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Keratoconus

Progressive corneal thinning and conical protrusion

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göz Hastalıkları department. Book Appointment →

What is Keratoconus?

Keratoconus is a non-inflammatory, progressive corneal ectatic disorder characterized by paraxial stromal thinning and corneal protrusion, leading to irregular astigmatism, myopia, and decreased vision. It typically begins in adolescence or early adulthood, progresses over years to decades, and is bilateral but often asymmetric.

The pathophysiology involves alterations in corneal collagen cross-linking, increased proteolytic enzyme activity, and oxidative stress, with strong associations to atopy, eye rubbing, and connective tissue disorders (Down syndrome, Ehlers-Danlos, Marfan). Genetic factors play a significant role, with VSX1 mutations and a 6-15% positive family history.

Diagnosis relies on corneal topography (placido disk or Scheimpflug imaging), pachymetry, and slit-lamp examination revealing classic signs (Vogt's striae, Fleischer ring, Munson's sign in advanced cases). Modern management ranges from spectacle and rigid gas-permeable contact lenses for early disease, to corneal cross-linking (CXL) for halting progression in active cases, intracorneal ring segments (ICRS) for visual rehabilitation, and deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty for advanced disease.

Symptoms

Progressive blurred vision
Frequent eyeglass prescription changes
Glare and light sensitivity
Monocular diplopia or ghosting
Distorted vision (irregular astigmatism)
Eye rubbing and itching
Acute corneal hydrops in advanced disease (sudden vision loss with pain)

Risk Factors

Adolescence to early adulthood onset
Family history (autosomal dominant inheritance in some cases)
Atopic disease (eczema, asthma, hay fever)
Chronic eye rubbing
Down syndrome
Connective tissue disorders (Ehlers-Danlos, Marfan)
Floppy eyelid syndrome and obstructive sleep apnea

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Rapidly changing eyeglass prescription
  • Vision not correctable by glasses
  • Family history with refractive symptoms
  • Halos and glare around lights
  • Sudden severe vision loss with pain (rule out hydrops)
  • Pre-refractive surgery evaluation
  • Annual follow-up if known keratoconus to monitor progression

Treatment Methods

01
Corneal topography and pachymetry for staging
02
Spectacles and soft toric contact lenses for early disease
03
Rigid gas-permeable, hybrid, or scleral contact lenses
04
Corneal cross-linking (CXL) with riboflavin/UV-A to halt progression
05
Intracorneal ring segments (ICRS) for visual rehabilitation
06
Deep anterior lamellar keratoplasty (DALK) for advanced disease
07
Penetrating keratoplasty for severe scarring or hydrops

Which Department to Visit?

You can visit our Göz Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.