In brief: Signs of keratoconus usually appear from adolescence through the early 20s. Vision becomes slightly blurred or distorted (straight lines look wavy), lights cause glare, especially at night, and glasses prescriptions—particularly astigmatism—change frequently. Risk is higher with eye allergies, frequent eye rubbing and a family history of keratoconus. It is detected with a corneal map (topography). When diagnosed early, cross-linking (CXL) treatment can stop or slow its progression.
What happens to the cornea in keratoconus?
The cornea is the clear, small dome-shaped layer at the front of the eye. In keratoconus (in Albanian also called “keratokoni”), the cornea becomes thinner and bulges forward into a cone shape. Light no longer focuses properly, and vision becomes blurred and distorted.
Keratoconus often begins in the late teens or early 20s and progresses slowly over 10 to 20 years. It usually affects both eyes, but not always equally. In the US, the National Eye Institute estimates that it affects around 1 in 2,000 people, according to a 2016 article by the American Academy of Ophthalmology (AAO).
Signs of keratoconus: what young people and parents notice
In teenagers, the early signs are easy to mistake for “just needing a new glasses prescription.” The table shows what young people and parents commonly notice:
| What you notice | Why it happens | What to do |
|---|---|---|
| Slightly blurred vision, even with new glasses | the cornea has become irregularly shaped | have the cornea checked, not just the prescription |
| Straight lines that look bent or wavy | distortion caused by the shape of the cornea | see an eye doctor |
| Double or shadowed vision in one eye, even when the other eye is closed | the irregular shape of the cornea | have the cornea checked |
| Glare, halos around lights, difficulty seeing at night | light is scattered by the irregular cornea | see an eye doctor, especially before getting a driver’s license |
| Glasses prescription changes often, especially astigmatism | the cornea continues to change | corneal topography |
| Contact lenses no longer fit as well or feel uncomfortable | the cornea has changed shape | have the cornea checked |
| One eye is much worse than the other | keratoconus affects the eyes unevenly | check both eyes |
Sensitivity to light and redness or swelling of the eyes may also appear early on. Glasses prescriptions often change during adolescence because of myopia too. If your prescription changes frequently along with your astigmatism, and new glasses still don’t make your vision completely clear, ask your eye doctor to check your cornea as well.
Who is most at risk?
- Age: Keratoconus is usually diagnosed around puberty, in the late teens or early 20s. When it starts later, it usually progresses more slowly. It can progress faster in young people.
- Family history: According to the AAO, around 1 in 10 people with keratoconus have a parent with the condition.
- Allergies: Keratoconus is more common in people with eye allergies, eczema, allergic rhinitis (seasonal allergies) or asthma.
- Eye rubbing: Frequent, vigorous eye rubbing is associated with keratoconus and can make it worse.
- Certain connective tissue disorders, such as Marfan syndrome and Ehlers-Danlos syndrome.
If you have one of these risk factors and any of the signs above, don’t wait for your next routine check-up. For everyone else, see how often you should get an eye exam for a schedule by age.
Why shouldn’t you rub your eyes?
Rubbing your eyes can make keratoconus worse, so we recommend avoiding it. Allergy-related itching is one reason people rub their eyes. So:
- treat eye allergies with the drops prescribed by your doctor to relieve the itching;
- when your eyes itch, don’t press or rub them with your fists;
- parents should watch for habitual eye rubbing in their child and mention it during the appointment.
These measures won’t always prevent keratoconus, but they can help keep the cornea from weakening further.
How is keratoconus detected early?
Keratoconus can be detected during a routine eye exam. To confirm it, we perform corneal topography: a computer-generated map of the cornea’s shape and curvature that shows steep areas, even in the early stages. We also measure corneal thickness. We compare the measurements at follow-up visits: when the shape, curvature, or thickness changes, the keratoconus is progressing. Monitoring is especially important for teenagers because the condition can progress more quickly.
At Indian Eye Institute & Laser Center (the Indian Eye Clinic) in Tirana, we diagnose and monitor keratoconus using corneal topography with OCULUS Pentacam HR and CSO topographers, and tailor care to each stage.
Before your appointment: Bring your old glasses and previous prescriptions so we can see how quickly your prescription has changed. Tell us if you have allergies, eczema or asthma, rub your eyes often, or have a family member with keratoconus. If you wear contact lenses, ask us when to remove them before your appointment, as lenses can temporarily change the shape of the cornea.
From Dr. Nishant Taneja’s experience: We tell young people with allergies not to rub their eyes, because vigorous rubbing can make keratoconus worse.
Why does early diagnosis matter?
Because cross-linking (CXL, corneal collagen cross-linking) stops or slows progression, but it cannot restore lost vision. That’s why it is most beneficial when done early. Riboflavin (vitamin B2) drops are activated with ultraviolet light to strengthen the cornea and prevent it from bulging further. In the U.S., the FDA approved it in 2016 for progressive keratoconus.
Vision is corrected with glasses or contact lenses, and most patients don’t need surgery. We explain lenses, cross-linking and corneal transplant, as well as how we choose treatment at our clinic, in keratoconus treatment.
Keratoconus and laser surgery: can you get rid of your glasses?
Laser eye surgery to get rid of glasses (such as LASIK) is usually not performed for keratoconus. The AAO lists keratoconus among the contraindications to refractive surgery because the cornea is already weak, and removing tissue may weaken it further. An irregular corneal map is the most important risk factor for corneal weakening after LASIK.
That’s why, before any laser surgery, we check the cornea with topography and measure its thickness. Sometimes early keratoconus is found during this check in a young person who came in to have their glasses removed. Find out what this check involves in pre-laser surgery examination.
When is it an emergency?
In some people, the cornea suddenly swells and scars. See an ophthalmologist or go to the emergency room immediately if you have:
- sudden loss of vision;
- vision that becomes cloudy;
- eye pain or redness.
This requires prompt attention. For other urgent signs, see when to see an eye doctor immediately.
Frequently asked questions
Can keratoconus be cured?
There is no treatment that eliminates it, but there are treatments that control it. Cross-linking (CXL) stops or slows progression, while vision can be improved with glasses or contact lenses and, in advanced cases, with intracorneal rings or a corneal transplant.
Can keratoconus make you go blind?
No. Keratoconus blurs and distorts vision, but it does not cause complete blindness. In advanced cases, a corneal transplant can improve vision.
Is keratoconus hereditary?
Sometimes: about 1 in 10 people with keratoconus have a parent with the condition, but the exact cause is unknown. Eye allergies and vigorous eye rubbing also increase the risk. If someone in your family has keratoconus, let us know at your appointment.
Can I wear contact lenses?
Yes. In the early stages, soft lenses are often enough. Later, rigid or hybrid lenses often provide the clearest vision because they create a regular surface in front of the cornea.
Sources
- American Academy of Ophthalmology — What Is Keratoconus?
- American Academy of Ophthalmology — Corneal Collagen Cross-linking Approved to Treat Keratoconus in U.S.
- American Academy of Ophthalmology — What Is Myopia?
- AAO EyeWiki — LASIK for Myopia and Astigmatism: Safety and Efficacy
- Cleveland Clinic — Keratoconus
- Bedfordshire Hospitals NHS Foundation Trust — Keratoconus
Your glasses prescription changes often, and your vision never becomes completely clear? Book a corneal exam at Indian Eye Institute & Laser Center in Tirana. Book an appointment · Tel. +355 67 50 30 017
