Medically Reviewed by Joseph Christenbury, M.D.
Keratoconus is an eye condition in which the cornea, or clear tissue covering the front of the eye, becomes weaker. As a result, the shape of the cornea changes from a normal gentle slope to a conical shape causing blurred and distorted vision. If you have keratoconus that can no longer be corrected with contact lenses, consider one of the many treatment options available to restore your vision.
Are You a Good Candidate?
You may be a good candidate for several different treatment options, including surgery, if you have been diagnosed with this eye condition. The cause is unknown, though it is believed some people are predisposed to develop it from birth. Some doctors believe that eye allergies or eye rubbing may play a role and there is thought there could be a link between Down syndrome and keratoconus. Most people who have keratoconus are diagnosed during adolescence and find that the most severe keratoconus is experienced between the ages of 20 and 40. In approximately 10% to 25% of cases, it progresses to a point where it can no longer be effectively corrected with contact lenses.
Learn about Your Treatment Options
There are a number of different treatment options available. In its early stages, the vision problems can be corrected with glasses or contact lenses. As keratoconus progresses, other treatments including surgery can be performed.. Corneal implants, known as intracorneal ring segments or Intacs, may be inserted to change the shape of the cornea. This procedure can also prevent the keratoconus from worsening. In more severe cases, a corneal transplant may be required, replacing the conical natural cornea with a donor cornea.
There is also a new technology that may soon delay or prevent the need for other treatments. Known as corneal collagen cross-linking, it involves an application of a riboflavin solution to the eye which is then activated with a UV-A light, causing new bonds to form within the collagen in the cornea. This method causes the cornea to strengthen, preventing the keratoconus from progressing. In some cases, PRK laser eye surgery can be performed along with cross linking to help correct the patient’s vision in addition to stabilizing the keratoconus.
These procedures are generally performed on an outpatient basis using anesthetic eye drops, sometimes accompanied by conscious sedation. Patients are awake during the procedure, but their vision is blurred. The procedures usually take about an hour to perform and patients leave the eye doctor’s office the same day. All cases will require long-term follow-up with an eye doctor.
The risks depend on the treatment method chosen. Potential risks include infection, overcorrection or undercorrection, and vision distortion. There is a small chance that the keratoconus can still progress after these treatment and a corneal transplant still may be needed. There is a chance that the patient will still need glasses or contact lenses after the surgery.
Recovery Time: What You Can Expect
Depending on the treatment option, the recovery period may be a few days or a few weeks. Patients may or may not need glasses or contact lenses after the procedure, depending on its success. Ask your doctor for post-operative instructions which may include avoiding driving, water in the eyes, and activities likely to irritate the eyes.
What’s the Cost?
The cost of keratoconus treatment can range from $1,000 to $10,000 per eye, depending on the treatments chosen. It may or may not be covered by health insurance. If you are paying out of pocket, ask your eye doctor about payment plans and other financing options that can help make the surgery more affordable.