Written by Dr. James Lehmann on 10/19/18

In 1859, British sugeon William Bowman accurately explained how to use mirror in a ophthalmoscope to see the shape of the cornea. Keratoconus could then be identified.

Keratoconus occurs in 1 out of every 2,000 people. Diagnosis often occurs in youth.

This eye disease causes the normally round cornea to become thinner. Over time, a cone-shaped bulge develops. This distortion causes visual impairment. Keratoconus is present in both eyes but can affect one eye more severely than the other.

Read on for the basics about keratoconus including causes and keratoconus treatment.

What Causes Keratoconus?

There is no conclusive data on keratoconus causes. Several factors have been named as contributing to this eye condition and so it is likely that there is no one single cause.

Allergies, asthma and eczemas are commonly associated with this disease. Eye rubbing aggravates the condition and people with allergies and eczema likely rub itchy eyes frequently.

Keratoconus can also be hereditary. Children of people with the condition should be checked annually by an optometrist for signs of the disease.

Some studies point to a decrease in protective antioxidants in the cornea as a cause of keratoconus.

If there are fewer antioxidants in the eye, the collagen is no protected and so weakens. As a result, the cornea develops the bulging, cone shape indicative of keratoconus. If antioxidants levels are low, the collagen weakens and the cornea bulges out.

Symptoms of Keratoconus

The symptoms of keratoconus change as the condition worsens. In the early stages of keratoconus, people will notice distorted or blurry vision. Eyeglasses prescription may change frequently in the early stages.

This is often the first indication that someone has keratoconus. It’s important to have your eyes checked by an eye care professional if you suspect you have keratoconus.

Other symptoms include seeing a glare on objects and seeing ghost images. In other words, seeing several copies of one object at once.

Keratoconus Treatments

There are many treatments that can help correct the vision and strengthen the cornea.


In the mildest cases of keratoconus, prescription glasses can fix the vision problems caused by the disease. Often a prescription for astigmatism will also be needed.

As the cornea gets thinner and thinner and more cone-shaped, glasses will no longer be able to offer the right amount of vision correction. So this option is only viable in the early stages of keratoconus.

Contact Lenses

When glasses no longer provide good vision, contact lenses become a good solution.

Hard or custom soft contact lenses are specifically designed to correct vision problems due to keratoconus. They even out the irregularities in the cornea.

Gas permeable lenses cover the cone-shaped portion of the cornea and provide a smooth surface for refraction.

Scleral contact lenses have a much larger diameter. These contact lenses rest on the whites of the eyes. The whites are called sclera.

The benefit of these lenses is that because they are so large, the entire eye is protected from dust and debris. Because the edges of the contact rest above and below the eyelid margins, wearers do not see the edges of the lens.

In some cases of keratoconus, contact lenses are no longer an option due to fit or comfort. In these cases, surgical options should be considered.


When keratoconus progresses beyond the help of contact lenses, your eye care professional may recommend corneal surgery.

Corneal Transplants

One option for a surgical keratoconus treatment is a corneal transplant. This procedure involves replacing the affected cornea with a healthy cornea from a human donor.

The precise lasers that are used in laser vision correction techniques have been adapted for corneal transplants.

The entire cornea may be replaced in severe cases. Other times, a corneal transplant may just replace a few layers of the cornea. Your eye specialist can recommend the best procedure for you.

Corneal Crosslinking

Corneal crosslinking is a procedure that stops the progression of the disease. An eye specialist will drop vitamin B2 into a patients eye. Then the cornea is exposed to UV rays.

Together, these two processes form a chemical reaction that stiffens the cornea and stops the progression of the disease. This treatment is pretty new and more studies are required for accurate statistics.

However, studies show that the failure rate is less than 3% and the complication rate is less than 1%.

Though this procedure can’t bring back the cornea to the normal shape, it can stop the keratoconus from becoming any worse.

Intracorneal Rings

These rings are inserted into the irregular-shaped cornea using a laser. The rings flatten the shape of the cornea back to a regular round, dome shape.

This option is for people who can no longer wear contact lenses but where the disease has not progressed extensively yet. Intracorneal rings improve vision and allow the patients to possibly wear contact lenses again.

Toric implantable Contact Lenses

This surgery is basically implanting permanent contact lenses into the patient’s eyes. This option is available to those who have keratoconus that is no longer progressing.

These implanted contacts make it possible for patients to stop using glasses or contacts to correct their vision in some cases. Depending on the severity of the condition, glasses might still be required for good vision.

Final Thoughts

We hope you found this guide on keratoconus treatment informative. As you can see, there are a variety of treatments available for this eye disease.

Contact Focal Point Vision to make an appointment to discuss the right treatment plan for your needs.