Keratoconus is the cone-like steepening of a patient's cornea that causes significant distortion of vision. When keratoconus starts ("forme fruste") there is only a very subtle distortion of the patient's vision that can often be treated with glasses. As the cone formation gets worse, rigid contacts are the main stay of treatment. This type of contact vaults over the distorted cornea and provides a new distortion free surface for the patient's cornea. Most patients are able to go through their entire life using this type of contacts.
Intacts are plastic segments that are used to strengthen and modify to corneas to help with vision.They do not work for every patient but have been very helpful in many. Recently, collagen crosslinking has been used (but not yet approved in the United States) to increase the cornea's rigidity and slow down, stop or sometimes reverse some of th keratoconus progression.
Corneal transplant is the main therapy for patients that are not helped by any or all of the above. This gives the patient a new, less distorted cornea. Current corneal transplant technology does not make the patient's cornea normal with a perfect curvature as the patient would like but it is usually much improved from keratoconus. Most patients can go back to wearing glasses or contacts with good vision and comfort. Patients should also realize that corneal transplants include a small risk of rejection.