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Keratoconus Diagnosis & Treatment

senior couple keratoconus austin txWho is at Risk? How is Keratoconus Treated?

The healthy eye has a transparent, outer layer called the cornea, which is smooth and rounded. Yet, if you have keratoconus, the corneal structure doesn’t maintain this ball shape. Instead, it bulges outward into a cone shape that affects vision. Typically, people with untreated keratoconus have blurred or distorted eyesight. In order to see sharp, keratoconus requires treatment by a knowledgeable eye doctor. Our Austin optometrists are experienced and qualified to offer the latest treatment of keratoconus and dry eye.

Definition of Keratoconus

Your cornea is held in place by numerous collagen fibers. Normally, corneal cells produce damaging by-products that are kept in check and destroyed by protective anti-oxidants. However, sometimes the amount of protective antioxidants is reduced. When this happens, it weakens the tiny collagen fibers and they become too fragile to preserve the rounded shape of the cornea.

Who gets keratoconus?

This ocular condition is relatively rare, with about one person out of every 2,000 being diagnosed with keratoconus. Typically, it appears during teenagehood and can then advance rapidly or slowly – every individual case is different.

Keratoconus tends to run in families. Therefore, if you have a relative with keratoconus, it is critical to visit your eye doctor for regular comprehensive eye exams. People who have suffered a serious eye injury are also at an increased risk of keratoconus.

Certain diseases and systemic conditions also raise the risk of developing keratoconus, such as:

  • Vernal keratoconjunctivitis
  • Retinitis pigmentosa
  • Retinopathy of prematurity
  • Down syndrome
  • Ehlers-Danlos syndrome

Keratoconus Diagnosis

Our eye doctors cannot diagnose keratoconus on the basis of symptoms alone. We will inspect your cornea thoroughly during an eye exam, using computerized Corneal Topography to map and analyze the surface of your cornea.

Treatment of Keratoconus


Usually, the first treatment recommended for keratoconus is new prescription eyeglasses. If this doesn’t work well enough, specialty contact lenses are the next option.

Specialty Contact Lenses

Due to the cone shape of a cornea with keratoconus, standard contact lenses do not rest well on the eye. That’s why specialty contacts are a common solution for vision correction.

  • Scleral lenses:  These specialized rigid, gas permeable contact lenses are a popular way to treat keratoconus. Scleral lenses vault over the full cornea with a rounded surface, thereby replacing the unhealthy cone-shaped cornea. Due to their extra-wide diameter, scleral lenses sit only on the whites of your eyes (sclera). Since they don’t touch the corneal surface, they offer enhanced comfort with crisp vision.
  • Hybrid contact lenses:  These specialty contacts combine the best of both worlds. Their hard middle zone is oxygen-permeable and encircled by a soft rim. Patients thereby benefit from the acute vision of a gas permeable lens along with the superior comfort of soft lenses.
  • Piggybacking lenses:  Wearing two contact lenses can be the best treatment of keratoconus. A soft lens is inserted directly on the eye, and then a hard lens is put on top of it. The soft lens forms a comfy cushion for the hard lens.

senior man with arms crossed keratoconus austin tx


During a surgical procedure, small plastic inserts called intacs are placed under the eye’s surface in the edges of the cornea. Intacs can help reshape the cornea to provide sharper vision. This treatment of keratoconus may be advised for patients who have lost functional eyesight. Intacs can postpone the need for a corneal transplant.

Corneal cross-linking

Corneal cross-linking is a minimally invasive outpatient procedure designed to treat progressive keratoconus.  The corneal cross-linking procedure strengthens and stabilizes the cornea by creating new links between collagen fibers within the cornea. The two-step procedure applies liquid riboflavin (vitamin B2) to the surface of the eye immediately followed by a controlled exposure of the eye to ultraviolet light.

Corneal transplant

A corneal transplant is generally the last resort treatment of keratoconus. During this surgery, your eye surgeon will remove the center of the cornea and replace it with a donor cornea, which is stitched into place. Following the procedure, you’ll need to wear contacts to achieve clear vision.

Only a professional eye exam can detect or rule out the presence of keratoconus. If you have a family history of this corneal abnormality or you experience blurry vision, contact us to reserve an appointment with our Austin eye care specialists!


  • The term, “Keratoconus” refers to an eye condition involving the cornea, the clear window at the front of the eye, thinning and warping into a cone-like bulge.

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