Medically reviewed by Krishna Surapaneni, MD, board-certified ophthalmologist and cataract, cornea, and refractive surgeon at SuraVision in Houston.
If you or your child was just told you have keratoconus, take a breath. This diagnosis feels big, but keratoconus is more treatable today than it has ever been. The key is matching the right treatment to the right stage, and starting sooner rather than later.
What is keratoconus?
Your cornea is the clear front window of your eye. It is normally round, like a dome. With keratoconus, the cornea slowly thins and bulges into more of a cone shape. That change bends light unevenly, which blurs and distorts your vision.
Keratoconus often starts in the late teens or early twenties, and it can change during those years. That is why eye doctors watch younger patients with keratoconus closely. Common signs include blurry vision that keeps changing, glare and halos at night, and prescription changes that come more often than they should (American Academy of Ophthalmology).
Why an early plan matters
Keratoconus tends to progress over time, and vision lost to scarring or severe thinning is hard to get back. The good news runs the other way too. When keratoconus is found early, treatment can usually keep your cornea stable and your vision working well. An early plan gives you the most options.
One thing you can do starting today: try not to rub your eyes. Rubbing puts stress on thin corneal tissue and is linked with keratoconus getting worse. If itchy eyes are what make you rub, tell your eye doctor, because treating the allergy is part of protecting your cornea.
Keratoconus treatment options by stage
Updated glasses and soft contact lenses
In the earliest stage, new glasses or soft contact lenses may be all you need to see clearly. Glasses do not slow the disease, but they can handle mild blur while your doctor tracks your corneal maps for any sign of change.
Specialty contact lenses
As the cornea becomes more irregular, glasses and soft lenses stop working as well. Specialty lenses, such as rigid gas permeable or scleral lenses, sit over the irregular surface and give your eye a smooth surface to focus through, which can sharpen vision a great deal. Your evaluation will show whether specialty lenses are the right next step for your corneas. Keep in mind that specialty lenses change how you see, but they do not stop keratoconus from progressing.
Corneal cross-linking
Corneal cross-linking, often called CXL, is the treatment that changed keratoconus care. It has been approved by the FDA since 2016, and it is the main treatment shown to slow or stop keratoconus from getting worse (American Academy of Ophthalmology).
During cross-linking, your surgeon applies riboflavin (vitamin B2) drops to the cornea, then activates them with a controlled ultraviolet light. This creates new bonds between the collagen fibers in your cornea, which stiffens and stabilizes it. The goal is to keep the cornea from bulging further.
A few honest points about cross-linking. The goal is stability, not sharper vision, although some patients do notice modest improvement over time. Your eyes may feel scratchy and light sensitive for several days while the surface heals. As with any eye procedure, there are risks, including infection, haze, and delayed healing, and your surgeon will walk you through them. Most patients get back to their normal routine within about a week. You can learn more on our corneal cross-linking page.
Candidacy matters here. Cross-linking works best when keratoconus is progressing but the cornea still has enough thickness to treat. That is one more reason early evaluation counts.
Advanced keratoconus
When scarring or extreme thinning makes clear vision impossible with lenses, a corneal transplant can replace the damaged tissue. Most people with keratoconus never need one, and modern treatment exists largely to keep it that way.
Can LASIK fix keratoconus?
No. LASIK reshapes the cornea by removing a small amount of tissue, and a keratoconus cornea is already too thin and too weak for that. Having keratoconus means LASIK is not the right procedure for you, and a careful LASIK screening checks for it. If you were turned down for LASIK because of corneal thickness or shape, a keratoconus evaluation is a smart next step. You can read more about how candidates are screened in our LASIK candidacy article. If you are exploring vision correction in general, our overview of vision correction procedures covers options that do not depend on reshaping the cornea.
What happens at a keratoconus evaluation
At SuraVision, your evaluation starts with detailed corneal mapping, called topography, which measures the exact shape and thickness of your cornea. Dr. Sura reviews your maps with you, explains what stage you are in, and builds a plan around your eyes and your life. If you already have older maps from another visit, bring them. Comparing maps over time is the clearest way to see whether your keratoconus is progressing.
Frequently asked questions about keratoconus treatment
Can keratoconus be cured?
There is no cure for keratoconus, but it can be managed well. Corneal cross-linking can slow or stop progression, and specialty lenses often bring vision back to a much sharper place.
What is the best treatment for keratoconus?
It depends on your stage. Early keratoconus may only need updated glasses and monitoring. Progressing keratoconus is usually treated with corneal cross-linking. Irregular corneas often see best with specialty contact lenses. Your corneal maps guide the choice.
Can I have LASIK if I have keratoconus?
No. LASIK removes corneal tissue, and a keratoconus cornea is already thin and weakened. Other paths to better vision exist, and a keratoconus evaluation will show which ones fit your eyes.
How do I know if my keratoconus is getting worse?
Repeat corneal mapping is the most reliable way. Prescription changes that keep coming, new glare at night, or vision that slips between visits are also signals worth a prompt visit.
Does cross-linking improve my vision?
The goal of cross-linking is to keep your keratoconus from progressing. Some patients notice modest sharpening over the months after treatment, but you should not expect to go without glasses or contacts because of cross-linking alone.
Schedule a keratoconus evaluation
The right plan starts with a conversation and a clear look at your corneas. Call us at 713-730-2020 or reach out through our contact page to schedule your keratoconus evaluation with Dr. Sura.