Keratoconus: What you always want to know

An keratoconus eye fitted with gas permeable lens



    Frequently Asked Questions About Keratoconus

    What is keratoconus?

    Keratoconus is a condition where the cornea becomes thinner and becomes cone-shaped.  This corneal protrusion causes blurry vision as the cornea becomes irregular in shape. The progression is usually in the first three decades of life.  

    Where does keratoconus come from?

    Most of the patients with keratoconus have history of eye rubbing. There are sets of genes that make one more susceptible to keratoconus.  It is said that the corneal hysteresis or rigidity of patients with keratoconus patients is less vs others. 

    How can keratoconus see?

    Keratoconus patients can see with special contact lenses such as rgp, scleral contact lenses, or custom soft lenses for keratoconus. 

    Can I drive with keratoconus?

    It depends on your vision. With mild keratoconus, even without correction, you may still have about 20/40 vision which is enough for driving. But as the disease progresses, you may encounter glare at night and this may make it more difficult for you to drive. Depending on the severity of your condition, it is best to wear your corrective glasses or contact lenses to ensure your safety, as well as everyone else’s.

    Can keratoconus be cured permanently?

    Keratoconus is a progressive condition, but when diagnosed early, it can be stabilized by a procedure called corneal collagen cross-linking. However, contact lenses are still needed to help you see better.  It cannot be cured or reversed.

    What are keratoconus lenses?

    Corneal gas permeable lenses, scleral contact lenses and custom soft lenses such as Kerasoft IC are know as keratoconus lenses.

    What causes keratoconus to get worse?

    The only thing that you can control is to avoid eye rubbing. Eye rubbing is known to cause and exacerbate the progression of the cone. There are reports too that some sleeping positions may also exacerbate and put people at risk for keratoconus.  Here is a link to our blog regarding that topic. 

    When keratoconus stop progressing?

    Yes. For some people, keratoconus does not progress at all and remains to be in the forme fruste or very mild stage. For others who are progressing, a procedure called collagen cross-linking can help to stabilize the condition. Progression naturally stops at the 4th decade of life.  Once we reach that age, our body has a natural cross-linking process.  So if you are just diagnosed with keratoconus and you are in your “late” 30s, you may not need to undergo cross-linking anymore. 

    Can keratoconus exist in 1 eye only?

    Yes. About 2% to 4% of patients will have keratoconus only in 1 eye. However, it is more common that the condition exists in both eyes but asymmetrically. 1 eye can be discovered earlier than the other, which can also make the stage of severity different as well.

    Does keratoconus exist in both eyes?

    Keratoconus is usually a bilateral condition, however, in some cases, patients initially present unilaterally.  It is important to monitor both eyes.

    Can a person go blind with keratoconus?

    Keratoconus can cause blurring of vision. It does not cause blindness but can cause low vision when not treated or managed.  Because of the continuous remodeling of the corneal cells, patients with advanced stages of keratoconus may develop scars which can greatly affect vision. 

    Can I wear contact lenses first before doing cross-linking procedure?

    Yes it is possible, however, here are some considerations:  

    When you are very young, your condition may aggressively progress, so postponing 2 or more years before doing cross-linking may cause your cornea to be more irregular due to the disease progression. 

    Cross-linking procedure may cause flattening of the cornea, and this continues over a few months, so there is usually a need to  change the previous contact lens fit. 

    What is the last stage of keratoconus?

    The last stage of keratoconus usually involves having full thickness scar on the cornea. At this time, the cornea will be too thin already for the cross-linking procedure, however, most often than not, customized contact lenses can still improve one’s vision.

    Can you live a normal life with keratoconus?

    Definitely, you can live a normal life with keratoconus. We have patients with keratoconus who are doctors, chefs, medical technologists, military officers, business owners, and engineers…. They work, study, travel, and drive.  Keratoconus should not stop you from being what you want to be. 

    Can I get my vision back after keratoconus?

    The vision of patients with keratoconus can get better or improved by wearing customized contact lenses such as gas permeable lenses, scleral lenses, and customized soft lenses for keratoconus. 

    Which doctor treats keratoconus?

    Both ophthalmologists and optometrists care for patients with keratoconus. Ophthalmologists are the ones who will perform procedures such as cross-linking, putting intracorneal rings and corneal transplant, while optometrists will be the one who will fit custom special contact lenses to improve the vision of a keratoconus patient.

    Is keratoconus rare?

    We used to think keratoconus is rare. The prevalence of keratoconus in the whole population was 1.38 per 1000.  However, in some areas, it is more such as in Netherlands which is 1:375

    Can keratoconus progress after corneal cross-linking?

    Most often than not, cross-linking will help stabilize the condition,  however, it was reported that 17%  may not respond to the procedure. Those with high preoperative corneal curvature, as well as those with atopic diseases and allergies, has more risks of progressing if they continue to rub their eyes. In pediatric KCs who underwent cross-linking, a study showed progression risk was about 10%. So you can see that it is still best to do cross-linking as there is over an 80% chance of stabilization. 

    Is keratoconus serious?

    Keratoconus is a condition where you need to take action. When diagnosed and managed early, you can still maintain good vision. If no action is done, the condition can progress and cause blurring of vision which may affect school and work. 

    Is corneal transplant the best option for keratoconus?

    No. A corneal transplant is the last option in treating keratoconus. The protocol for keratoconus treatment is Collagen Cross-Linking. In mild cases, regular contact lenses and eyeglasses may provide good vision. In moderate to advanced stages, some would consider getting intacs and customized specialty contact lenses such as gas permeable contact lenses, soft customized contact lenses and scleral contact lenses. A retrospective study showed that 40 of the 51 eyes with severe keratoconus that would otherwise have undergone transplant surgery were successfully treated with long-term scleral lens wear. If gas permeable lenses already pop-out because of the advanced stage, you can always try scleral contact lenses first. 

    What is the best type of contact lens for keratoconus? 

    The best type of contact lenses would depend on the age of the patient, the stage of the keratoconus, the lifestyle, and the adaptability of the patient.

    Gold Heart Optical Centre is an eye clinic in the Philippines that fit specialty contact lenses for the management or treatment of keratoconus. Keratoconus contact lenses fitted are gas permeable lenses (rgps), scleral contact lenses and customized soft contact lenses such as Kerasoft IC.  

    Book an appointment with us. You can also visit us at our Facebook page.



      About the Doctor:

      Dr. Millette Romualdez is a Fellow of the American Academy of Optometry, Scleral Lens Society, Philippine College of Optometry and International Association of Contact Lens Educators. She has also received a Certification of Advanced Contact Lenses from the Australian College of Optometry.

      To book an appointment for a doctor that fits keratoconus contact lenses in the Philippines such as scleral contact lenses, GP lenses and Kerasoft IC , contact us via 09215452389 or send us an email  Gold Heart Optical Centre is a scleral lens provider.


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