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Keratoconus is a weakness in the cornea that allows pressure inside the eye to distort the curve of the front of the eye. This results in increased astigmatism, reduced vision and thinning of the cornea.

Keratoconus generally first affects people ages 10 to 25. It is more common in individuals with conditions that cause itchy eyes such as hay fever, eczema and allergies. While patients can have a genetic predisposition to the disease, it is often random. Eye rubbing is a risk factor for both developing keratoconus and its progression. It is also more likely to progress in younger patients.

What to expect from your consultation at Hunter Laser Vision

Your opthamologist will begin with a review of your medical history and a thorough eye exam. They will also take images of your cornea to determine its shape, as well as to measure corneal thickness and intraocular pressure. These tests will confirm if you have keratoconus, and if it is progressing.

After your doctor has examined your cornea and retina they will make a recommendation based on the severity of your keratoconus and how fast it is progressing. If the disease is getting worse or is severe enough, surgery may be recommended. In this case, they will discuss the recommended procedure with you, including any risks. Once you’ve agreed on a treatment plan they will book a date for your procedure.

Keratoconus Treatment

Keratoconus is not curable, but often stabilizes naturally by the early 30s. Glasses or rigid gas permeable contact lenses are generally the first treatment option for patients with mild keratoconus. However, if the disease is more severe or progressing rapidly, surgery may be recommended.

Two minimally invasive procedures used to treat keratoconus are kerarings and ultraviolet corneal crosslinking.

  • Kerarings are clear, semicircular rings inserted within the cornea to restore it to a more normal curve and improve vision. Kerarings are generally used when the disease is moderate. The procedure is safe and minimally invasive.
  • Ultraviolet corneal crosslinking involves applying a dye to the cornea, followed by an ultraviolet laser. This creates a reaction that leads the collagen fibres to “crosslink” and strengthen the cornea. UV crosslinking is generally recommended if the condition is worsening or is at risk of worsening. Approximately one third of patients will experience improvement in their vision from the procedure. However, if the condition continues to progress the treatment can be repeated.

Your surgeon may use a combination of crosslinking, kerarings and intraocular lenses depending on the severity of your condition and its progression. Patients with advanced keratoconus that doesn’t respond to these treatments may require a corneal transplant.

Post-operative Keratoconus surgery care

At Hunter Laser Vision we firmly believe that post-operative care is just as important as the surgery itself. The day after your procedure you will need to return to the clinic for a check-up. You will also need to come back two weeks later and again at two months so we can monitor your progress. You may be able to see your local optometrist for some of these post-operative appointments if you live outside the area.

It’s important to take good care of your eye after keratoconus surgery to help reduce the risk of complications and ensure a good recovery. While most patients resume regular activities in 2 or 3 days, you should avoid heavy lifting and stay out of dirty, dusty environments for two weeks after the surgery. You’ll also need to keep the area dry; showering is fine, but no swimming. Your doctor will let you know when it’s OK to return to driving.

If you have keraring or UV crosslinking treatment we’ll need to examine your eyes again in six months. Keraring patients will need annual reviews.

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RANZCO - The Royal Australian and New Zealand College of Ophthalmologists - The Leaders in Collaborative Eye Care
ASO - Australian Society of Ophthalmologists

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