Understanding Your Keratoconus Diagnosis and Prognosis

Receiving a keratoconus diagnosis can be anxiety-producing, and especially for a young adult in college or in the early stage of a budding career. Meanwhile, parents of children or young adults diagnosed with keratoconus can fear that their offspring will rapidly become permanently disabled. The Cornea Research Foundation of America reports that between 50-200 of every 100,000 people are keratoconus-afflicted, and describe this eye disorder as characterized by thinning and protrusion of the cornea. Meanwhile, there are other cornea disorders besides keratoconus.

Understanding the difference between keratoconus and other eye disorders is important to understanding the course of treatment that makes sense for you (or a loved one) newly-diagnosed with keratoconus. By speaking with a professional at the Precision Keratoconus Center, you can acquire more in-depth information regarding the diagnosis and treatment of keratoconus.

Myopia and Astigmatism – Relationship to Keratoconus

Most keratoconus-afflicted people have myopia (nearsightedness) and astigmatism. However, a person can have myopia and astigmatism due to a different underlying cause. For a person living with keratoconus, the cause is a cone-shaped cornea that interferes with the way light hits the retina. According to the American Optometric Association, myopia can occur if the eyeball is overly-long or the cornea overly-curved, and myopia is a common eyesight disorder.

In contrast, astigmatism is caused by an imperfection in the curvature of the lens and/or cornea that affects visual perception. The manner in which light is refracted when it hits the retina impacts how you “see” the objects in your field of vision. Astigmatism due to an irregularly-shaped cornea is termed a corneal astigmatism, while one due to a distortion in lens shape is termed a lenticular astigmatism (per the American Academy of Ophthalmology).

While increased nearsightedness and astigmatism interfering with daily activities may be the primary reason for your optometrist visit leading to a keratoconus diagnosis, the degree of myopia and astigmatism in keratoconus-afflicted people is not the same in all people with this cornea disorder. Furthermore, other visual disturbances may occur in keratoconus-afflicted people (such as light sensitivity and intermittent visual blurriness).

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What Does a Keratoconus Diagnosis Mean for Your Future?

Learning that you have keratoconus does not necessarily mean that you will become legally-blind. However, keratoconus-afflicted people have a higher risk for progressing to legal-blindness than the general public living with nearsightedness. Since soft contact lenses cannot be worn by people with myopia who also have astigmatism, keratoconus-afflicted people are often prescribed Rigid Gas Permeable (RGP) contact lenses.

Since keratoconus is likely to progress until middle-age, you may find that your eyeglass prescription (or contact lens prescription) may need to be changed more frequently than if you did not have this cornea disorder. You may also have another cornea disorder (such as Fuchs’ dystrophy), which can complicate treatment for your eyesight disorder and more easily lead to profound vision loss in young adulthood.

Identifying Keratoconus Risk Factors

The diagnosis of keratoconus in parents and/or grandparents is considered a major risk factor for keratoconus, but only 14 percent of keratoconus-afflicted people have this hereditary connection. Three other risk factors are:

  • Excessive eye-rubbing in childhood;
  • High UV light exposure (such as can occur during outdoor activities in sunlight without the use of sunglasses);
  • Diagnosis of a genetic tendency toward allergies

However, for many keratoconus-afflicted people, no underlying risk factors are ever identified.

Treatment Options for Keratoconus

Due to the frequently-combined problem of vision loss and corneal eye pain in people who have a cornea disorder such as keratoconus, wearing RGP contact lenses (often called “hard” contact lenses) may be difficult. Scleral contact lenses may be preferable for keratoconus-afflicted people with eye pain, as these contact lenses do not rest on the cornea (as occurs with other contact lenses). Instead, scleral contact lenses rest on the sclera (white) of the eye.

Over time, the cornea shape becomes increasingly irregular in people living with keratoconus, and three common surgical treatment options are:

  1. Insertion of intrastromal corneal ring segments;
  2. Corneal cross-linking;
  3. Corneal transplantation

Since not every person with significant vision loss who is living with keratoconus is a good candidate for cornea surgery, it is important to understand how any major health disorder you have can affect your surgical outcome.

The Precision Keratoconus Center is an excellent resource to learn about keratoconus treatment options.

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