While there currently is no cure for keratoconus, there are many treatment options that aim to slow down the progression of the condition and improve the vision and comfort of someone with keratoconus.

In this blog we will cover everything you need to know about keratoconus treatments.

How does keratoconus affect your eyes?

Keratoconus is a progressive eye disease that affects the cornea, the front part of the eye. Over time, your cornea becomes progressively thinner, causing it to bulge and protrude outward into an irregular surface, which results in a cone-like shape.

A normal cornea has a smooth round shape and a regular surface, but keratoconus leads to an irregular corneal shape, causing astigmatism and scarring, leading to other symptoms such as pain and poor vision.

What symptoms can keratoconus cause?

Keratoconus can lead to blurring in your vision, distortions in your vision, shadowing around letters and objects, increased sensitivity to light and glare, eye redness or swelling. If your keratoconus is severe, you may also experience eye pain.

If you notice any of these symptoms or experience sudden changes in your vision and find it difficult for you to perform your daily activities, please schedule an eye exam with your eye doctor.

What causes keratoconus?

When it comes to the causes of keratoconus, the exact mechanism of action is complex, but it is known that there is a genetic component associated with keratoconus. It is thought to be due to the enzymatic breakdown of collagen structures within your cornea, leading to a thinner cornea.

Is there a cure for keratoconus?

Currently, there is no cure for keratoconus. However, there are several medical interventions that can help slow down or even stop the progression of keratoconus, as well as help improve your vision. We will discuss these medical interventions below.

• Corneal cross-linking - One treatment option that may help slow down the progression of keratoconus is corneal cross-linking. It involves the use of riboflavin and UV light by an eye surgeon, with the goal of stiffening collagen fibres and strengthening them, and activating the cells on your eye's surface, which will straighten them in order to slow down the progression of keratoconus. Although this treatment option only slows keratoconus' progression, it does not actually improve vision.
• ICRS (Intracorneal Ring Segments) - Intracorneal ring segments are another treatment option. In this procedure, plastic rings are placed into your cornea, causing the cornea to become more plateaued so it does not protrude as much. The goal is to smooth out the cone of the keratoconic eye, oftentimes leading to improved vision and reduced discomfort.
• Speciality contact lenses - Various specialty contact lenses can also be used to help improve your vision and reduce discomfort. One type of contact lens is a rigid gas permeable lens, which is a hard corneal lens that will cover your eyes and help mask distortions.  In some cases hybrid lenses are used. The lenses are hard in the middle and have soft skirts around the edges to ensure that you are comfortable while wearing scleral lenses.
• Scleral lenses - Dr. Pinkhasov thinks scleral lenses are a great way to improve vision in patients with keratoconus. Generally speaking scleral lenses are considered the gold standard for improving both vision and comfort for patients with keratoconus. They are also specially designed hard contact lenses that use a topographical map of your cornea to design the lenses which leads to improved comfort and vision. These lenses are larger than standard hard contact lenses. They sit on the white part of the eye. As a result, it will vault over the cone and won't touch the cornea, this vaulted design creates a new lens, replacing the scarred and misshapen keratoconic lens, while also reducing discomfort that is the result from a lens coming in contact with a scarred cornea. The scleral lenses are filled with a fluid before being placed on the eye. Thus, the fluid layer can eliminate distortions that are caused by the irregular cornea. Therefore, by creating a new surface on the front part of your eye, the goal is to improve your vision.
• Piggyback lenses - Piggyback lenses are another option for treatment. They work in the same way as rigid gas permeable lenses. The purpose of these lenses is to improve your comfort while wearing them. A soft contact lens may be placed first, and a hard contact lens may then be placed over it to make them more comfortable.
• Keratoplasty (corneal transplant) - Severe cases of keratoconus and end stage cases may require keratoplasty, which is a corneal transplant. It is, however, more of a last resort.
• Soft toric contact lenses  - These lenses are specially designed for patients with early stages of keratoconus, however they generally are not considered a good solution for someone who has corneal irregularities that are impacting their vision and comfort.

Can glasses help improve your vision if you have keratoconus?

Glasses don't really help to improve your vision because they don't actually sit on the front part of your eye. So they don't help to reshape that front part of the eye or create a new front surface of the eye. As a result, they do not really improve your vision or discomfort.