Your Ultimate Guide To Understanding Keratoconus

Keratoconus is a type of eye disease that affects your cornea, changing its shape and distorting your vision over time. This condition is progressive, which means it can get worse over the years, especially without proper treatment.

If you think you might have keratoconus or just want a better understanding of this eye condition, you’ve come to the right place. Here’s everything you need to know about keratoconus, its causes, the best treatment options, and more.

What Is Keratoconus?

Keratoconus is a degenerative eye disorder that makes your cornea bulge, taking on a cone shape. As a result of this change, light enters your eye from a different angle, which causes refraction problems and distorts the way you see.

While keratoconus is slightly similar to astigmatism, the changes it causes to your eye are very different. Keratoconus is also less common and more challenging to treat.

What Are the Risk Factors for Keratoconus?

We don’t know exactly what causes keratoconus, but we do know that genetics, environmental factors, and eye enzymes can all affect changes in corneal topography.

Based on the current research, this eye disease can run in families, especially with hereditary joint conditions like Ehlers-Danlos syndrome. However, others appear to develop keratoconus without a family history because of habitual eye rubbing, severe allergies, and even poorly fitted contact lenses.

Finally, changes in the enzyme balance in your cornea can weaken the structure of this delicate part of your eye, making its shape more flexible.

What Are the Symptoms of Keratoconus?

Keratoconus usually starts developing in your 20s, and its symptoms tend to worsen over time, especially without treatment.

This eye disease can cause blurry vision, which can become even more severe as the cornea's shape changes. It can also cause nearsightedness, also known as myopia. Additionally, keratoconus can make objects look distorted and warped — a telltale sign of refractive problems. These refractions can take the form of glares, light trails, or even halos.

Some people with keratoconus are also susceptible to bright light. Glares from headlights, traffic lights, and streetlights can make it difficult for them to drive, especially without corrective glasses.

Speaking of glasses, keratoconus can quickly change your eyeglass prescription. Because the disease causes ongoing changes to the cornea, people with keratoconus often need their prescriptions updated multiple times each year.

Finally, as keratoconus progresses, it can cause a refractive issue called monocular diplopia. People with this symptom experience double vision in one eye, which can sometimes be helped with a specialized prescription.

How Is Keratoconus Treated?

Luckily, there are multiple treatment options for this disease, and the right one for you will depend on whether you have early or advanced keratoconus.

The best way to select a treatment plan is to follow your ophthalmologist's instructions.

They might recommend the following treatment options, depending on whether you’re dealing with early keratoconus or a more progressed case:

Standard Glasses or Soft Contact Lenses

In the early stages of keratoconus, regular glasses or contacts are usually all a person needs for vision correction. This is usually the case for people in their 20s and 30s, but more serious treatment for vision loss may be needed as the condition progresses.

Specialized Hard Contact Lenses

Rigid gas permeable contact lenses (RGP) are made from hard plastic, encouraging oxygen flow through the lens and into the eye. This extra breathability supports your cornea and keeps your contacts from impacting corneal shape.

As a bonus, many people with keratoconus find RGP lenses more comfortable and easier to wear than soft contacts. With RGP contacts, you don’t get as many protein deposits in your lenses, which makes RGP a cleaner option that doesn’t give you that “something in your eye” sensation.

Hybrid Contacts

The right contacts for you depend on how keratoconus affects your eyes. For some people, a combination of hard and soft lenses is the best way to preserve the shape of the cornea and slow the disease’s progression.

These hybrid contact lenses have a hard RGP center and a soft ring segment, which makes them just as comfortable as regular RGP contacts but sometimes easier to use in cases of keratoconus.

Scleral Lenses

Scleral contact lenses are larger than normal contacts. They cover the white of the eye and the cornea, which can help slow down the effects of keratoconus and improve the cornea's curvature.

These contacts are gas permeable, which means they’re more breathable and better for eye health than soft lenses. However, these lenses are sometimes four to five times more expensive than soft contacts. Still, they last much longer, which can make the price worth it if you’re dealing with keratoconus.

Corneal Collagen Cross-Linking

Corneal collagen cross-linking, sometimes called CXL, is a light-based treatment that can strengthen corneas and correct vision with help from riboflavin (vitamin B2). CXL is minimally invasive, which makes it a simpler option than surgery.

During a CXL procedure, an ophthalmologist deposits a vitamin B2 eye drop into your cornea and then shines a bright ultraviolet light to strengthen the corneal tissue. This slows down the progression of the disease and improves distorted vision.

Intacs

Intacs are small inserts that improve the shape of your cornea, stopping it from warping and worsening your vision. They’re applied by an ophthalmologist through surgery, making this option more invasive than contacts or CXL.

Corneal Transplants (Keratoplasty)

Cornea transplants are the most heavy-duty treatment for keratoconus, and they’re only used for the most severe cases. When keratoconus advances so far that it causes significant ocular distortion, an eye doctor might recommend replacing the affected cornea with a healthy one from a donor. It’s an expensive, invasive procedure, but it can be life-changing.

How To Manage Keratoconus

Dealing with keratoconus can be difficult, but there are ways to manage the condition and live your life to the fullest. Seeking support from a healthcare professional, along with family and friends, goes a long way. No one should have to manage any disease on their own, and a degenerative condition like keratoconus calls for a strong support system.

Additionally, regular eye exams, protecting your eyes, and sticking with your treatment plan can also help you manage the condition.

Eye Exams and Eye Care

Keratoconus can progress fast, which typically means you’ll need an eye exam every few months.

Depending on your treatment plan, you might need to see an ophthalmologist, which is an eye doctor who can prescribe medication and perform surgeries. Ophthalmologists are better equipped than optometrists to deal with ongoing treatment for eye diseases.

When you visit the eye doctor, they’ll set you up on a recurring exam schedule to ensure you stay up-to-date on your prescription. Wearing glasses or contacts that match the current state of your eyes is one of the best ways to live well while dealing with keratoconus, so make sure you don’t skip those appointments.

Avoid Eye Rubbing

Rubbing your eyes can cause irritation and start a vicious cycle of even more rubbing. Because your corneas are sensitive, you may accidentally cause corneal scarring, which can worsen the symptoms of keratoconus over time.

It’s also crucial for those with keratoconus and other degenerative eye diseases to wear protective eyewear in risky environments. Anytime you think you might be exposed to dust, debris, or harsh chemicals, shield your eyes with personal protective eyewear (PPE).

Stick to Your Treatment Plan

When you skip medications and appointments, you’re setting yourself up for more severe symptoms. That’s why it’s worth it to stick to the treatment plan prescribed by your eye doctor. While it can sometimes be tiring to take extra care of your eyes every day, you’ll end up with better vision in the long run as a result.

Get Support

Dealing with keratoconus is an emotional rollercoaster, with lots of appointments, possible changes to your treatment plan, and the day-to-day struggle of living with a degenerative disease. The more support you can get, the better.

Going to groups, having weekly sessions with a therapist, and doing whatever you can to enjoy life and have fun are all great ways to keep your head up and stay hopeful.

Living Well With Keratoconus

Keratoconus is a serious eye disease that can turn your life upside down, but it doesn’t have to stop you from living well. When you get the treatment you need, work closely with an eye doctor, and seek support from friends and family, you have everything it takes to live a fulfilling, happy life with keratoconus.

If you’ve been diagnosed with keratoconus and need a high-quality pair of glasses, Pair is here to help. Our collection of stylish Base Frames and magnetic Top Frames gives you the freedom to support your visual acuity and express yourself with a lineup of distinct looks. With Pair, you can accommodate your eye doctor’s prescriptions and your individuality.

Sources:

What Is Keratoconus? | American Academy of Ophthalmology

Personal Protective Equipment | OSHA

Intacts for Keratoconus | NCBI

Ehlers-Danlos syndrome - Symptoms and causes | Mayo Clinic