KERATOCONUS
Keratoconus is a progressive eye condition that affects the shape and strength of the cornea, the clear, dome-shaped surface at the front of the eye responsible for focusing light onto the retina. In a healthy eye, the cornea is smooth and evenly curved, allowing light to focus precisely for clear vision. In keratoconus, however, the cornea gradually thins and weakens, causing it to bulge outward into a cone-like shape. As this happens, vision can become blurry, distorted, and increasingly difficult to correct with standard glasses.
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​Although keratoconus often develops during the teenage years, it can begin earlier, making early detection especially important. Left untreated, the condition may progress over time, leading to worsening vision and, in more advanced cases, potential vision loss. Fortunately, with modern diagnostic tools and treatment options, early identification and intervention can significantly slow—or even halt—its progression, helping to preserve long-term visual health.
Signs, Diagnosis, and Risk Factors
Keratoconus is often first suspected during a comprehensive eye exam, particularly when certain patterns emerge. Common signs include rapidly changing prescriptions, increasing nearsightedness (myopia), and astigmatism that shifts over time. Eye care providers may also detect irregularities during routine measurements or observe changes in the cornea using a slit lamp examination.
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If keratoconus is suspected, advanced imaging such as corneal topography (also known as Pentacam imaging) is used to map the front and back surfaces of the cornea. This technology allows for early detection—even before significant vision changes occur—and can also be used to monitor the condition over time.
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While the exact cause of keratoconus is not fully understood, several factors are associated with an increased risk. These include a family history of the condition, frequent eye rubbing, and chronic eye allergies. Because of this, children with these risk factors should be monitored closely for early signs of corneal changes.
Treatment Options
Treatment for keratoconus depends on the severity and progression of the condition, but the primary goal is always to preserve vision and prevent further corneal weakening.
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One of the most important advancements in treatment is corneal cross-linking, a minimally invasive procedure designed to strengthen the cornea. This treatment uses riboflavin (vitamin B2) eye drops combined with controlled ultraviolet light to reinforce the cornea’s collagen fibers, helping to stabilize the condition and slow or stop its progression. Corneal cross-linking has become a standard and highly effective option, particularly for children and teens diagnosed early.
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As keratoconus progresses, glasses may no longer provide adequate vision correction. In these cases, specialty contact lenses can significantly improve clarity by creating a smoother optical surface over the cornea. Options may include rigid gas permeable (RGP) lenses, hybrid lenses, or scleral lenses, all of which are customized to meet each patient’s needs.
Living With Keratoconus
In most cases, children and teens with keratoconus can continue to live active, healthy lives. Participation in sports and daily activities is typically not restricted, although in more advanced cases, certain high-impact activities may be limited based on individual needs.
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Because keratoconus can progress over time, ongoing monitoring is essential. Regular eye exams allow for early detection of changes and timely adjustments to treatment, helping to protect vision as your child grows.
When to Schedule an Evaluation
You should consider scheduling an evaluation if your child experiences frequent changes in their prescription, increasing or shifting astigmatism, or worsening blurry vision. A family history of keratoconus is also an important reason to seek early screening.
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Early diagnosis can make a meaningful difference in long-term outcomes. With today’s advanced technology and treatment options, we are better equipped than ever to manage keratoconus and protect your child’s vision for the future.
Schedule an Appointment
If you have concerns about your child’s vision, our team is here to help. Contact University Children’s Eye Center to schedule a comprehensive evaluation and learn more about your child’s eye health.