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What is Keratoconus?

eyechart2Keratoconus is a progressive eye disease in which the front surface of the eye, called the cornea, begins to thin and bulge out like a cone. As the cornea changes, it causes light rays to improperly focus causing people to experience blurry and distorted vision, glare, and light sensitivity. At  River Oaks, our eye doctor specializes in accurately diagnosing keratoconus. Our optometrist provides a range of effective treatment options customized to the patient's needs.

How would someone know if they have Keratoconus?

We have mentioned blurriness, distorted vision, sensitivity to glare and light.  These symptoms are also common in patients with regular uncorrected sight. To avoid confusion, we recommend visiting an eye doctor who will be able to diagnose the condition accurately.

Are some people more likely to develop Keratoconus? (age, gender, risk factors)

While the exact mechanism of Keratoconus is not known, most people develop symptoms in the late teens or 20’s and it can progress in the next 10-20 years.  Keratoconus could occur in both males and females. Risk factors for Keratoconus include a history of mechanically rubbing of the eyes and genetics.

How do we Diagnose Keratoconus?

woman getting eyes checkedOur eye doctors provide a comprehensive eye exam and obtain a careful history of your eye conditions, your symptoms and your family history.  Our River Oaks eye clinic will also examine your glasses and/or contact lens prescriptions to help achieve the best possible vision. Most importantly, our office is equipped with the Medmont topographer - technology that enables us to map the contours of the cornea necessary to diagnose and monitor the progression of Keratoconus.

How do you treat Keratoconus?

Treatment for Keratoconus depends on the severity. Most patients with mild Keratoconus can achieve good vision with glasses and soft contact lenses.

As Keratoconus progresses into a moderate stage, where glasses and conventional soft contact lenses may not provide adequate vision, our River Oaks eye doctors will prescribe and fit specialty lenses which can include:

  • custom soft contact lenses;
  • rigid gas permeable hard contact lenses
  • hybrid contact lenses, or;
  • scleral lenses.

Gas Permeable and Scleral Contact Lenses

contact lense on a fingerAt these more advanced stages of keratoconus rigid gas permeable (RGP) contact lenses, scleral or semi-scleral lenses may be used for increased comfort and visual acuity. Since they are more rigid, RGP and scleral lenses are able to create a smooth, round shape around the cornea, creating a smoother surface for better vision. Scleral or semi-scleral lenses have a larger diameter which covers the entire cornea and reaches over into the white part of the eye, which is known as the sclera. Many patients find these more comfortable than regular RGPs and find that they move around less when the eyes move. The main disadvantage of these rigid lenses is that for some, they are somewhat less comfortable than soft lenses and they must be continually refitted as the shape of the eye changes.

All patients fitted into contact lenses are properly trained and educated on insertion & removal of the contact lens, a healthy wearing schedule, and cleaning & storage of the contact lens. Proper training and education are critical to minimize the risk of infection.

Severe Keratoconus

In severe stages of Keratoconus, where glasses or specialty lenses mentioned above are not providing adequate vision and/or becoming intolerable due to comfort, surgical options can be considered. These surgical options include:

  • Corneal Cross-linking (CXL);
  • intacs, or;
  • corneal transplant.

Surgical options require consultation with a corneal specialist. At River Oaks Family Optometry, we can refer you to the right surgeon, as well as provide the pre-surgical and post-surgical care.


Intacs are small, surgically implanted plastic inserts which are placed on the cornea to flatten it back to shape. Usually they are able to restore clear vision, with the continued use of glasses. Intacs are often recommended when contact lenses and eyeglasses are no longer able to correct vision adequately. Intacs take about 10 minutes to insert and can delay the need for corneal transplant.

Corneal Crosslinking (CXL)

In corneal crosslinking, a UV light and eye drops are used to strengthen and stiffen the cornea which helps to reduce bulging and restore the cornea to its natural shape.

Corneal Transplant

When corneal scarring occurs and eyeglasses and contact lenses no longer help, doctors may suggest a corneal transplant to replace the corneal with healthy donor tissue to restore vision. Most patients will still require eyeglasses or contact lenses for clear vision following the transplant.

smiling eye doctorShould I see an eye doctor that is specialized in hard- to- fit contacts?

Yes! Patients with Keratoconus should see an eye doctor who specializes in hard-to-fit contact lenses because these eye doctors undergo hours of extensive training to ensure success and safety of a properly fitted contact lens. Many Keratoconus patients also have the best vision with specialty lenses.

What consequences can occur if Keratoconus is left untreated?

While not all stages of Keratoconus require immediate treatment, it is important to see an eye doctor to monitor the condition. If Keratoconus is left untreated, vision may progressively get worse even with best-corrected glasses or contact lenses.