Overview
Keratoconus is an eye condition in which the cornea, the clear dome at the front of the eye, gradually thins and bulges into an irregular cone shape. Because the cornea focuses most of the light entering the eye, this changed shape distorts vision in ways ordinary glasses may not fully correct.
Keratoconus usually begins in the teen or young-adult years and often progresses for a decade or more before stabilizing. It typically affects both eyes, though one is often worse. The good news is that early diagnosis and modern treatments can slow progression and restore clear, comfortable vision. At Bespoke Eye Care in Chester Springs, we specialize in detailed corneal evaluation and custom contact lens fitting for keratoconus.
Symptoms
Symptoms often start subtly and change as the cornea becomes more irregular.
Early Keratoconus
- Mild blurring or distortion that glasses still correct well.
- Increasing astigmatism.
- Frequent changes in your glasses prescription.
- Mild glare and light sensitivity.
Progressing Keratoconus
- Ghost images or double vision in one eye.
- Glare, halos, and streaks around lights, especially at night.
- Vision that stays distorted even with new glasses.
- Difficulty wearing standard soft contact lenses.
Acute Corneal Hydrops
Rarely, in advanced keratoconus, a tear in the back of the cornea allows fluid to rush in. This causes sudden clouding, blurry vision, and discomfort.
Causes & Risk Factors
The exact cause of keratoconus is not fully understood. It likely involves a combination of genetics and weakness in the collagen fibers that give the cornea its strength. Repeated, vigorous eye rubbing is a well-recognized factor that can worsen it.
Who is at risk?
You may be at higher risk if you:
- Have a parent or sibling with keratoconus.
- Rub your eyes frequently or forcefully.
- Have significant allergies, eczema, or asthma.
- Have Down syndrome, certain connective-tissue disorders, or sleep apnea.
- Are a teen or young adult, when it most often begins.
Why it matters
Without treatment, progression can lead to severe irregular astigmatism, contact lens intolerance, corneal scarring, and reduced vision. Advanced disease may eventually require corneal transplant surgery.
Diagnosis
Early keratoconus can be hard to detect without specialized imaging. At Bespoke Eye Care, we use detailed corneal measurements to diagnose it and track any progression.
- Refraction: Measuring your prescription and how well vision can be corrected.
- Slit-lamp examination: A magnified look for thinning, scarring, and other corneal signs.
- Corneal topography or tomography: Mapping the front and back surfaces of the cornea to detect irregular shape.
- Pachymetry: Measuring corneal thickness to identify thinning.
Repeat imaging over time shows whether keratoconus is stable or progressing.
Treatment & Management
Treatment has two goals: slowing or stopping progression and giving you the clearest, most comfortable vision possible.
Vision Correction
- Glasses or soft lenses: May work well in early keratoconus.
- Rigid gas permeable (RGP) and hybrid lenses: Create a smooth new surface that masks corneal irregularity.
- Scleral lenses: Larger custom lenses that vault over the cornea and rest on the white of the eye. They often provide excellent vision and comfort in moderate to advanced cases.
Slowing Progression
- Corneal cross-linking: A procedure using riboflavin drops and UV light to strengthen the cornea. We refer progressive cases to a corneal specialist.
- Stop eye rubbing: Treating allergies helps reduce the urge.
Advanced Options
For advanced disease, a corneal specialist may consider corneal ring implants or a corneal transplant. We coordinate referrals and continue specialty lens care afterward.
See More Clearly With a Custom Plan
Bespoke Eye Care provides detailed corneal evaluation and specialty lens care for keratoconus patients in Chester Springs.
Schedule Your Visit Call (484) 606-3937More detail: Scleral lenses for keratoconus: what to expect.