To diagnose keratoconus, our trained doctors will review your medical and family history and conduct an eye exam. Other tests to determine more details regarding the shape of your cornea such as topography or a corneal OCT may be performed. During an annual eye health examination we perform testing that would alert us of the signs of developing keratoconus. Most cases are diagnosed in the 20s and 30s with an equal occurrence in males and females.
Treatment for keratoconus depends on the severity of your condition and how quickly the condition is progressing. Generally, there are two approaches to treating keratoconus: slowing the progression of the disease and improving your vision.
If your keratoconus is progressing, corneal collagen cross-linking might be indicated to slow or stop the progression. This is a newer treatment that has the potential to prevent you from needing a cornea transplant in the future. However, this treatment does not reverse keratoconus or improve vision.
Improving your vision depends on the severity of keratoconus. Mild to moderate keratoconus can be treated with eyeglasses or contact lenses. This will likely be a long-term treatment, especially if your cornea becomes stable with time or from cross-linking.
Eyeglasses or soft contact lenses. Glasses or soft contact lenses can correct blurry or distorted vision in early keratoconus. But people frequently need to change their prescription for eyeglasses or contacts as the shape of their corneas change.
Hard contact lenses. Hard (rigid, gas permeable) contact lenses are often the next step in treating more-advanced keratoconus. Hard lenses may feel uncomfortable at first, but many people adjust to wearing them and they can provide excellent vision. This type of lens can be made to fit your corneas.
Piggyback lenses. If rigid lenses are uncomfortable, your doctor may recommend "piggybacking" a hard contact lens on top of a soft one.
Hybrid lenses. These contact lenses have a rigid center with a softer ring around the outside for increased comfort. People who can't tolerate hard contact lenses may prefer hybrid lenses.
Scleral lenses. These lenses are useful for very irregular shape changes in your cornea in advanced keratoconus. Instead of resting on the cornea like traditional contact lenses do, scleral lenses sit on the white part of the eye (sclera) and vault over the cornea without touching it.
In some people with keratoconus, the cornea becomes scarred with advanced disease or wearing contact lenses becomes difficult. In these people, cornea transplant surgery might be necessary.