Keratoconus
What Is Keratoconus?
Keratoconus is a rare, progressive disorder of the cornea (the clear, front part of the eye) that causes thinning, steepening, high astigmatism, and can lead to scarring and permanent vision loss.
What Causes Keratoconus?
Keratoconus can be caused by excessive eye rubbing. Treating underlying causes of eye itching and discomfort, such as allergies, can decrease the risk of this condition. It is more common in patients with a family history of keratoconus and it can be associated with other medical conditions such as Down Syndrome.
What Are Signs and Symptoms of Keratoconus?
- Increasing astigmatism
- Blurred vision that doesn’t fully improve with glasses
- Corneal abnormalities (e.g. cone shaped cornea, scarring)
How Is Keratoconus Diagnosed?
Keratoconus may be suspected in patients who have high, increasing astigmatism and/or findings on their cornea suggestive of thinning and steepening. Corneal topography, a test that takes a photo of a patient’s cornea and provides analysis, in coordination with these clinical findings provides the diagnosis.
How Is Keratoconus Treated?
Since 2016, corneal collagen cross-linking has been FDA approved to limit the progression of corneal thinning and steepening in patients with keratoconus. In this treatment, the top layer of the cornea (epithelium) is removed, then the cornea is treated with riboflavin and UV light to strengthen it. This treatment is currently offered at Lurie Children’s under general anesthesia with our Pediatric Ophthalmologists, Dr. Kelly Laurenti and Dr. Jennifer Rossen.
To improve vision in patients with keratoconus, glasses and sometimes special contact lenses are needed. Lurie Children’s Optometrists specialize in fitting pediatric patients with contact lenses and have extensive experience in treating patients with corneal irregularities, such as keratoconus. In patients with scarring from keratoconus (sometimes after acute swelling known as hydrops), a corneal transplant may be beneficial to improve vision. Our Cornea specialist, Dr. Surendra Basti, has expertise in pediatric corneal transplants.
What Are the Long-Term Effects of Keratoconus?
Keratoconus may progress slowly or rapidly. For patients with progression, corneal cross-linking may prevent severe disease and scarring. Patients without scarring can often see well with special glasses or contact lenses. Those with scarring may have limited visual potential depending on the severity of the scar unless corneal transplantation is done.
Appointments/Referrals
Pediatric Ophthalmologist Jennifer Rossen, MD, in the Division of Ophthalmology provide corneal cross-linking for patients. Surendra Basti, MD is a cornea specialist who often evaluates patients with keratoconus and performs corneal transplants. Our Pediatric Optometrists, Magdalena Stec, OD, Noreen Shaikh, Huizi Yin, OD specialize in contact lens fitting.