7 Things to Know About Keratoconus

  • A closeup picture of an open, hazel brown eye
    Facts About Keratoconus of the Eye
    Keratoconus is a disease of the cornea—the front transparent part of the eyeball. The cornea is made up of a special type of connective tissue that is perfectly clear. Usually the cornea holds a rounded, domed shape on the front of the eyeball, which allows focused light to pass through to the iris and lens. Keratoconus causes the cornea to become thin and bulge at the front of the eyeball, distorting corneal curvature and creating a cone shape. This misshapen cornea can cause vision problems that require treatment. Learn the facts about keratoconus, including which people face at substantially higher risk than others for developing the condition.
  • Business woman with Down syndrome at company party
    1. Some people are at higher risk of developing keratoconus.
    Keratoconus can affect anyone and most people diagnosed with the condition have no family history of it. However, your risk is higher if either of your parents had keratoconus because the condition can be inherited. People with Down syndrome face the highest risk of all. Up to one-third of people with Down syndrome will develop keratoconus, though experts don’t know exactly why. Unfortunately, there is nothing you can do to reduce your risk of keratoconus affecting your cornea.
  • Senior woman's eye exam
    2. You can develop keratoconus at any age.
    Most cases of keratoconus appear by adolescence and are diagnosed in teenagers and young adults. However, people in older age also may develop keratoconus. Even if your vision doesn’t require correction, you should see an optometrist regularly for an eye exam. During a routine eye exam your optometrist will check for eye diseases, such as glaucoma and keratoconus. You also should see an eye doctor if you develop any keratoconus symptoms, like light sensitivity. Diagnosing the condition early means starting treatment earlier, and potentially fewer keratoconus vision problems.
  • Senior woman waking up squinting and reaching for glasses on bedside table
    3. Keratoconus may progress through stages.
    Keratoconus progresses differently in each person. Some people never progress beyond a mild stage of the condition, while other people ultimately develop serious vision symptoms. In general, keratoconus stages may include: mildly blurry vision; progressively worse light sensitivity; halos around lights at night that make driving difficult or impossible; progressive eye strain, irritation and pain; or severe blurriness.

    Keratoconus may progress over the course of decades, then stabilize. Or it may remain mild throughout a lifetime. Even if your keratoconus has been stable, you should have an ophthalmologist monitor it regularly.
  • Patient in ophthalmology clinic seeing eye doctor
    4. Keratoconus is not caused by high pressure inside the eye.
    Although it may seem logical to think that the cornea may become misshapen due to high pressure inside the eyeball, this is not the case. Eye doctors don’t know exactly what causes the cornea to become thin and cone-shaped in keratoconus, but excessive intraocular pressure is not the reason. High pressure inside the eye is a different condition called glaucoma. Glaucoma is a serious eye disease that can cause loss of vision. Always see an eye doctor for vision problems to ensure a correct diagnosis.
  • Eye surgeon performing eye surgery
    5. Keratoconus treatments can include surgery.
    Some people never require treatment for keratoconus, while others with a severe form of the condition require advanced treatments. The most common initial treatment for keratoconus is rigid gas-permeable (RGP or GP) contact lenses that provide a more natural shape to the cornea. For serious vision problems in later stages of the condition, keratoconus surgery may be required. These procedures include corneal transplant surgery, radiofrequency procedures to reshape the cornea, implanting rings into the cornea to help contacts fit better, and collagen cross-linking surgery that slows or halts corneal thinning.
  • Man holding a contact lens
    6. Keratoconus correction may require wearing different contacts in each eye.
    Keratoconus affects the cornea in each eye differently. The condition may progress more rapidly in one eye than in the other. Because each cornea needs to be treated individually, a person with keratoconus may need to wear different contacts in each eye. For instance, one contact may correct only near-sightedness related to keratoconus, while the other contact corrects for both near-sightedness and astigmatism. Sometimes the lenses even come from different manufacturers. Your contact lens specialist can explain why you’ve been prescribed the specific lenses you need for keratoconus.
  • Patient undergoing lasik eye surgery
    7. People with keratoconus cannot get Lasik surgery.
    If you’ve been diagnosed with keratoconus, you cannot have any type of laser vision surgery because this surgery removes very thin layers of the cornea to reshape the cornea. Lasik procedures would then further weaken the cornea, which can accelerate the progression of keratoconus. Lasik eye surgeons normally screen patients for keratoconus and other eye conditions prior to accepting them as a surgical candidate. Lasik surgeons also may decline to treat patients with a family history of keratoconus. If you’re researching Lasik, be sure to tell the surgeon about any family history of keratoconus.
7 Things to Know About Keratoconus of the Eye

About The Author

As “the nurse who knows content,” Elizabeth Hanes, RN, works with national and regional healthcare systems, brands, agencies and publishers to produce all types of consumer-facing content. Formerly a perioperative and cosmetic surgery nurse, Elizabeth today uses her nursing knowledge to inform her writing on a wide variety of medical, health and wellness topics.
  1. Keratoconus. U.S. National Library of Medicine, MedlinePlus. https://medlineplus.gov/ency/article/001013.htm
  2. Keratoconus. U.S. National Library of Medicine, Genetics Home Reference. https://ghr.nlm.nih.gov/condition/keratoconus#
  3. Understanding KC. National Keratoconus Foundation. https://www.nkcf.org/understanding-kc/
  4. Down Syndrome. American Association for Pediatric Ophthalmology and Strabismus. https://aapos.org/glossary/down-syndrome
  5. Keratoconus Frequently Asked Questions. National Keratoconus Foundation. https://www.nkcf.org/keratoconus-frequently-asked-questions/
  6. Corneal Collagen Cross-Linking. American Academy of Ophthalmology. https://eyewiki.aao.org/Corneal_Collagen_Cross-Linking
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 May 11
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.