How is keratoconus treated?

Treatment often depends on the severity of the condition. During early stages, vision can be corrected with eyeglasses. As the condition progresses, rigid contacts may need to be worn so that light entering the eye is refracted evenly and vision is not distorted. You should also refrain from rubbing your eyes, as this can aggravate the thin corneal tissue and make symptoms worse.

Keratoconus can also be treated with Intacs, which are small curved implantable corneal devices that can reshape the cornea. Intacs are FDA approved and can help flatten the steep cornea found in keratoconus.

Another treatment option for keratoconus that is not FDA approved is collagen cross-linking. Collagen cross-linking is a new treatment that uses a special laser and eyedrops to promote “cross-linking” or strengthening of the collagen fibers that make up the cornea. This treatment may flatten or stiffen the cornea, preventing further protrusion.

When good vision is no longer possible with other treatments, a corneal transplant may be recommended. This surgery is only necessary in about 10 percent to 20 percent of patients with keratoconus. In a corneal transplant, your ophthalmologist (Eye M.D.) removes the diseased cornea from your eye and replaces it with a healthy donor cornea.

A transplanted cornea heals slowly. It can take up to a year or more to recover good vision after corneal transplantation.

While a corneal transplant will relieve the symptoms of keratoconus, it may not provide you with flawless vision; however, of all conditions requiring corneal transplants, keratoconus has the best prognosis for clear vision.

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.