Keratoconus: Causes & Symptoms

What is Keratoconus?

Keratoconus is a progressive eye disease that causes a thinning of the cornea, the clear front surface of the eye. The cornea, which is the clear, dome-shaped front surface of the eye, gradually becomes thinner and weaker. In individuals with keratoconus, the cornea bulges outward, adopting a more conical shape instead of its normal rounded form. This irregularity leads to visual distortions and refractive errors such as astigmatism and short-sightedness.

Keratoconus is usually a bilateral condition, but one eye may progress faster than the other. This is sometimes referred to as keratoconus in one eye only. Familial occurrence has been noted, although most cases show no definitive inheritance pattern.

What Causes Keratoconus?

The exact cause of keratoconus is not fully understood. However, researchers believe it results from a combination of genetic, environmental, and hormonal influences.

Common keratoconus risk factors include:

• Family history of keratoconus or other corneal conditions
• Excessive or frequent eye rubbing
• Allergies such as asthma, eczema, or hay fever
• Poorly fitted or prolonged contact lens wear
• Hormonal changes during puberty or pregnancy
• Certain systemic or connective tissue disorders

Keratoconus often begins during teenage years or early adulthood and may progress over several years before stabilising.

Symptoms of Keratoconus

Prompt detection of keratoconus can make a difference. Early keratoconus symptoms may include:

• Blurred or distorted vision
• Frequent changes in glasses or contact lens prescription
• Sensitivity to light or glare
• Halos around lights, especially at night
• Eye strain or discomfort after visual tasks

Keratoconus signs detected by an eye specialist may include:

• Irregular or steep corneal curvature
• Thinning of the cornea
• Corneal scarring in advanced stages

Recognising these indicators early is crucial for timely intervention and to slow keratoconus progression.

Keratoconus Differential Diagnosis

A keratoconus differential diagnosis is essential because other conditions, such as pellucid marginal degeneration or post-LASIK ectasia, may cause similar corneal irregularities. An accurate diagnosis using corneal topography and tomography ensures that patients receive the most suitable treatment plan.

Keratoconus Treatment with personalEYES

In the past, patients with keratoconus were often told that they were not suitable for refractive surgery (LASIK). Today, there are a number of effective options available.

Usually, the first step in keratoconus treatment is to correct the refractive error with glasses or hard contact lenses. This helps you achieve adequate vision. As keratoconus progression continues, the quality of vision may deteriorate, and contact lenses or glasses may no longer provide satisfactory results.

A Toric Implantable Contact Lens (with built-in astigmatism correction) is an option for those with mild keratoconus, provided the cornea is stable and good vision can be achieved with glasses. Corneas can also be stabilised through corneal cross linking, also known as CXL, which strengthens the corneal tissue and helps halt the disease.

Many patients eventually require a corneal transplant; however, other procedures such as CAIRS (Corneal Allogenic Intrastromal Ring Segments) are also available and less invasive.

Corneal Cross Linking

Corneal cross linking is a medical procedure used to treat keratoconus and other corneal conditions. The goal is to strengthen the cornea by creating additional cross-links between collagen fibres, increasing its stability and halting the progression of the disease.

Studies have shown that corneal cross linking is effective in reducing the progression of keratoconus and improving visual outcomes. It can also reduce corneal steepness, leading to better clarity and fewer distortions. With a low risk of complications, it remains one of the most successful modern treatments for stabilizing the cornea.

Corneal Allogenic Intrastromal Ring Segments (CAIRS)

Corneal allogenic intrastromal ring segments (CAIRS) use donor corneal tissue to improve corneal shape and stability in patients with keratoconus. The donor tissue provides structural support and helps maintain a more regular corneal curvature, enhancing visual acuity. This procedure is generally covered by health funds and offers a viable alternative for patients unsuitable for synthetic implants.

Stages of Keratoconus Treatment

Understanding the stages of keratoconus is vital for selecting the right treatment plan.

• Eyeglasses: used in the early stages.
• Rigid contact lenses: used when eyeglasses no longer provide adequate correction.
• CXL – Corneal Collagen Cross-Linking: strengthens the cornea and prevents disease progression.
• CAIRS (Corneal Adaptive Image Refractive System): combines methods for strengthening and shape correction.
• Corneal transplant: in advanced stages – either partial thickness (DALK) or full thickness (PK).

Book a Consultation with personalEYES

At personalEYES, our specialists can assess your condition and recommend the most effective keratoconus treatment options. From early management to advanced surgical solutions, we’ll explore every possibility to help you achieve sharper, more stable vision.

Book your consultation today to learn how personalEYES can help protect and restore your sight.