CERA

Eye conditions

Keratoconus

In keratoconus, the cornea of the eye develops a conical shape that impairs vision. In most cases, it appears before the age of 30.

What is keratoconus?

Keratoconus is a common eye condition that affects the cornea – the front window of the eye. The cornea helps to bend and focus light to help us see.

In keratoconus, the cornea gets thinner over time. As a result, the round shape of the cornea gets distorted and a cone-like shape develops.

When the cornea loses its shape, light can’t come to a sharp focus on the retina. This can cause blurry vision, double vision, astigmatism, short sightedness or light sensitivity. If left untreated, vision will continue to get worse.

In most cases, keratoconus appears between the ages of 16 and 30 years and stabilises by middle age. Due to its early onset, it can impact school, work, social and family life if it’s not treated.

Learn about our keratoconus research

Our corneal research team strives to improve all aspects of corneal transplantation, and develop better treatments for conditions such as keratoconus.

How common is it?

  • One in every 84 Australian 20-year-olds has keratoconus. It affects men and women equally.

It’s the most common reason for corneal transplant in Australia.

Causes and risk factors

The exact cause of keratoconus is not known. But both genetic and environmental factors seem to play a role.

Many people who are affected have no family history of the condition. But it is likely to have a genetic component.

Keratoconus often occurs alongside diseases where people have itchy eyes. For example hay fever, allergies and asthma. Lots of vigorous eye rubbing can break down the fibres of the cornea. This might increase risk of keratoconus, but the exact link is still unclear.

Signs and symptoms

In the early stages, keratoconus may not cause any symptoms.

As the condition progresses, it causes blurring and distorted vision. One of the tell-tale signs of the disease is frequent changes in glasses prescription.

Other possible symptoms include:

  • increased light sensitivity
  • halos around light sources
  • double images (especially at night).

Diagnosis

Keratoconus can be hard to diagnose early on as the symptoms are like other eye conditions. Early diagnosis requires a special camera to map the shape of the cornea. This is not part of a routine eye exam.

If your eye healthcare provider picks up signs of the disease they will refer you to someone who specialises in keratoconus.

Treatment

There is no known cure for keratoconus or way of reversing damage done to the cornea. But treatment can help manage most vision loss caused by the condition.

Corneal collagen crosslinking is a new treatment option to slow the progress of the disease. It involves applying vitamin B2 drops and UV A light to stiffen the cornea and stop it losing its shape.

In the early stages of keratoconus, glasses or soft contact lenses can correct vision. As the condition progresses, treatment moves to hard contact lenses.

In advanced cases, corneal transplant surgery is required to improve vision. Even after surgery, glasses or contact lenses may still be needed.

Can it be prevented?

Keratoconus cannot be prevented. But treatment can manage symptoms and slow disease progression.

Our keratoconus research

Our Corneal Research Unit is working to better understand the causes of keratoconus and potential treatments.

The team is led by ophthalmic surgeon Professor Mark Daniell, whose main focus is assessing new treatments for keratoconus and looking for underlying causes. He is also developing a tissue-engineered cornea for transplant.

A few of our key keratoconus research projects include:

  • Work proving the safety and efficacy of collagen crosslinking of the cornea.
  • Identifying clinical, environmental and genetic risk factors that contribute to keratoconus. This research aims to find the underlying cause of the condition. It includes a study looking at the genes involved in the diseased corneal tissue discarded after corneal transplant.
  • Using artificial intelligence to fill in gaps in the clinical understanding of keratoconus. This includes detecting subclinical keratoconus and predicting disease progression.
  • The Keratoconus International Consortium established by CERA. This aims to enhance international collaboration and data-sharing to improve understanding of the disease.

Learn more about our keratoconus research