Keratoconus Issues and Answers

Dieters will sometimes joke about waging their own personal “Battle of the Bulge” as they work to lose weight. But some individuals are more concerned about another “Battle of the Bulge” — a battle that can have serious consequences for their eyesight. Keratoconus, a progressive condition that causes the cornea to take on an abnormal bulging shape, can produce major refractive errors and other vision-limiting problems. But if you’re suffering from keratoconus, you’ll be happy to know that medical science offers a variety of options to treat your condition and optimize your eyesight.

The Distorted World of Keratoconus

Sharp, clear vision relies on the proper refraction of incoming light. The cornea normally offers a smoothly curved surface that guides the light into the eye without distorting it before it can reach the lens and retina. But a cornea afflicted by keratoconus will have an uneven, cone-shaped bulge to it that acts more like a funhouse mirror than a clear window. As the disease progresses, you may experience ever-worsening astigmatism and/or myopia. You may even have bouts of acute vision trouble caused by tiny cracks that form in the corneal surface.


Treatment Options

Keratoconus presents more of a corrective challenge that the usual refractive errors. Eyeglasses and standard soft contacts have trouble compensating for the uneven corneal curvature. Our Kansas City ophthalmologists are more likely to prescribe sophisticated alternatives such as:

Custom soft, GP, or hybrid contact lenses

Soft contacts custom-fitted for your particular corneal shape and dimension may correct mild keratoconus adequately. Rigid GP (gas permeable) lenses may do an even better job, since they hold their shape independent of the corneal curvature. You can get the best of both types of lenses by trying hybrid contacts (which have a soft rim) or piggyback lenses (a pair of GP lenses on top of a pair of soft lenses).

Scleral contact lenses

Scleral contact lenses are the best contact lens choice for many keratoconus sufferers. That’s because they cover the entire corneal area, resting on the sclera of the eye, lending a rigid, perfectly spherical outer shell that compensates for the corneal aberration.

Corneal cross-linking

Keratoconus can be caused by inadequate collagen, the connective tissue that normally lends the cornea tissue its resilience and helps it maintain its shape. Corneal cross-linking is a method of strengthening and reinforcing that collagen, thus preventing your keratoconus from getting worse. The cornea is treated with a type of Vitamin B called riboflavin; UV rays then activate the riboflavin.


Intacs are a minimally-invasive treatment that can reshape the corneal curvature. These small, clear plastic rings are inserted just inside the cornea, where they help to restore a more normal contour to the tissue. Our Kansas City eye doctors can replace or remove these devices in a matter of seconds.

Conductive keratoplasty

Conductive keratoplasty, or CK, was originally developed for presbyopia but can also reduce the effects of keratoconus. Radio frequency energy applied to the outer edge of the cornea heats the tissue, causing it to shrink slightly and reducing the degree of bulge. Corneal cross-linking can then help stabilize the resulting changes.

Corneal transplants

If your corneas are too far gone to respond to other keratoconus treatment methods, replacing them with healthy donor corneas can provide remarkable improvement in your vision. Our eye care clinic can perform corneal transplant surgery safely and effectively using advanced technology. Since it may take awhile for the vision in the treated eye to clear up, you’ll probably want to have the procedure done for only one eye at a time.

Keratoconus can be both frightening and frustrating, but you don’t have to let it get you down. Contact our eye care clinic to learn more and schedule a consultation so we can recommend the right treatment approach for you.

Posted July 23, 2018 by Silverstein Eye Centers
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