What is Keratoconus?

Keratoconus is an progressive eye condition in which the structural integrity of the cornea is compromised, leading to the cornea to lose its healthy structure and bulge outward into a shape that resembles a cone.

Due to this abnormal structural change in the cornea, this leads to undesirable symptoms of blurred, double vision, and also leads to poor nighttime vision where one can experience a lot of halos, starbursts, and streaks of light.

Keratoconus is an eye condition that can cause irreversible vision loss that can lead to a corneal transplantation and even potential blindness if not treated and managed appropriately.

Visual symptoms reported from patients with keratoconus?

Visual symptoms include but not limited to:

• Blurring of vision and/or loss of vision
• Decreased tolerance to contact lenses
• Increased sensitivity to light and glare
• Difficulty driving at night
• A Halo around lights and ghosting (especially at night)
• Eye strain
• Headaches and general eye pain
• Eye irritation, redness, swelling

I have Keratoconus, how can I see better?

Since Keratoconus is due to an irregularity in the shape of the front of the eye, the means to provide normal, comfortable vision is by providing an optical lens/medium that can negate aberrations. Custom contact lenses have the ability to cancel out aberrations caused by keratoconus that are responsible for poor vision. Different custom contact lenses such as Scleral Lenses, Rigid Gas Permeable Lenses, and Hybrid Contact lenses, have the ability to provide crisp vision. Read more about the different types of Custom Contacts for Keratoconus.

How is Keratoconus diagnosed?

Keratoconus is diagnosed through objective measurements performed during an eye examination with specific equipment that measures the symmetry or regularity of the cornea, the front surface of the eye. This equipment is called Topography & Tomography.

Only eye doctors with specialized equipment to screen keratoconus can appropriately diagnose keratoconus successfully. At NJ Vision & Dry Eye Center, the eye doctors have the appropriate equipment to measure and screen for Keratoconus. Read more about how we use Corneal Topography to diagnose keratoconus.

How common is Keratoconus?

The most commonly referred to study by the NIH performed in 1986 shows the prevalence of Keratoconus is 1 in 2000 people. However this study is nearly 35 years old and there are more recent studies to show the prevalence of keratoconus is much higher than originally understood.

There is a more recent Global Meta-analysis performed in 2020 that shows that the prevalence of keratoconus is 1 in 700 people.

Moreover, there is another study performed in Australia in 2020 that has shown Keratoconus incidence of 1 in 84 people.

The incidence of keratoconus is not increasing. Eye health care professionals are simply getting better at screening and diagnosing this eye condition.

What are risk factors for Keratoconus?

The most common modifiable risk factor for keratoconus is eye rubbing. Eye rubbing is an epigenetic risk factor for keratoconus.

There are various systemic/medical conditions that are highly associated with keratoconus. Some of these conditions include, but not limited to, the following:

• Ehlers-Danlos Syndrome
• Atopic dermatitis
• Mitral Valve Prolapse
• Downs Syndrome – (10 – 20 times more likely to have keratoconus)
• Floppy eyelid syndrome
• Marfan’s Syndrome
• Osteogenesis Imperfecta

Frequently Asked Questions

Can Keratoconus be caused by Lasik surgery?

There are cases of patients that have been diagnosed with keratoconus or corneal ectasia following lasik surgery. However, it is more likely that the patient already had an existing (or mild) case of keratoconus that was not successfully screened prior to the lasik procedure. Today, patient’s are more aggressively screened for keratoconus prior to having a lasik procedure performed on their cornea.

Can you have Keratoconus in one eye?

Keratoconus is almost always a bilateral condition. Because keratoconus is a genetic condition, it is expected to present itself in both eyes. However, although keratoconus is present in both eyes, sometimes a patient may be more symptomatic for blurred vision in one eye over the other, therefore this may leave one to believe they have the condition present in one eye.

Can you be born with Keratoconus?

Keratoconus is not congenital. However, there is a variant of keratoconus called Keratoglobus that can be associated with someone with Ehler’s Danlos syndrome (a connective tissue disorder).

In Keratoglobus, there is an observed diffuse corneal thinning. In contrast, Keratoconus is a focal thinning in the cornea.

At what age does Keratoconus start affecting the eyes?

Keratoconus can be diagnosed at any age, however most people are diagnosed between the ages of 11 years old to 25 years of age. Unfortunately, this diagnosis can be commonly missed if the eye doctor is not screening for this condition routinely.

Who is likely to have permanent vision loss from Keratoconus?

Individuals who are diagnosed at an early age (younger than 20 years of age) are more likely to experience a more progressive form of keratoconus. However, the earlier the diagnosis of keratoconus, the better the prognosis because of earlier intervention with treatment. There are many available treatments to prevent further progression of keratoconus.

Can Keratoconus be cured?

Unfortunately there is no cure for Keratoconus. However, there are low-risk procedures that can prevent keratoconus from progressing and causing further reduction in vision. This includes the FDA approved treatment of Corneal Cross-linking (CXL).

Are there different types of Keratoconus?

There are variations of keratoconus. They are known as the following:

• Pellucid Marginal Degeneration (PMD)
• Keratoglobus
• Forme Fruste Keratoconus
• Post-Lasik Ectasia

If you are concerned you may have Keratoconus because you experience visual symptoms as described, or you have a family history of Keratoconus, please contact our office to schedule an eye examination. You can call the office at 732-727-7450, or you can request a comprehensive exam online with Dr. Christian Crespo using our online scheduler.