What is keratoconus?

Keratoconus is a condition in which the cornea, the clear front window of the eye, gradually thins and bulges forward into a cone shape. This irregular shape bends light unevenly, causing blurred and distorted vision and an increasing, irregular astigmatism.

Keratoconus usually starts in the teens or twenties. Eye rubbing and eye allergy are linked to its progression, and it can run in families. Early diagnosis matters, because treatment can slow or stop the condition from getting worse.

Signs that need checking

• Glasses prescription that keeps changing, especially increasing astigmatism
• Blurred or distorted vision that glasses do not fully correct
• Ghosting or multiple images, and streaks around lights at night
• Being told you are not suitable for LASIK because of your corneal shape
• A family member with keratoconus

How keratoconus is diagnosed

Diagnosis relies on corneal topography or tomography scans, which map the shape and thickness of the cornea. A single scan can show the pattern of keratoconus, and repeated scans over time show whether it is progressing. This information decides whether treatment is needed now and which option suits you.

Treatment options

Treatment is matched to the stage of the disease and whether it is progressing. Your doctor may combine or stage treatments.

Glasses and specialty contact lenses

Glasses may be enough in early stages. As the cornea becomes more irregular, rigid gas permeable (RGP) and scleral lenses can improve vision for many people by creating a smooth optical surface. RGP and scleral lens fitting is available at the clinic, based on your corneal measurements.

Corneal cross-linking (CXL)

Cross-linking uses riboflavin (vitamin B2) drops and controlled ultraviolet light to strengthen the bonds between collagen fibres in the cornea. Its aim is to slow or stop progression, not to restore normal vision. It is usually recommended when keratoconus is shown to be progressing.

During the procedure the eye is numbed, the surface layer is usually removed, riboflavin drops are applied, and the cornea is exposed to ultraviolet light. It usually takes under an hour.

Intracorneal ring segments

These are small, thin arcs placed inside the cornea to flatten and regularise its shape. They may improve vision and help contact lens tolerance in suitable eyes.

Corneal transplantation

For advanced keratoconus or corneal scarring, a partial or full-thickness corneal transplant may be considered.

Recovery after cross-linking

• Expect discomfort, watering and light sensitivity for a few days.
• A bandage contact lens is used until the surface heals.
• Vision may be blurred for several weeks.
• After ring implantation, the eye is usually irritated for a few days and vision improves gradually.

Long-term care matters as much as the procedure: stop rubbing your eyes, treat any eye allergy, and keep up regular scans for years so that the cornea can be confirmed stable.

Your doctor

Keratoconus diagnosis and treatment, including cross-linking, intracorneal rings and corneal transplantation, are led by Dr. Omar Khaled Al-Duwailah, consultant ophthalmologist specialising in cornea, cataract and refractive surgery, with a fellowship in cornea and refractive surgery.

Frequently asked questions

Can keratoconus be cured?

No treatment returns the cornea to a completely normal shape. Cross-linking aims to stop progression, and other treatments improve vision. Many people keep good functional vision with the right care.

Will cross-linking improve my vision?

Its main purpose is to stabilise the cornea. Some people notice a small improvement, but most still need glasses or contact lenses.

Can I have LASIK if I have keratoconus?

LASIK is generally not suitable for eyes with keratoconus, because it can weaken the cornea further. Your doctor will discuss other options based on your scans.

Should my children or siblings be checked?

Keratoconus can run in families, so a screening scan for close relatives, especially teenagers, is reasonable. Discuss it with your doctor.

Why is eye rubbing so important?

Rubbing is linked to progression of keratoconus. Stopping it, and treating the itch from allergy, is an important part of protecting the cornea.

This page provides general information and does not replace a medical consultation. Suitability, risks and results differ from person to person.