I’m known as “the Keratoconus doctor” because I have treated thousands of patients for Keratoconus, I am on the cutting edge of treatment research for Keratoconus, and because I actually have Keratoconus, just like my patients. If you think you have Keratoconus, or have a new diagnosis, or have been frustrated with your previous Keratoconus treatment, this collection of frequently asked questions about Keratoconus may help you understand KC better. If after reading this you still have questions, contact me or make an appointment.
- What Is Keratoconus?
- What Are the Symptoms of Keratoconus?
- How Can Keratoconus Affect My Life?
- How Common Is Keratoconus?
- What Causes Keratoconus?
- Can LASIK or RK Surgery Cause Keratoconus?
- Are There Multiple Forms of Keratoconus?
- How Is Keratoconus Diagnosed?
- How Do You Measure the Severity of Keratoconus?
- How Can I Treat My Keratoconus?
- What is the Best Keratoconus Treatment?
- How Can I Stop My Keratoconus From Getting Worse?
- Is Keratoconus Always Progressive?
- Does Keratoconus Cause Eye Pain?
- How Is Keratoconus Diagnosed?
- Can Keratoconus Go Away On Its Own?
- Can Keratoconus Cause Dry Eye?
- What Do I Do If I Think I Have Keratoconus?
1. What Is Keratoconus
Keratoconus (pronounced KEHR-uh-toh-KOH-nus) is a progressive eye disease that turns your normally round cornea into a bulging cone shape. The cornea is an important part of the eye that is responsible for two main things:
- Bending and focusing light so you can see, similar to how a camera uses light to capture photographs
- Protecting your eyes from dirt, germs and harmful UV rays
In people with Keratoconus, the light bends in unusual ways depending on what part of the bulging cornea the light passes through.
2. What Are the Symptoms of Keratoconus?
Keratoconus has many symptoms, including…
- Blurry and distorted vision
- Double vision with one eye closed
- Triple “ghost” images
- Night time halos
- Streaks when viewing bright lights
- Sensitivity to light, and frequent headaches.
If you find yourself experiencing any of these symptoms, make an appointment for a Keratoconus Screening exam.
3. How Can Keratoconus Affect My Life?
Keratoconus affects your vision which can degrade your quality of life. Individuals with this disease may find it hard to work, read, watch TV, and drive. It can also stress, lower your confidence, make you unable to enjoy those important moments in life, reduce your ability to take part in recreational sports, and affect your personality.
4. How Common Is Keratoconus?
Keratoconus is a lot more common than people think. In the past, it was predicted that 1 in 2,000 people had it, while today that number has drastically increased to 1 in 400. The reason for this increase is that more people are properly diagnosed due to advances in technology, awareness, and Optometrists like myself who have dedicated themselves to helping individuals overcome this condition.
5. What Causes Keratoconus?
There is no firm consensus in the medical community about the causes of Keratoconus. However, we do know that it develops when the collagen protein fibers in the eye weaken. When collagen in the eye weakens, it can cause the cornea to lose its shape. (Think back to your days on a playground when a rubber ball became lopsided with a bulge on one side.)
One cause of this weakness could be due to free radicals in your eyes. Every day, your corneas produce harmful by-products known as free radicals. Antioxidants in your eyes typically get rid of these free radicals, but individuals with Keratoconus don’t produce enough antioxidants to fight off the free radicals. As collagen levels decrease, the corneas lose their strength and start to bulge.
The weakness can also be caused by frequent rubbing of the eyes. There may be a genetic component as well, since those with KC in their family are more likely to also have the condition.
6. Can LASIK or RK Surgery Cause Keratoconus?
LASIK or RK eye surgery can cause Keratoconus for certain individuals. Because the LASIK and RK procedures involve operating on the cornea, they can result in Corneal Ectasia. While the LASIK screening process is more efficient today, many individuals who received the surgery in the past may develop Keratoconus.
7. Are There Multiple Forms of Keratoconus?
Keratoconus comes in a variety of forms. Depending on your symptoms, you may be experiencing one of the following forms of this disease:
- Forme fruste Keratoconus is a mild form and a precursor of the disease. It is a mild form of the condition that usually causes few issues.
- Nipple cone Keratoconus involves the cornea forming a cone-like shape. Common symptoms include blurry and distorted vision.
- Oval cone Keratoconus is a version where the cornea bulges into an oval shape. The bulging tends to occur at the bottom outer part of the cornea and can make it look as if it is sagging.
- Pellucid Keratoconus is a version of KC with inferior thinning of the cornea from the outside in.
- Globus cone Keratoconus is the most severe form of the disease. It causes an individual’s cornea to thin and bulge into a round shape.
8. How Is Keratoconus Diagnosed?
There are several tests that we use to diagnose Keratoconus. These tests include:
- A slit-lamp exam where an Optometrist analyzes your eye with a special microscope.
- A standard vision test.
- Computerized corneal mapping (topography) that uses specialized equipment to measure and render a detailed map of your cornea. This can include a keratometry exam that measures the curvature of your cornea to determine the level of your corneal bulge.
- Pachymetry measures the thickness (and thinness) of the cornea.
9. How Do You Measure the Severity of Keratoconus?
An Optometrist can assesses the severity of Keratoconus by determining how steep your cones are, how thin your corneas are, and their shape.
10. How Can I Treat My Keratoconus?
Depending on the type of Keratoconus you have, we would treat your Keratoconus with one of the following…
- Standard eyeglasses, only with the most mild forms of KC
- Standard soft lenses
- Custom soft lenses
- Hybrid Lenses, which are small RGP lenses with a soft lens skirt
- Small RGP (rigid gas permeable) especially made for Keratoconus
- Small RGP lenses with a piggyback soft contact lens below it
- Large RGP (or “Scleral” lenses)
11. What is the Best Keratoconus Treatment?
While every eye is different, there is no single “best” keratoconus treatment. But I’ve seen the greatest successes with moderate to severe cases of Keratoconus with Scleral Contact Lenses.
I’ve spent the better part of my career developing effective solutions for patients with Keratoconus. The Eaglet Eye Surface Profiler is a tool that I can use to measure your entire cornea and much of the white part of your eye, called the Sclera. This level of accuracy allows me to create a pair of Scleral contact lenses that completely vaults over your cornea and gently rests on your sclera, resulting in a more comfortable Keratoconus contact lens that helps you see more clearly. It’s the state of the art for more severe cases of Keratoconus, and what I wear every day.
12. How Can I Stop My Keratoconus From Getting Worse?
Like most diseases, early detection is crucial when it comes to Keratoconus. If your Keratoconus is progressing, you may need to receive the Corneal Crosslinking treatment to stop the progression. Studies have shown it to be 98% effective.
13. Is Keratoconus Always Progressive?
Keratoconus is a progressive eye condition that can worsen with age. Progressive Keratoconus can be halted using the CXL or C3R (corneal cross-linking) procedure. If you have Keratoconus, it’s highly recommended that you monitor it to keep track of its progression by visiting a Keratoconus specialist regularly.
Kerataconus doesn’t always affect both eyes equally. Some patients may experience stronger symptoms in one eye. While corneal cross-linking can halt Keratoconus, it isn’t always necessary to have this procedure performed on both eyes. In cases where a single eye is more affected, corneal cross-linking may be performed on the affected eye while the other one is monitored over time.
14. Does Keratoconus Cause Eye Pain?
Keratoconus doesn’t always cause eye pain. However, its symptoms can cause discomfort and other problems. The most common symptoms of Keratoconus include astigmatism, degrading vision quality, and corneal thinning, bulging, or rounding. Some individuals may experience corneal scarring and find themselves unable to use contact lenses. These individuals may require a corneal transplant to correct this problem.
If you have Keratoconus and experience sudden pain in your eyes, you should consult with your Keratoconus specialist immediately.
15. How Is Keratoconus Diagnosed?
There are several methods available for diagnosing Keratoconus. These methods include:
- Eye refraction where an Optometrist uses special equipment to analyze your eyes for vision problems.
- Keratometry which involves your eye doctor focusing a circle of light into your cornea to measure the reflection and check the shape of your cornea.
- Slit-lamp exam involves an eye doctor shining a vertical beam of light on your eye and a microscope to analyze the surface of it. This test assesses the shape of your cornea and can spot other problems too.
- Corneal mapping is a more advanced technique that uses specialized optical coherence tomography and corneal topography to map the shape of your cornea.
- Pachymetry is a test to measure the thickness of the cornea.
Which of these methods you require will depend on the resources available to your Keratoconus doctor and how advanced your Keratoconus is.
16. Can Keratoconus Go Away On Its Own?
Keratoconus is a lifelong eye disease that does not go away on its own. In severe cases a corneal graft might be needed, but that does not eliminate Keratoconus. Individuals with less severe Kerataconus can reduce its effects using specialized contact lenses (hard, piggyback, hybrid, or scleral). Scleral lenses are a unique type of contact lens that rests on the white part of your eye (the sclera) and does not sit on the cornea.
17. Can Keratoconus Cause Dry Eye?
Your eyes rely on tears to stay lubricated and to reduce irritation and dryness. Keratoconus can result in dry eyes because of your eyes inability to spread tears over your uneven cornea.
Individuals with Keratoconus may experience dry eye naturally or as a byproduct of wearing contact lenses that further interfere with their eye’s ability to lubricate using tear drops.
18. What Do I Do If I Think I Have Keratoconus?
Keratoconus is a relatively rare eye disease that few optometrists are trained to diagnose, and even fewer are trained to treat. Dr. Barry Leonard is one of the top Keratoconus Doctors in the country and has been treating patients with KC since he was in optometry school and was diagnosed with his own Keratoconus in the 80’s. If you think you have Keratoconus, make an appointment with Dr. Leonard for a Keratoconus Screening Exam. Call our office at 818-891-6711 or make an appointment online.