Conical cornea
(Keratoconus)
What is keratoconus?
Keratoconus is an eye condition that affects the cornea, making it become asymmetrical. The cornea is the transparent, outermost part of the eye. Normally, the cornea is round. In the case of keratoconus, the structure of the cornea weakens, and therefore it loses its roundness and becomes more conical in shape. Because of this gradual deformation, the cornea thins and visual acuity decreases. In extreme cases, the cornea may even become cloudy and tear.
Symptoms of keratoconus
- Distorted vision
- Light sensitivity
- Light scattering
- Astigmatism
- Possible nearsightedness (objects or people at a distance appear blurred)
- Seeing a ‘fog’ (at an advanced stage)
Treatment of keratoconus
The diagnosis is made by carrying out various tests. The aim of the tests is, on the one hand, to correctly assess the asymmetry of the cornea, and on the other hand, to carefully monitor the progression of the condition over time. The tests check what glasses prescription enable you to see the best. Moreover, the curvature of the cornea is measured and the cornea is imaged in three dimensions (topography). Based on these tests, your eye doctor can detect any further deterioration of the condition very precisely at an early stage.
The aim of the treatment of keratoconus is twofold:
- Optimising your visual acuity
- Slowing or halting further deterioration
Optimising your visual acuity
In mild cases of keratoconus, vision can be improved effectively with glasses or contact lenses. For more advanced cases, special ‘scleral contact lenses’ are needed to restore visual acuity.
Slowing or halting deterioration
It has been shown that rubbing the eyes leads to further deformation of the cornea. It is essential therefore to avoid rubbing your eyes as much as possible. Your eye doctor will treat the underlying causes of itchy eyes.
In some cases, avoiding rubbing your eyes is not enough to stop the deterioration. In such situations, your eye doctor will discuss with you the possibility of a treatment involving UV crosslinking.
What treatments do we offer?
UV crosslinking is a safe, effective treatment to slow down the progression of keratoconus by strengthening the collagen fibres in your cornea. The procedure takes around half an hour and is carried out under topical (with drops) anaesthesia. During the operation, the outermost layer of the cornea is removed, after which the eye is treated with vitamin B2 drops and a beam of ultraviolet light is shined at your cornea. After the treatment, you need to care for your eyes with eye drops and ointment to prevent complications.
How much does the treatment of keratoconus cost?
During the consultation, we will discuss in detail the total cost of a potential treatment. For an overview, please go to our fees page.
Frequently Asked Questions
What is keratoconus and what are its symptoms?
Keratoconus is an eye condition in which the cornea gradually weakens and develops a cone-shaped bulge instead of maintaining its normal round shape. Patients often experience distorted vision, increased sensitivity to light, and glare. The condition typically develops between the ages of 10 and 20 and affects approximately 1 in 2,000 people. Known risk factors include genetics and frequent eye rubbing.
Can keratoconus cause blindness?
Keratoconus does not usually lead to complete blindness, but it can significantly reduce visual acuity. As the cornea becomes increasingly distorted, vision becomes more blurred. In advanced stages, scarring of the cornea may develop. In very rare cases, the cornea can rupture, requiring a corneal transplant to restore vision.
Which lenses are suitable for keratoconus?
In mild cases, glasses or soft contact lenses may provide sufficient vision correction. In more advanced cases, specialised rigid gas-permeable lenses, scleral lenses, or hybrid lenses are often required to achieve clear vision. A typical feature of keratoconus is irregular astigmatism, which cannot be fully corrected with ordinary glasses. At Brussels Eye Doctors, we fit these specialised lenses according to your individual needs.
What is corneal cross-linking and how does it treat keratoconus?
Corneal cross-linking strengthens the collagen fibres within the cornea and can prevent further progression of the condition in up to 90% of cases. During the procedure, vitamin B2 (riboflavin) eye drops are applied to the eye, followed by exposure to ultraviolet light. The treatment takes approximately 20 minutes under local anaesthesia. Vision typically begins to clear within a few days, allowing patients to return to their normal activities.
Is keratoconus hereditary and can it be cured?
Keratoconus has a strong hereditary component. Family members of people with keratoconus are at increased risk of developing the condition. At present, there is no definitive cure, but the disease usually stabilises around the age of 30. It is important to avoid rubbing your eyes as much as possible, as this can further weaken the cornea. When necessary, corneal cross-linking can successfully slow the progression of the condition in up to 90% of cases.