Published: 2023-05-16

Keratoconus is a rare condition that occurs when the cornea thins and bulges outward, creating a cone shape and causing a number of symptoms, including a sudden change in vision in one eye.

How keratoconus develops

The cornea is the clear outer lens of the eye. A healthy, normal cornea is completely round, like a basketball, and remains in place thanks to tiny fibers of protein. When these fibers weaken, they are unable to hold the perfectly round shape. As a result, the cornea begins to progressively bulge outward and form a cone-like shape – causing keratoconus. The condition tends to develop in one eye first, and the second eye almost always follows eventually.

Keratoconus is an unpredictable condition. The cornea can change shape quickly or gradually, and the changes can either stop suddenly or continue progressing for many years. Additionally, it's impossible to predict how a patient's condition is going to progress. In severe cases, the stretched fibers of protein can lead to severe corneal scarring.

Keratoconus tends to run in families. As such, it's recommended to begin testing children with a family history at around ten years of age. In most cases, keratoconus begins to develop in the teen years, though it's been known to appear throughout the 30s and 40s as well.

Symptoms and diagnosis

Dr. Benjamin and his team typically diagnose keratoconus during a routine eye examination. In most cases, they first notice that the cornea is irregularly shaped and your vision is worsening. Depending on those indications, they will ask about any symptoms you may have been experiencing, such as:

  • A sudden change in vision, particularly if it affects only one eye
  • Objects both near and far appear distorted
  • You see halos surrounding bright lights

Treatment Options

Because keratoconus affects the vision, treatment typically begins with a new pair of eyeglasses or contacts. If your case is mild, these corrective lenses should suffice to improve your eyesight so you can function normally again.

In some cases, sufferers of keratoconus may find that they require contacts to fully correct their vision, but the lenses are uncomfortable. When this occurs, Dr. Benjamin can perform a procedure called a PTK to smooth the corneal scar and increase comfort while wearing contacts. If the condition is developing rapidly, Dr. Benjamin may recommend a procedure called cornea collagen crosslinking to slow down the progression. With this treatment, implants are placed under the surface of the cornea to create a rounder shape.

The final and most permanent treatment option for keratoconus is a cornea transplant. This is a last resort, and only recommended for the most advanced cases. During this procedure, Dr. Benjamin will remove the center of the cornea and replace it with a donor cornea. Most patients will require contact lenses after this procedure.