Keratoconus

Keratoconus is an eye condition in which the normal, round-shaped cornea (the transparent front window of the eye) becomes thin and bulges outward to form a cone shape. Keratoconus usually affects both eyes, but can be asymmetric and it may initially affect one eye more than the other.

Who does keratoconus affect?

Keratoconus can manifest at different ages, from childhood up to the age of about 40 years.

What are the symptoms of keratoconus?

Keratoconus usually progresses slowly over several years, but it can also worsen more rapidly. The signs and symptoms of keratoconus vary with the progression and stage of the disease. Early symptoms include:

  • Blurring of vision
  • Halos (rings seen around lights)
  • Night vision problems and glare


A patient with keratoconus may notice frequent changes in their spectacle prescription especially the degree of astigmatism. Rarely, patients may experience sudden clouding of vision (hydrops).

What are the causes of keratoconus?

The exact cause of keratoconus is not clearly understood.

  • Keratoconus has an inherent genetic component, meaning it can be passed on from one generation to the next.
  • It is thought to be due to weakening of collagen fibres, which maintain the shape of the cornea.
  • There is a strong association between keratoconus and excessive eye rubbing, and hence people with allergic eye disease are strongly advised to stop eye rubbing.


Also, keratoconus is more commonly seen in patients with certain medical conditions, such as Down’s syndrome, Ehlers-Danlos syndrome and atopic dermatitis.

How is keratoconus diagnosed?

When you present with any of the above symptoms or your optometrist is concerned about possibility of keratoconus, you should consult a corneal specialist (an ophthalmologist with subspecialty interest in corneal diseases). Your ophthalmologist will:

  • Review your medical history
  • Conduct a thorough eye examination, from front to the back of the eye.
  • Order a few diagnostic tests to measure the corneal curvature (such as corneal topography) to evaluate the projection and shape of your eyes
What are the current treatments for keratoconus?

The current treatment for keratoconus emphasizes on stabilising the disease and improving the vision. It is essential to recognise that the treatment of keratoconus should be personalised for individual patient. Your ophthalmologist should be able to suggest appropriate treatment options based on the severity and progression of your condition, your work and lifestyle.


The mainstay of treatment for keratoconus is to stop eye rubbing.

As mentioned, it has been shown that excessive eye rubbing is strongly associated with the progression of keratoconus. Patients with keratoconus must:

  • Stop rubbing their eyes at all time
  • Receive appropriate medical therapy for any co-existing allergic diseases

For visual improvement, glasses and soft contact lenses should be prescribed in the first instance.

Specialised contact lenses (rigid gas permeable or semi-scleral contact lenses) are usually needed in the majority of cases to neutralise the irregular corneal astigmatism.

Other treatment options for keratoconus that are offered by corneal specialists include corneal collagen crosslinking therapy and corneal surgery such as corneal transplantation.

If you would like more information on the treatment options for keratoconus, please call Eastwood Eye Specialists for an appointment.