You may have experienced this: you change your glasses, but your vision still doesn’t feel right. You might see slightly better, but not clearly enough. Or your prescription keeps changing without really improving your vision.
Keratoconus is a condition of the cornea in which it changes shape and becomes more pointed, like a cone. As a result, the surface of the eye is no longer uniform, and vision becomes distorted.
To better understand why this happens, it’s important to know the role of the cornea. It is the transparent outer layer of the eye, through which light enters and reaches the retina, where the image is formed.
Normally, the cornea has a smooth, round shape that helps focus light correctly. With keratoconus, this curvature changes, and the eye can no longer focus as precisely.
How keratoconus affects vision
Over time, keratoconus leads to increasingly blurred vision that becomes harder to correct. You may notice that your vision doesn’t improve even after changing glasses, and prescriptions seem to change frequently without real improvement.
An important thing to know is that after reaching adulthood (around 20–45 years old), your prescription should no longer change significantly. And most importantly, with a new pair of glasses, your vision should not be less clear than before.
If this happens, it’s a sign that your vision needs a more detailed examination!
Why is keratoconus not always diagnosed in time?
Keratoconus is not always easy to detect in its early stages.
Without specific investigations such as corneal topography, or without sufficient experience, changes may go unnoticed. That’s why some patients go through multiple prescription changes before the real cause is discovered.
At Best Optic..
Our optometrists are trained to diagnose keratoconus, and corneal topography is a basic investigation included in every consultation. This allows us to detect subtle changes early and establish the correct diagnosis.
When does keratoconus appear and how does it progress?
Keratoconus usually appears during adolescence and may progress until around the age of 30. After this period, its progression slows down or stabilizes.
It may start in one eye, but in most cases it eventually affects both eyes, usually to different degrees.
There is also a genetic component, although it is not present in all cases. Approximately 10–15% of patients have a family history.
Signs and symptoms to watch for
Keratoconus does not always have obvious symptoms at first, but there are some important warning signs:
frequent changes in prescription
poorer vision, especially at night
difficulty achieving clear vision even with glasses or lenses
frequent headaches
frequent eye rubbing
similar cases in the family
If you recognize yourself in several of these situations, we recommend a more detailed consultation.
How vision is corrected in keratoconus
It is important to understand that glasses or regular contact lenses do not treat keratoconus, but only help correct vision in certain stages.
In the early stages, vision can be corrected with glasses or soft contact lenses. As the condition progresses, more specialized solutions are needed.
Rigid contact lenses are often recommended because they create a smooth optical surface over the irregular cornea, providing clearer and more stable vision.
There are also hybrid lenses, which combine a rigid center with soft edges, offering better comfort in certain cases.
Surgical options
In certain cases, surgical options may also be necessary, such as:
Corneal cross-linking.
A minimally invasive procedure that helps stabilize the cornea and is especially recommended in cases where progression is present, particularly in younger patients. It does not replace optical correction, but complements correction with rigid contact lenses and can slow the progression of the condition.
Corneal transplant
In advanced cases, where the cornea is severely affected and satisfactory vision can no longer be achieved with contact lenses, a corneal transplant may be considered. However, this is a rare solution.
Who can be affected
Anyone, regardless of age or lifestyle.
It occurs in all ethnic groups, and although some studies indicate a higher incidence in certain populations, the risk exists for everyone.
The exact cause is not fully known, but it is believed to involve a combination of factors: genetic, environmental (such as allergies), and behavioral.
For example, frequent eye rubbing can contribute both to the onset and the progression of the condition.
What is important to remember
The earlier keratoconus is identified, the more options there are to slow its progression and maintain good vision in the long term.
If you feel your vision is no longer as clear or notice frequent changes, the most important step is a comprehensive evaluation.
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