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Keratoconus

What Is Keratoconus?

Keratoconus is an eye disorder in which the normally round and dome-shaped cornea becomes increasingly thinner, causing a cone-shaped bulge to form. Typically both eyes are affected.

Keratoconus occurs in approximately 1 in 2,000 people, most frequently developing in late childhood to early adulthood.  Whilst it occurs in people of all races, keratoconus is most common in those of Asian descent.

The exact cause of keratoconus is unknown, but it is believed to occur due to a combination of genetic, environmental and hormonal factors. Keratoconus is more common in those who:

  • Have a family history of the disorder
  • Suffer from allergies such as asthma and eczema
  • Have Down’s Syndrome
  • Have a connective tissue disorder such as rheumatoid arthritis
  • Suffer from chronic eye irritation
  • Excessively rub their eyes
  • Have been overexposed to ultraviolet rays from the sun
  • Have a history of poorly fitted contact lenses

Keratoconus Symptoms

Keratoconus is a progressive disorder meaning that its symptoms get increasingly worse over time. In the early stages of the disorder, the symptoms of keratoconus are often no different from those of common refractive errors of the eye, such as myopia (nearsightedness) and hyperopia (farsightedness). As the disorder progresses, keratoconus can lead to a significant decline in visual function.

Initial Symptoms

  • Blurred vision
  • Sensitivity to light
  • Frequent changes to your optical prescription
  • Vision issues not being corrected by glasses or contact lenses

Further Symptoms

  • Impaired vision at all distances
  • Eye strain and irritation
  • Poor night vision
  • Double vision in one eye
  • Significantly worse vision in one eye
  • Halos or streaking around light sources

Here, CT Pillai, Consultant Refractive Surgeon and Medical Director at Advanced Vision Care, talks about the early warning signs of keratoconus.

Since many symptoms are also associated with other eye disorders, this can make it difficult to diagnose keratoconus. An optician will carry out tests on your eyes using an instrument called a slit lamp to diagnose keratoconus. These tests will detect typical signs of the disorder, including:

  • Corneal thinning
  • An iron coloured ring around the cone (Fleischer’s ring)
  • Cone scarring (Apical scarring)
  • Stress lines caused by corneal thinning (Vogt’s striae)

An optician will also measure the curvature of your corneas. This can be done in two ways, using:

  • Keratometry: this machine shines a pattern of light onto your cornea. The reflection of this pattern is then measured which informs the optician how curved your cornea is.
  • Cornea topography: this digital instrument produces a 3D map of your corneas, showing their curvature.

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Keratoconus Treatment

male-with-keratoconus-having-an-eye-testKeratoconus can be treated using different techniques. The treatment you will be given will depend on the severity of your symptoms.

When the disorder is in its early stages, treatment will most likely be some form of non-surgical intervention such as contact lenses or prescription glasses.

As the disorder progresses, these treatments are no longer effective and you will have to undergo surgery such as a corneal transplant. Laser eye surgery is not typically performed on those who have keratoconus however, as it can further damage the already weak cornea.

More information about the different keratoconus treatment options can be found below.

Non-Surgical Treatment Options

The most common types of non-surgical treatment to correct keratoconus include:

  • Prescription glasses or soft contact lenses: these are prescribed when keratoconus symptoms are mild.
  • Rigid gas permeable contact lenses: these are made from a firm plastic and are used when the symptoms of keratoconus become more moderate.

Surgical Treatment Options

The most common types of surgical treatment to correct keratoconus include:

  • Corneal collagen cross linking: vitamin B2 (riboflavin) drops are administered into the. Ultraviolet light is used to activate the drops, and stiffen the cornea.
  • Intacs: these are clear crescent-shaped segments of plastic that are inserted into the cornea to reshape the front of the eye.
  • Cornea transplant: in the most advanced stages of the disorder, all or part of the damaged cornea is removed and replaced with donor cornea tissue.

Keratoconus Treatment Cost

This cost comparison table shows you how much you should expect to pay for the different non-surgical and surgical treatments for keratoconus. The prices in this table have been obtained from leading eye surgery clinics in the UK, but it is important to remember that these prices are only a guide.

The amount you will actually pay for your treatment may differ considerably from these prices, based on factors such as the clinic at which you receive your treatment and the experience of your surgeon. To find out more about the factors which can affect the cost of your keratoconus treatment, visit our eye surgery pricing page.

Type Of Treatment Price
Prescription Glasses From £69
Soft Contact Lenses From £16
Rigid Gas Permeable Contact Lenses From £34
Corneal Collagen Cross Linking From £950
Intacs From £2600
Cornea Transplant From £6600

As you can see, surgical treatments are a lot more expensive than non-surgical treatments since this type of intervention is invasive, requiring an operation and specialist expertise to carry it out. This drives up the cost.

Is Finance Available?

The costs involved with keratoconus treatment can often be too expensive for many people to be able to afford it. Many clinics offer patients finance packages however, that typically require you to pay an upfront deposit with the remaining balance paid in small monthly amounts over a pre-agreed time. These finance offers can vary wildly between different clinics, so it is essential that you shop around for quotations that best suit your financial situation before going ahead with expensive treatments.

There are a few factors to consider when using finance options:

  • The initial deposit is typically 10% of the total price of the treatment, although it can be more. For expensive treatments this can still mean a large upfront cost, so making sure you have enough money to fund this is vital.
  • Monthly financial instalments are agreed on a fixed interest rate basis. In general, the longer the payback period the higher the fixed interest rate, meaning you will pay back the clinic more money than the cost of the treatment. It is advisable therefore to opt for shorter payback periods if possible.
  • Using finance can impact your credit rating, so it is important that you keep up with payments. Missing payment deadlines can affect your ability to be accepted for financial packages in the future.
  • Read the terms of your finance agreement carefully and make sure you understand them in order to avoid any hidden surprises.

Can I Get Treatment On The NHS?

For many patients, their symptoms are often mild and are easily managed using disposable contact lenses or glasses for the rest of their life. However in some cases, their symptoms can worsen and progress so far that cornea transplant surgery is necessary in order to save their sight. In this instance keratoconus treatment is available for free on the NHS.

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