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What is keratoconus: Diagnosis and Treatment

What Is Keratoconus?

Keratoconus is a progressive eye condition that affects the cornea, the clear, dome-shaped outer surface of the eye. In keratoconus, the cornea gradually thins and bulges outward into a cone shape, causing distorted vision. This can lead to blurred vision, sensitivity to light, difficulty seeing at night, and frequent changes in eyeglass or contact lens prescriptions.


Keratoconus is typically diagnosed through a comprehensive eye examination conducted by an ophthalmologist or optometrist. The diagnosis process may include several steps:

  1. Medical History: The doctor will ask about your symptoms, family history, and any eye conditions you may have had in the past. Eye Hospital In Sirsa
  2. Visual Acuity Test: This test assesses how well you can see at various distances using an eye chart. Keratoconus often causes blurred or distorted vision, so your visual acuity may be affected.
  3. Refraction Test: This test determines your eyeglass prescription to correct refractive errors such as nearsightedness, farsightedness, and astigmatism.
  4. Slit-lamp Examination: A slit lamp is a microscope with a bright light that allows the doctor to examine the structures of your eye, including the cornea. They’ll look for thinning, scarring, or other irregularities characteristic of keratoconus.
  5. Corneal Topography: This non-invasive imaging technique creates a detailed map of the curvature of the cornea. It helps identify abnormal steepening or irregularities associated with keratoconus.
  6. Pachymetry: This test measures the thickness of the cornea. In keratoconus, the cornea is often thinner than normal.
  7. Keratometry: This test measures the curvature of the cornea’s surface. Keratoconus typically results in an irregular or cone-shaped cornea, which can be detected through keratometry.

Once a diagnosis is confirmed, the eye care professional will discuss treatment options with you, which may include glasses, contact lenses, or in more severe cases, surgical interventions such as corneal cross-linking or corneal transplant. Regular follow-up appointments are essential to monitor the progression of the condition and adjust treatment as necessary.


Glasses or Contact Lenses: In the early stages of keratoconus, eyeglasses or soft contact lenses may help correct mild to moderate astigmatism and improve vision. However, as the condition progresses, specialized contact lenses may be necessary to provide better visual acuity and comfort.

Rigid Gas Permeable (RGP) Contact Lenses: RGP lenses are often the preferred option for correcting vision in keratoconus because they provide a smooth and uniform refractive surface over the irregular cornea, resulting in clearer vision. These lenses may take time to adapt to but can provide excellent visual outcomes.

Scleral Contact Lenses: Scleral lenses are larger in diameter than RGP lenses and rest on the sclera (the white part of the eye) rather than the cornea. They vault over the corneal surface, providing a more comfortable fit and improved visual acuity for individuals with advanced keratoconus.

Corneal Cross-Linking (CXL): This minimally invasive procedure is used to strengthen the cornea and slow or halt the progression of keratoconus. It involves applying riboflavin (vitamin B2) eye drops to the cornea, followed by exposure to ultraviolet (UV) light. CXL helps to create new bonds within the corneal collagen fibers, increasing corneal strength and stability.

Intacs: Intracorneal ring segments, or Intacs, are small, crescent-shaped implants inserted into the cornea to flatten and reshape its curvature, improving vision in keratoconus patients. Intacs can be an option for those who are not suitable candidates for corneal transplant surgery.

Corneal Transplant Surgery: In cases of advanced keratoconus where other treatments are ineffective, a corneal transplant (keratoplasty) may be recommended. During this procedure, the damaged cornea is replaced with healthy donor tissue obtained from a corneal donor.

Treatment for keratoconus is individualized based on the severity of the condition, the progression of the disease, and the patient’s visual needs and preferences. Regular monitoring and follow-up appointments with an eye care professional are essential to manage keratoconus effectively and preserve vision.