the white part of the eye (the sclera). This liquid-filled vault masks the irregularity, giving you 20/20 vision instantly.
3. Intacs
Small plastic arcs inserted into the cornea to flatten the cone. This is less common now due to the success of Scleral Lenses.
4. Corneal Transplant (The Last Resort)
Only necessary in about 10-15% of neglected cases. With early detection and scleral lenses, most patients never need surgery.
About the Author
Dr. Alexander Bonakdar is a specialist in complex contact lens fitting for keratoconus. With over 20 years of experience, he is a trusted referral source for CHOC and UCI Medical Center.
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