Unveiling the Enigma: Signs and Symptoms of Keratoconus

Keratoconus, a progressive eye disorder that affects the cornea, has intrigued medical professionals and researchers for decades. Characterized by the cornea’s gradual thinning and cone-like distortion, this condition can lead to distorted vision and a range of visual anomalies. Understanding the signs and symptoms of keratoconus is crucial for early detection and intervention. In this article, we delve into the enigmatic world of keratoconus, exploring its key indicators and emphasizing the importance of timely diagnosis.

Anatomy of the Cornea

Before diving into the signs and symptoms of keratoconus, let’s briefly understand the cornea’s role in vision. The cornea, the transparent front surface of the eye, plays a vital role in focusing light onto the retina. Its smooth curvature is crucial for clear and accurate vision.

Keratoconus cone
Keratoconus cone

Signs and Symptoms of Keratoconus

Blurred or Distorted Vision: One of the initial indicators of keratoconus is blurred or distorted vision. Patients often experience a gradual decline in visual acuity, leading to difficulty in reading, recognizing faces, and performing tasks that require sharp vision.

Frequent Changes in Prescription: Individuals with keratoconus may frequently experience changes in their eyeglass or contact lens prescriptions. As the cornea’s shape changes, corrective lenses may become less effective in providing clear vision.

Increased Sensitivity to Light and Glare: Another common symptom is increased sensitivity to light, known as photophobia, and glare. This sensitivity can be especially problematic in bright sunlight or when driving at night.

Halos and Ghosting: Patients may report seeing halos or ghost images around light sources, particularly at night. This phenomenon can further impair night vision and overall visual comfort.

Keratoconus cone in eye with halo
Cone shape of cornea in Keratoconus

Frequent Eye Rubbing: Excessive and frequent eye rubbing, often due to itching or discomfort, is associated with keratoconus. This habit can exacerbate the condition by further weakening the corneal structure and modifying the shape of the cornea.

Astigmatism: Astigmatism, a refractive error caused by irregular corneal curvature, is a common outcome of keratoconus. It results in distorted, blurry, or skewed vision.

Corneal Irregularities: The cornea may display specific irregularities, such as Vogt’s Striae – thin, dark lines that appear under the corneal surface – visible during a slit-lamp examination. Corneal hydrops, a condition where the innermost layer of the cornea swells, can also occur in advanced stages.

Progressive Vision Changes: Keratoconus tends to progress over time, with symptoms worsening gradually. Monitoring visual changes and seeking regular eye examinations are crucial to track its advancement.

Diagnosis and Treatment

Early diagnosis is pivotal in managing keratoconus effectively. An eye care professional may use various diagnostic tools, such as corneal topography and pachymetry, to assess corneal shape and thickness. Once diagnosed, treatment options may include:

Prescription Eyewear: Initially, eyeglasses or soft contact lenses may help correct mild keratoconus by compensating for refractive errors.

Rigid Gas Permeable (RGP) Contact Lenses: These specialized lenses can help create a smooth corneal surface, improving vision by compensating for corneal irregularities.

Scleral Lenses: These larger lenses vault over the cornea and rest on the sclera, offering better comfort for individuals with advanced keratoconus.

Collagen Cross-Linking (CXL): This procedure involves applying riboflavin drops to the cornea, followed by exposure to ultraviolet light. CXL aims to strengthen the corneal tissue and slow down the progression of the condition.

Riboflavin drops being inserted for Collagen Cross Linking (CXL). Under UV light
Riboflavin drops being inserted for Collagen Cross Linking (CXL)

Intacs: Intracorneal ring segments (Intacs) are small, semi-circular devices implanted in the cornea to reshape its curvature, improving vision.

Corneal Transplantation: In severe cases, where other treatments are ineffective, a corneal transplant may be necessary. This involves replacing the damaged cornea with a healthy donor cornea.


Keratoconus remains a challenging yet intriguing eye disorder, impacting the lives of those affected. Recognizing the signs and symptoms of keratoconus is pivotal in seeking timely medical attention, preventing the progression of the condition, and ensuring better visual outcomes. If you or someone you know experiences any of the aforementioned symptoms, consulting an eye care professional is essential for accurate diagnosis and tailored treatment options. With advancing research and evolving treatments, the outlook for individuals with keratoconus continues to improve, offering hope for a clearer and brighter future.

We can help

If you suffer from Keratoconus and think we can help, then you can request an appointment online or call the clinic on 1300 393 322. We have 2 Sydney locations for consultation, Westmead and the city on Macquarie Street opposite the Eye Hospital.