6 Things to Know About Keratoconus

Keratoconus is an eye disease that causes the cornea, the clear dome-shaped front surface of the eye, to thin and bulge into an irregular shape. This progressive condition usually affects both eyes and can cause significant vision problems if left unmanaged. At Insight Vision Optometry, Las Vegas, our specialty cornea team helps patients at every stage of keratoconus achieve the clearest and most comfortable vision possible.

People with keratoconus often experience blurred vision, distorted vision, increased sensitivity to light, and difficulty seeing at night. Achieving clear vision correction can be challenging because the irregular corneal shape makes it difficult or impossible for standard eyeglasses or soft contact lenses to provide sharp sight. Fortunately, there are effective ways to manage keratoconus and maintain good quality of life.

What Are the Risk Factors for Keratoconus?

Researchers have identified several factors that may increase the likelihood of developing keratoconus:

• Family history of keratoconus or other corneal conditions
• Chronic eye rubbing, which can accelerate corneal thinning
• Associated medical conditions such as Down syndrome, allergic dermatitis, Ehlers-Danlos syndrome, and other connective tissue disorders
• Chronic eye inflammation or allergies

If any of these risk factors apply to you, discuss them with your eye doctor so that appropriate monitoring can be put in place.

Can Keratoconus Develop at Any Age?

Although keratoconus is most commonly diagnosed during adolescence or young adulthood, it can appear at any stage of life. Some patients are not diagnosed until their 30s, 40s, or later, particularly if the condition progresses slowly. This is one reason why regular comprehensive eye exams are important even when your vision seems fine. Early detection allows your doctor to begin monitoring and, if needed, intervene before significant progression occurs.

Why Is Early Diagnosis So Important?

Keratoconus tends to progress more rapidly during its earlier stages, particularly in younger patients. Catching the condition early gives your doctor the opportunity to implement strategies that may slow progression. Corneal cross-linking, a procedure that strengthens the corneal tissue using UV light and riboflavin drops, is currently the only treatment demonstrated to slow or halt keratoconus progression. When performed early, cross-linking can help preserve corneal shape and visual function for the long term. Your doctor can provide a referral for cross-linking evaluation when appropriate.

Does Keratoconus Progress the Same Way in Everyone?

Keratoconus progression varies significantly from person to person, and even between the two eyes of the same individual. Some patients experience mild keratoconus that remains stable for years or decades, while others develop more severe corneal changes relatively quickly. Regular monitoring with corneal topography or tomography allows your doctor to track changes over time and adjust your management plan accordingly.

How Are Scleral Contact Lenses Used for Keratoconus?

For many patients with keratoconus, scleral contact lenses are the most effective non-surgical option for achieving clear, stable vision. Scleral lenses are large-diameter gas permeable lenses that vault completely over the cornea and rest on the sclera, the white part of the eye. The space between the lens and the cornea fills with preservative-free saline, creating a smooth optical surface that corrects for corneal irregularity.

Key benefits of scleral lenses for keratoconus patients include:

• Sharp, stable vision that glasses and standard soft lenses often cannot provide
• A fluid reservoir that keeps the cornea hydrated and comfortable throughout the day
• No direct contact with the sensitive corneal surface, reducing irritation
• Protection of the cornea from environmental exposure and the mechanical effects of blinking

Because eye rubbing and corneal irritation are risk factors for keratoconus progression, the protective qualities of scleral lenses may offer an additional benefit beyond vision correction. In cases of severe keratoconus where a corneal transplant becomes necessary, scleral lenses are also frequently used after the procedure to optimize visual outcomes.

Can You Live a Normal Life With Keratoconus?

With proper management and the right vision correction, keratoconus should not prevent you from living a full, active life. While it can be frustrating to learn that standard glasses or contacts are not providing clear vision, effective alternatives exist. Many patients achieve excellent visual outcomes with scleral lenses or other specialty contact lens options and continue to work, drive, play sports, and enjoy daily activities without significant limitations.

The key is working with a team that has extensive experience managing keratoconus and fitting specialty lenses. Proper lens selection, customized fitting, and ongoing follow-up care all contribute to the best possible results.

Who Else Can Benefit From Scleral Contact Lenses?

Scleral lenses are not only for keratoconus. They can also help patients with other corneal irregularities, severe dry eye syndrome, complications after LASIK or other refractive surgery, corneal transplants, corneal scarring, and high prescriptions that are difficult to correct with standard lenses. Ask your eye doctor whether scleral lenses may be appropriate for your situation.

Does Every Optometrist Fit Scleral Lenses?

No. Scleral lens fitting requires specialized training, advanced diagnostic equipment, and significant clinical experience. Not every optometry practice offers this service. When seeking scleral lens care, it is important to choose a practice with demonstrated expertise in specialty contact lenses.

Schedule a Keratoconus Consultation

Dr. Stephanie Woo, OD, FAAO, FSLS, Dr. Nathan Schramm, OD, FSLS, FBCLA, and Dr. Thanh Mai, OD, FSLS bring years of specialized experience in keratoconus management and scleral lens fitting. To learn more about your options or to schedule a specialty lens consultation, contact Insight Vision Optometry, Las Vegas at 702-747-4070 or visit www.insightvisionlv.com.