Keratoconus

- Op. Dr. Mehmet Ali Özdil
- Last updated:
- 4 min read
- Medically reviewed by Op. Dr. Deniz Oygar Baylançiçek
What is Keratoconus Disease?
The transparent layer called cornea forms the front layer of the eye. The cornea is important in terms of enabling us to see objects clearly and determining the degree of refraction of the eye. The cornea normally has a certain curvature, but in keratoconus patients this curvature gradually increases and the cornea hangs forward. Astigmatism occurs as a result of the increase in the forward curvature of the cornea in keratoconus patients. Since the astigmatism that occurs in keratoconus patients is not symmetrical in the entire cornea, it cannot be fully corrected with contact lenses or glasses, and the quality of life of the patients decreases, and the quality of vision can be severely affected.

What are the Symptoms of Keratoconus Disease?
- Irregular myopia and astigmatism development
- Increased sensitivity to light
- Double vision
- Glare in the eye
- Seeing rings around the lights
- Burning
- Stinging
- Redness
- The emergence of ghostly images while driving
Keratoconus Treatment
As keratoconus is progressive, complaints about the quality of vision tend to increase gradually. At an advanced stage, permanent clouding (scarring) may develop in the centre of the cornea; in that case keratoplasty (corneal transplantation) may be needed. In the early stage, vision can often be corrected with glasses. As the disease progresses, irregular astigmatism increases and can no longer be fully corrected with glasses; this is why keratoconus patients may be unhappy with glasses that have been prescribed again and again, or repeated attempts to wear contact lenses may fail.
In the treatment of keratoconus, treatment options vary depending on the levels of the disease. These options can be listed as follows:
- Crosslinking
- Corneal Ring Implantation
- Keratoplasty (Cornea Transplant)
How Much Does Keratoconus Treatment Cost?
Since keratoconus is a progressive disease, its treatment varies depending on the stage at which the disease is diagnosed and how much the cornea is affected. Keratoconus treatment price varies depending on the underlying cause and the operation to be performed. The treatment plan to be created by our specialist ophthalmologist depending on the detailed examination results may vary from person to person.
How Is Keratoconus Diagnosed?
Keratoconus is diagnosed with a map of the cornea, not from a spectacle prescription. Corneal topography and tomography measure the front and back surface point by point and show where the cornea has thinned and steepened. A visual acuity test on its own can miss the condition in its early stages.
A prescription that keeps changing, astigmatism that keeps increasing and blur that glasses do not fix are often the first clues. When those are present, corneal mapping is added to the examination.
Does Keratoconus Progress?
Keratoconus usually progresses during the teenage and young adult years and slows down in most patients after their thirties. That is not a rule that holds for everyone, and whether it is progressing can only be established by repeating the same measurement months apart.
If progression is found, the priority is to stop it. In a keratoconus that has stabilised, the aim is instead to correct the vision the eye has. The choice of treatment starts with that distinction.
Which Treatment at Which Stage?
In the early stages vision can often be corrected with glasses or rigid gas permeable contact lenses. If progression is demonstrated, crosslinking comes up as a way of halting the disease. It does not reshape the cornea; it stops the progression.
When the cornea has become too irregular for glasses or lenses to give useful vision, an intracorneal ring implant is considered. In advanced disease, once the cornea has lost its clarity, a corneal transplant comes into question. These steps are not alternatives to one another; they follow the stage of the disease.
Can Laser Correct the Prescription in Keratoconus?
No. The standard eye laser used to correct myopia and astigmatism thins the cornea, and in keratoconus the cornea is already thinned and weakened. For that reason these methods are not performed on eyes with keratoconus.
This is one of the reasons corneal mapping is done before laser surgery: if a patient coming in for laser has an undiagnosed keratoconus, it is picked up.
How Often Are Check-ups Needed?
In patients diagnosed with keratoconus, the interval between check-ups depends on age and on whether the disease is progressing. Check-ups are more frequent in younger patients and in newly diagnosed eyes, and less frequent in eyes where the disease has been shown to be stable.
Corneal mapping is repeated at every visit and compared with the previous measurement. Keeping to those appointments matters, because progression usually begins without the patient noticing.
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Frequently Asked Questions
What causes keratoconus?
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Does keratoconus progress?
Can keratoconus patients wear glasses?
Is keratoconus genetic?
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References
- 1.Photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus and keratectasia (IPG466) · NICE, 2013
- 2.Corneal Cross-Linking · EyeWiki
- 3.Keratoconus · Moorfields