Keratoconus
Blurry or distorted vision that glasses can't seem to fix, glare and halos around lights at night, or a prescription that keeps changing? It could be keratoconus, a condition where the cornea gradually thins and bulges into a cone shape, and it most often starts in the teens through the 30s. At Dr. Della Chow, we confirm what's changing with detailed corneal mapping, check your overall eye health, and find the correction that fits your life.
Keratoconus: Symptoms, Causes & Treatment
Your cornea — the clear, dome-shaped front surface of your eye — needs a smooth, even curve to focus light properly. Keratoconus is a progressive condition where the cornea thins and bulges into an irregular, cone-like shape, distorting vision in ways that glasses often can’t fully correct. Dr. Della Chow — a trusted optometrist in Kitsilano — focuses on catching keratoconus early. Keratoconus is diagnosed and monitored here, and co-managed with a corneal specialist — we arrange the referral for corneal topography, cross-linking, and specialty lens fitting.
TL;DR: Keratoconus is a progressive thinning and bulging of the cornea that distorts vision, usually starting in the teens to early twenties. There’s no cure, but Dr. Della Chow diagnoses it early and refers you for specialty contact lens fitting and, if needed, corneal cross-linking to help slow or halt its progression.
What Is Keratoconus?
Keratoconus (“cone-shaped cornea”) occurs when the collagen fibers that give the cornea its strength and shape weaken and thin. Instead of holding a smooth, round curve, the cornea gradually bulges outward into a cone. This irregular shape scatters and distorts light before it ever reaches the retina, causing blurred and distorted vision that changes as the condition progresses. Keratoconus usually affects both eyes, though often unevenly — one eye can be significantly more advanced than the other.
| Stage | Vision Impact | Typical Correction |
|---|---|---|
| Early | Mild irregular astigmatism | Glasses or standard soft contact lenses |
| Moderate | Noticeable distortion, frequent prescription changes | Specialty (RGP, hybrid, or scleral) lenses — by referral |
| Advanced | Significant thinning, possible scarring | Specialty lenses, cross-linking, or transplant — all by referral |
What Causes Keratoconus — and Who’s at Risk?
The exact cause of keratoconus isn’t fully understood, but several factors are strongly linked to it:
- Genetics and family history of keratoconus
- Chronic eye rubbing
- Certain connective tissue disorders
- Allergic conditions, particularly chronic eye allergies
- Poorly fitted contact lenses over long periods (a contributing factor, not a root cause)
- Onset commonly in the teens to early twenties
If keratoconus runs in your family, earlier and more frequent eye exams — including for children — can help catch it before it significantly affects vision.
What Are the Symptoms of Keratoconus?
- Blurred or distorted vision that doesn’t fully correct with a glasses update
- Increased sensitivity to light and glare
- Difficulty with night driving
- Frequent changes in eyeglass prescription
- Halos or streaking around lights
- Eye strain or headaches
- In advanced cases, sudden clouding or scarring of the cornea
Because early keratoconus can look a lot like ordinary astigmatism — including whether astigmatism can cause headaches or how it compares to normal vision (see astigmatism vs. normal vision) — a comprehensive exam, with referral for corneal imaging when needed, is the only reliable way to tell the difference.
How Is Keratoconus Diagnosed?
Diagnosing keratoconus goes beyond a standard vision check. At Dr. Della Chow, this typically includes:
- Refraction: measures how much irregular astigmatism is present, often the first clue something beyond typical astigmatism is going on
- Slit-lamp examination: checks for thinning, scarring, or other structural changes
When these findings point to keratoconus, Dr. Della Chow refers you to a corneal specialist for corneal topography and pachymetry — the imaging that maps corneal curvature and thickness and confirms the diagnosis and its severity.
Because keratoconus can progress, patients diagnosed with it are typically monitored at more frequent intervals than a standard annual exam.
How Is Keratoconus Treated?
Early Stage
- Glasses or standard soft contact lenses may still provide workable vision
- Regular monitoring to track any progression
Moderate to Advanced Stage
- Specialty contact lenses — rigid gas permeable (RGP), hybrid, or scleral lenses — often make the single biggest improvement in day-to-day vision; Dr. Della Chow diagnoses the need and refers you to a specialty contact lens fitter
- Corneal cross-linking (CXL): a procedure performed by an ophthalmologist that strengthens corneal collagen to slow or halt progression; Dr. Della Chow monitors for signs it may be appropriate and refers to a trusted ophthalmologist when needed
- Corneal transplant: reserved for advanced cases with significant scarring or thinning, performed by an ophthalmologist with optometric co-management before and after
You don’t have to navigate the specialty-lens fitting process or a referral alone — Dr. Della Chow coordinates that care every step of the way.
Living With Keratoconus
- Avoid rubbing your eyes, which can accelerate progression
- Keep up with scheduled follow-up exams, even when vision feels stable
- Update specialty lenses as recommended — fit matters more here than for typical prescriptions
- Manage any underlying eye allergies that contribute to eye rubbing
See Clearly, Manage Confidently
Keratoconus is a lifelong condition to manage, not a battle to face alone. With early detection, the right specialty lenses, and coordinated care when more advanced treatment is needed, most people with keratoconus maintain functional, comfortable vision for life.
If your prescription keeps changing, night driving feels harder than it should, or keratoconus runs in your family, our team at Dr. Della Chow in Kitsilano is here to help.
This article is for general education and is not a substitute for a professional eye examination or personalised medical advice. If you have concerns about your eyes or vision, book an appointment with your optometrist.
Got Questions? We’ve Got Answers
What is keratoconus?
Keratoconus is a progressive eye condition where the cornea thins and bulges into an irregular, cone-like shape, distorting vision in ways that standard glasses often can’t fully correct.
What causes keratoconus?
The exact cause isn’t fully understood, but genetics, chronic eye rubbing, certain connective tissue disorders, and chronic eye allergies are all strongly linked to its development.
Can keratoconus be cured?
There’s no cure for keratoconus, but its progression can often be slowed or stopped with corneal cross-linking, and vision can usually be well-managed with specialty contact lenses.
Can keratoconus cause blindness?
Complete blindness from keratoconus is rare. However, advanced, untreated keratoconus can cause significant vision impairment, which is why early detection and monitoring matter.
Is keratoconus genetic?
Genetics plays a meaningful role. Having a family history of keratoconus increases your risk, though not everyone with a family history develops it.
What are the treatment options for keratoconus?
Options range from glasses and specialty contact lenses (RGP, hybrid, or scleral) to corneal cross-linking and, in advanced cases, corneal transplant. Treatment is tailored to how advanced the condition is.