Specialty Eye Care
Keratoconus Diagnosis and Management
Keratoconus is a condition in which the cornea thins and bulges into a cone shape, distorting vision in a way glasses cannot fully correct. It is diagnosed with corneal topography and managed with specialty contact lenses and, where appropriate, cross linking.
In short
The cornea thins into a cone. Glasses stop working. Specialty lenses restore vision.
Keratoconus usually announces itself as a prescription that will not settle. Glasses are updated, they help for a while, then they do not, and the next update helps less. Vision becomes distorted rather than simply blurred, lights develop halos and starbursts at night, and the eye becomes noticeably sensitive to glare.
What is happening underneath is structural. The cornea, normally a smooth dome, thins and begins to bulge forward into a cone. Because the front surface of the eye does most of the focusing, an irregular cornea scatters light in a way no spherical lens can compensate for. That is why glasses stop being enough: the problem is not the strength of the correction but the shape of the surface it is correcting.
Diagnosis is made from a corneal topography map, which shows the characteristic steepening long before it becomes obvious on an eye chart. OCT imaging and pachymetry add the depth measurements that show how much corneal tissue remains and whether the condition is progressing. Getting that baseline recorded early matters enormously, because keratoconus that is caught while it is still progressing can often be stabilised.
What to expect
- Corneal topography
- A three dimensional map built from over 20,000 surface points, showing the location and severity of the cone.
- OCT imaging
- Cross sectional imaging revealing corneal layer structure and any scarring beneath the surface.
- Pachymetry
- Corneal thickness measured at multiple points, which determines both progression risk and cross linking candidacy.
- Wavefront analysis
- Measures the optical distortions the irregular surface is producing, which explains the symptoms better than an eye chart does.
Our process
Initial consultation60 to 90 minutes
Comprehensive examination, corneal mapping, symptom review and a plain explanation of what the maps show and what the options are.
Diagnostic lens fitting45 to 60 minutes
Trial lenses from the specialty fitting set are placed and assessed on the eye. Scleral, hybrid and rigid designs are all evaluated where relevant.
Custom lens ordering1 to 2 weeks
Precise measurements are taken and lenses are made to them individually.
Delivery and training45 minutes
Fit is confirmed, and insertion, removal and care are taught properly rather than described.
Follow up careevery 6 to 12 months
Vision, comfort, corneal health and progression are reassessed and compared against your baseline.
What is included
- Corneal topography, OCT, pachymetry and wavefront analysis
- Diagnostic specialty lens fitting on the eye
- Custom lens design and ordering
- Insertion, removal and care training
- Progression monitoring against a recorded baseline
- Referral and co-management for cross linking where appropriate
What this does not do
- Keratoconus has no permanent cure. It is managed, and managed well, but not reversed.
- Specialty lenses restore vision. They do not stop the underlying condition progressing. Cross linking is the procedure that addresses progression.
- Cross linking is performed by a corneal surgeon, not in this office. Candidacy assessment and co-management happen here.
- Advanced cases with significant central scarring may need surgical options beyond lens correction.
Questions and answers
How do I know if I have keratoconus?
Common early signs are blurred or distorted vision that glasses do not fully correct, frequent prescription changes, increased light sensitivity, and halos or starbursts around lights at night. A comprehensive examination with corneal topography and OCT imaging gives a definitive answer.
Can keratoconus be cured?
There is no permanent cure, but it is very manageable. Specialty contact lenses restore functional vision for the large majority of patients, and corneal cross linking can slow or halt progression when it is caught in time.
Will I need a corneal transplant?
Most people with keratoconus never do. Modern specialty lens options handle a far wider range of corneal irregularity than was possible even fifteen years ago, and transplant has become a much rarer endpoint. It remains an option for advanced cases with central scarring.
How often should my eyes be checked?
Typically every six to twelve months, depending on how stable your condition is. Younger patients and anyone showing active progression are monitored more frequently, because that is the window in which cross linking is most useful.
Does insurance cover keratoconus treatment?
Many vision and medical plans provide coverage for medically necessary contact lenses and diagnostic testing, since keratoconus is a medical condition rather than a refractive preference. The office reviews your benefits and works to maximise them.
What is corneal cross linking?
A procedure that uses riboflavin drops and controlled ultraviolet light to strengthen the bonds between corneal collagen fibres, stiffening the cornea and slowing or halting progression. It is performed by a corneal surgeon. Candidacy assessment and follow up care happen here.
Talk to someone about keratoconus diagnosis and management
Appointments are scheduled two per hour, so there is time to answer questions properly. Call (480) 706-3937 or request a time online.