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Keratoconus
is a bulging distortion of the cornea, leading to loss of visual
acuity.
Keratoconus is a slowly progressive thinning and bulging of the cornea, usually bilateral, beginning between ages 10 and 25. Its cause is unknown.
The distorted cone shape of the cornea causes major changes in the refractive characteristics of the cornea (irregular astigmatism) that cannot be fully corrected with glasses. Progressing keratoconus necessitates frequent change of eyeglasses. Contact lenses may provide better vision correction and should be tried when eyeglasses are not satisfactory. Corneal transplant surgery may be necessary if visual acuity with contact lenses is inadequate, contact lenses are not tolerated, or a visually significant corneal scar (caused by tearing of stromal fibers) is present.
Newer treatments appear promising. Implantation of corneal ring segments appears to have the potential to save selected patients from transplantation. Corneal cross-linking, an ultraviolet light treatment that strengthens the cornea, has shown positive results in European studies and may become more common.
Last full review/revision October 2008 by Melvin I. Roat, MD
Content last modified October 2008
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