Unveiling the Mystery: What Causes Keratoconus and How to Manage It

Introduction to Keratoconus

Keratoconus is a progressive eye condition that affects the shape of the cornea, the clear front surface of the eye. Keratoconus, once thought to be a rare disorder, has turned out to be relatively common. This disease can have a significant impact on a person’s vision and quality of life. Understanding the causes of keratoconus is essential for early detection and appropriate management. In this article, we will delve into the anatomy of the eye, explore the development of keratoconus, discuss its common symptoms, identify the risk factors associated with the condition, explain the diagnostic tests and examinations used, and explore the available treatment options. We will also touch on the importance of lifestyle changes and self-care in managing keratoconus, as well as the potential surgical interventions that may be recommended.

Understanding the Anatomy of the Eye

Before we delve into the intricacies of keratoconus, it is important to have a basic understanding of the anatomy of the eye. The cornea is the clear, dome-shaped surface that covers the front of the eye. It plays a crucial role in focusing light onto the retina, which then sends signals to the brain, allowing us to see. The cornea is normally smooth and round, but in individuals with keratoconus, it becomes thin and bulges outward, resembling a cone shape. This change in shape leads to visual distortions and a decrease in visual acuity.

What is Keratoconus and How Does it Develop?

Keratoconus is a progressive disorder that typically begins during adolescence or early adulthood. It is believed to be a multifactorial condition, meaning that a combination of genetic and environmental factors contribute to its development. The exact cause of keratoconus is still not fully understood, but research suggests that it involves a thinning and weakening of the corneal collagen tissue, leading to the “bulging” characteristic of the condition. 

Common Symptoms of Keratoconus

Recognizing the symptoms of keratoconus is crucial for early detection and intervention. While the severity and progression of the condition can vary among individuals, there are some common signs to watch out for. Blurred or distorted vision, increased sensitivity to light, frequent changes in eyeglass prescriptions (particularly astigmatism prescriptions), inability to correct vision to 20/20 with glasses, and the appearance of ghosting or multiple images are all potential indicators of keratoconus. It is important to note that these symptoms may also be present in other eye conditions, so a comprehensive eye examination is necessary for an accurate diagnosis.

Risk Factors for Developing Keratoconus

While the exact cause of keratoconus remains unknown, certain factors have been identified as potential risk factors for its development. A family history of keratoconus increases the likelihood of developing the condition, suggesting a genetic component. Additionally, individuals with certain systemic conditions, such as allergies and asthma, have a higher risk of developing keratoconus. Rubbing the eyes vigorously is a known risk factor which is believed to contribute to the development and progression of the condition.

Diagnosing Keratoconus: Tests and Examinations

Diagnosing keratoconus involves a comprehensive eye examination that includes several specialized tests and examinations. One of the primary tools used in diagnosing keratoconus is corneal topography, a non-invasive imaging technique that maps the curvature of the cornea. Nowadays corneal tomography, which looks at both the front and back surface and the thickness of the cornea, is the gold standard for diagnosis and monitoring of this disease. At the Cornea and Laser Eye Institute we use the most modern techniques including both types of tomography, optical coherence tomography (OCT) and scheimpflug tomography, and wavefront aberrometry, to diagnose and monitor your keratoconus over time. These advanced imaging techniques allow eye care doctors to identify any irregularities or abnormalities indicative of keratoconus early in the disease so that treatment can potentially be performed before severe visual loss.

Treatment Options for Keratoconus

Once diagnosed, the treatment approach for keratoconus may vary depending on the severity of the condition. In the early stages, when visual disturbances are mild, eyeglasses or basic soft contact lenses may be sufficient to correct vision. However, as the condition progresses, specialized contact lenses, such as rigid gas permeable lenses or scleral lenses, are often prescribed to provide clearer vision.. Here at the Cornea and Laser Eye Institute, we are involved in developing some of the most specialized contact lens designs for keratoconus patients. Some of these designs include custom soft contact, ocular scan based, and wavefront guided lenses. All of these lenses work by creating a smooth optical surface that compensates for the irregularities caused by keratoconus.

Surgical Interventions for Keratoconus

Traditional keratoconus management was limited to rigid gas permeable lenses and/or full thickness corneal transplant. Modern keratoconus management includes stabilizing the cornea and improving the cornea shape, with the goal of improving vision in glasses and contact lenses. In certain cases, vision without glasses can also be improved. This is a management process which we call KC 1…2…3.

One procedure to stabilize the cornea is corneal crosslinking. Corneal crosslinking involves the application of riboflavin (vitamin B2) eye drops followed by exposure to ultraviolet light. This procedure strengthens the cornea and can help slow down or halt the progression of keratoconus. Currently there are new procedures available to reshape the cornea and potentially avoid the need for corneal transplant. Some of these procedures included CTAK (Corneal Tissue Addition Keratoplasty), Topography Guided PRK, and Intacs.  In more advanced cases, a corneal transplant may still be necessary, where the damaged cornea is replaced with a healthy donor cornea. In many of these cases advanced corneal transplantation techniques such a femtosecond laser assisted deep anterior lamellar keratoplasty (Femto DALK) can be performed for a safer and faster recovery. These surgical interventions require careful evaluation and consultation with a cornea specialist, such as Cornea and Laser Eye Institute.

Managing Keratoconus: Lifestyle Changes and Self-Care

In addition to the prescribed treatments, there are several lifestyle changes and self-care practices that can help individuals manage keratoconus. Protecting the eyes from excessive rubbing or trauma is crucial, as these actions can exacerbate the progression of the condition. Avoiding activities that increase eye dryness, such as prolonged screen time or exposure to dry environments, can also be beneficial. Regular follow-up visits with an eye care professional are important to monitor the condition and ensure that the prescribed treatments are effective.


Keratoconus is a complex eye condition that requires early detection and appropriate management to prevent further visual deterioration. By understanding the causes, symptoms, and risk factors associated with keratoconus, individuals can seek timely diagnosis and access the available treatment options. Lifestyle changes and self-care practices can also play a significant role in managing the condition. To have a complete evaluation of your keratoconus, and to achieve the best possible outcome,, book a consultation with a reputable cornea specialist at the Cornea and Laser Eye Institute. Remember, vision is precious, so don’t hesitate to seek professional guidance in managing your keratoconus today.

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