Kerataconus is an eye condition in which the cornea weakens and thins over time causing the development of a cone-like bulge and optical irregularity of the cornea.  Symptoms include blurred vision, increased sensitivity to bright light and glare, and a need for frequent changes in eyeglass or contact lens prescription.  In some cases of kerataconus there can be an acute deterioration of vision associated with corneal swelling, referred to as “hydrops”.   The cause of kerataconus is unknown, but is believed to be a combination of genetic, environmental, and possibly hormonal factors.  A family history of kerataconus is a strong risk factor, as is Trisomy 21.  The condition is also often associated with ocular allergy and eye rubbing.

Kearataconus treatment depends on the severity of the condition and a patient’s symptoms.  In many cases, vision can be acceptably corrected with eyeglasses or soft contact lenses.  Monitoring by a corneal specialist is very important.  Special hard contact lenses are more effective at improving vision in more advanced cases.  Other treatments intended to improve or preserve vision are:

Intacs- A small plastic device implanted in the cornea used to flatten the curvature

Cornea Cross-Linking- A procedure intended to stiffen the cornea, flattening its curvature and limiting further progressive deterioration.

Corneal transplant- Reserved for patients with severe vision deterioration who cannot be helped with hard contact lenses.

The diagnosis of kerataconus can be made on a routine eye examination with the recognition of an irregularly shaped corneal surface.  Several examination tools are helpful in confirming the diagnosis and in directing care.  Corneal topography asseses the shape of the cornea with a computer analysis that is very sensitive to kerataconus.  Corneal pachymetry measures the corneal thickness which is generally reduced, and corneal OCT creates images of the cornea that can be measured and analyzed.