Keratoconus

Keratoconus is more likely if you:

• Are a teen or young adult
• Have a family member with keratoconus
• Rub your eyes often or hard
• Have allergies, eczema or asthma, which can lead to eye rubbing
• Have certain other conditions, such as Down syndrome or some connective tissue disorders

Your eye doctor will check your vision and prescription and look at your cornea with a special microscope. The most important test maps the shape and thickness of your cornea. This is called corneal topography or tomography. It is quick and painless, and it can find keratoconus early, even before you notice much change. Repeating the map over time shows whether it is getting worse.

Treatment depends on how much keratoconus affects your vision and whether it is changing.

• Glasses or soft contact lenses may work in the early stages.
• Specialty contact lenses, such as rigid gas permeable, hybrid or larger scleral lenses, create a smooth surface over the uneven cornea. They can often give much clearer vision.
• Corneal cross-linking uses special eye drops and ultraviolet light to strengthen the cornea. It can slow or stop keratoconus from getting worse. It does not undo changes that have already happened, so it works best when it is done early.
• Other procedures, such as small implants in the cornea or, in advanced cases, a corneal transplant, may be options when lenses no longer help.

Most people with keratoconus never need a transplant. Your eye doctor will talk with you about what fits your eyes, and may send you to a cornea specialist for some treatments.

• Don’t rub your eyes. Rubbing can make keratoconus worse. If your eyes itch, ask your eye doctor about treating allergies.
• Keep your follow-up visits, especially while you are young and your eyes may still be changing.
• Take good care of your specialty lenses and keep up with your lens checkups.
• Tell your family, since keratoconus can run in families. Brothers, sisters and children of people with keratoconus may benefit from an eye exam that includes a corneal map.
• If glare makes night driving hard, tell your eye doctor. A change in lenses may help.
• If you have allergies, eczema or asthma, keep them well treated so your eyes itch less.
• Laser vision correction, such as LASIK, is not recommended for people with keratoconus. It can weaken the cornea further. Talk with your eye doctor before considering any eye surgery.