Keratoconus

What are the symptoms of keratoconus?

The symptoms of keratoconus differ from person to person, depending on the stage of the condition they have. For some people, keratoconus comes on quite quickly, but for others it develops slowly. People usually begin experiencing symptoms in their early teens through to their early twenties, though it can affect people earlier or later in life. 

Here are some of the main symptoms, depending on the stage of keratoconus:

Symptoms of the early stages of keratoconus:

• Mild blurring or clouding of vision: As the shape of the front of your eye changes, light that passes through the cornea doesn't form a clear image at the back of your eye. 

• Distortion of vision: Some parts of your vision are clear, but other parts become blurry. You might get some double vision. 

• Light sensitivity: You might find you become more sensitive to light and glare. Bright lights can feel uncomfortable to look at. 

• Short‑sightedness (myopia): People with keratoconus often notice they become short‑sighted, meaning they can't clearly see things further away. 

• Astigmatism: This is a common condition caused by an irregular eye shape. It leads to blurred vision and difficulty seeing at night or in low‑light conditions. 

• Regular changes of prescription: If you often find you need to change your glasses or contact lens prescription, this could be a sign of keratoconus.  

Symptoms of more advanced stages of keratoconus:

• Visible change in eye shape: In more advanced stages of keratoconus, the cornea becomes more visibly pointed or cone‑shaped, rather than being smooth and rounded. 

• Monocular polyopia (multiple 'ghost' images): As keratoconus advances, you may find there are multiple 'ghost' images that surround a main image. These can appear scattered randomly around the main image. Over time, the way these 'ghost' images appear can change. 

• Very blurry or distorted vision: Over time, your vision will become noticeably worse, with very blurry, distorted or cloudy vision, making it harder to see.  

• Scarring on the cornea: As your cornea gets thinner, it can be more easily damaged. This can cause scarring on the cornea, which can make vision blurrier. 

• Inability to wear contact lenses: Because your cornea has changed shape so much, it can become almost impossible to place normal contact lenses over the cornea. Specialist contact lenses can sometimes help. 

• Eye discomfort: While keratoconus isn't usually painful, it can cause discomfort, throbbing, a gritty feeling or even a burning sensation for some people.

How is keratoconus treated?

Most people with keratoconus can manage the condition well, and there are several treatment options depending on how advanced it is. At Specsavers, we focus on helping you see clearly and comfortably. Your optometrist will talk through the right option for you, based on how far your keratoconus has progressed, your age, and your overall eye health. 

• Glasses for keratoconus: If your keratoconus is fairly mild, your optometrist may advise wearing prescription glasses. These will help treat astigmatism or short‑sightedness, making it easier for you to see things.  

• Contact lenses ‑ Another option for mild keratoconus is to use regular contact lenses. Again, these help with astigmatism and short‑sightedness. 

• Rigid Gas Permeable (RGP) keratoconus lenses: RGP lenses are made of a rigid breathable plastic that creates a tear layer that's the shape of the cornea, correcting it to fit the natural shape of the lens. These contact lenses are easy to put in and take out, but can be a little uncomfortable to start with. 

• Scleral keratoconus lenses: A scleral lens is a large, made‑to‑measure lens that sits on the sclera (the white of your eye), rather than on your cornea. As your sclera is less sensitive than your cornea, these lenses can be more comfortable for people with keratoconus compared to RGPs. 

• Piggyback lenses: Piggybacking is when you wear a pair of soft contact lenses underneath hard contact lenses for keratoconus. It can help to prevent the rigid RGP lens from irritating the corneal surface and ease contact lens discomfort. 

• Behaviour changes: Because keratoconus can be caused by excessive eye rubbing, your optometrist might suggest ways to change this behaviour. If you're rubbing your eyes because of allergies, medication might help. If it's caused by dry eye syndrome, artificial tears could be beneficial.

• Collagen cross‑linking (CXL): This hospital treatment helps to stop keratoconus from getting worse. It uses vitamin B2 eye drops and ultraviolet light to strengthen the cornea. If your optometrist thinks it could help, they’ll refer you to an eye specialist for assessment and treatment. 

• Keratoconus surgery: In some cases, where the cornea is very thin or scarred, surgery may be needed. This could involve laser treatment to reshape the cornea or a transplant to replace it. Your optometrist will explain your options and refer you to an eye hospital if needed.