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Understanding Keratoconus: Causes, Symptoms, and Treatments

Keratoconus is a progressive eye disease that affects the structure of the cornea, leading to distorted vision. This condition, though not very common, can significantly impact a person’s quality of life if not properly managed.

In this article we’ll explore what Keratoconus is, its causes, symptoms, associated conditions, the severity of the disease, its stages, and the various treatment options available. Our goal is to provide a comprehensive understanding of Keratoconus to help you recognise and manage this condition effectively.

What is Keratoconus?

Keratoconus is a degenerative disorder of the cornea (the front surface of the eye), which is normally round and dome-shaped, progressively thins and begins to bulge into a cone-like shape. This abnormal curvature distorts light as it enters the eye, leading to blurred vision and glare. The condition typically begins in adolescence or early adulthood and can worsen over time.

Causes of Keratoconus

The exact cause of Keratoconus is not well understood, but it is believed to result from a combination of genetic, environmental, and cellular factors. Some potential causes and risk factors include:

  • Genetics: Family history of Keratoconus increases the likelihood of developing the condition.
  • Eye Rubbing: Frequent and vigorous rubbing of the eyes has been linked to the progression of Keratoconus.
  • Underlying Conditions: Certain systemic conditions, such as connective tissue disorders, may contribute to the development of Keratoconus.
  • Oxidative Stress: Imbalance between free radicals and antioxidants in the cornea can weaken the corneal structure.

Symptoms of Keratoconus

Keratoconus symptoms can vary depending on the severity of the condition. Common symptoms include:

  • Blurred or distorted vision
  • Increased sensitivity to light and glare
  • Difficulty seeing at night
  • Frequent changes in eyeglass or contact lens prescriptions
  • Double vision in one eye (monocular diplopia)
  • Seeing halos around lights


Conditions Linked to Keratoconus

Keratoconus is often associated with other medical conditions. Some of these include:

  • Atopic Diseases: Allergies, asthma, and eczema are commonly seen in patients with Keratoconus.
  • Down Syndrome: There is a higher prevalence of Keratoconus in individuals with Down syndrome.
  • Connective Tissue Disorders: Conditions like Marfan syndrome and Ehlers-Danlos syndrome can increase the risk of Keratoconus.
  • Leber Congenital Amaurosis: This genetic disorder also shows a strong association with Keratoconus.

Is Keratoconus Serious?

Keratoconus is a serious condition that can significantly impair vision if it progresses and is not managed. While it rarely causes complete blindness, severe cases can lead to significant visual impairment. Early detection and appropriate management are crucial to slow progression effectively and prevent severe vision loss.

The 4 Stages of Keratoconus

Keratoconus progresses through four stages:

Stage 1: Mild – Slight thinning and steepening of the cornea with minimal vision changes.

Stage 2: Moderate – Increased thinning and steepening with more noticeable vision changes.

Stage 3: Advanced – Significant thinning and bulging of the cornea, leading to severe vision distortion.

Stage 4: Severe – Extreme thinning and scarring of the cornea, often requiring surgical intervention.

Can Keratoconus be Corrected?

While there is no definitive cure for Keratoconus, there are several treatment options available that can help manage the condition and improve vision. The choice of treatment depends on the severity and progression of the disease.

Keratoconus Treatment Options

Optometrists play a crucial role in diagnosing and managing Keratoconus. Some of the treatment options include:

  • Eyeglasses and Soft Contact Lenses: In the early stages, vision can often be corrected with glasses or soft contact lenses.
  • Rigid Gas Permeable (RGP) Contact Lenses: These lenses provide a more regular surface for the eye, improving vision in moderate to advanced cases.
  • Scleral Lenses: Scleral lenses are another type of RGP which are larger vault over the cornea, providing excellent vision correction and comfort.
  • Corneal Cross-Linking: This procedure involves applying riboflavin (vitamin B2) drops to the cornea and then exposing it to ultraviolet light. This strengthens the corneal tissue and slows the progression of Keratoconus.
  • Intacs: These are small, crescent-shaped inserts placed in the cornea to flatten the cone shape and improve vision.
  • Corneal Transplant: In severe cases where other treatments are ineffective, a corneal transplant may be necessary to restore vision.

Lifestyle and Management Tips

In addition to medical treatments, there are lifestyle changes and management strategies that can help individuals with Keratoconus:

  • Avoid Eye Rubbing: Reducing eye rubbing can prevent further damage to the cornea. If you have allergies such as hayfever or eczema causing itchy eyes, this needs to be managed with appropriate preservative-free eye drops or medication as recommended by your optometrist.
  • Regular Eye Exams: Regular check-ups with an optometrist are essential to monitor the progression of the disease.
  • Protective Eyewear: Wearing sunglasses can help reduce light sensitivity and protect the eyes from UV damage.
  • Hydration and Nutrition: Maintaining a healthy diet and staying hydrated can support overall eye health.


Keratoconus is a complex and progressive eye disease that requires careful management and treatment. While there is no cure for Keratoconus, various treatment options can help manage the condition and improve vision. Early detection and intervention by an optometrist are key to preventing severe vision loss. If you experience any symptoms of Keratoconus, it is important to seek professional advice and explore the best treatment options for your needs.

At Bayside Eyecare, our experienced optometrists are dedicated to supporting those in the Bayside Melbourne area with the diagnosis and management of Keratoconus.