Keratoconus is a progressive eye condition where the normally round cornea thins and begins to bulge into a cone-like shape, leading to distorted vision. It typically affects both eyes and can worsen over time if left untreated. Understanding the stages of keratoconus is essential for early intervention and managing the condition effectively.
At Vision Clinic Sydney, we offer comprehensive keratoconus diagnosis and treatment options tailored to each stage of the disease. This article explores the symptoms, changes in vision at each stage, and what treatments are available to help maintain your sight.
What Are the Stages of Keratoconus?
Keratoconus is generally classified into four stages based on the degree of corneal thinning and bulging. The progression varies for each person, but understanding these stages helps guide appropriate treatment.
Stage 1: Mild Keratoconus
In the earliest stage, many people are unaware they have keratoconus. Vision changes are usually mild, often appearing as slight blurring or distortion, especially in dim lighting or at night.
You might notice increased sensitivity to light or that your glasses prescription changes more often than usual. The cornea begins to thin, but its overall shape remains close to normal, which can make keratoconus difficult to detect without specialised testing.
At this point, glasses or soft contact lenses usually correct vision effectively. However, early intervention is important to prevent further progression.
Stage 2: Moderate Keratoconus
As keratoconus progresses into the moderate stage, vision becomes increasingly distorted. Many individuals experience ghosting, where objects appear doubled or have a shadow, and halos around lights become more pronounced, especially at night. Astigmatism worsens, and glasses often no longer provide clear vision.
The cornea continues to bulge into a cone-like shape, which may now be visible during a detailed eye exam. More specialised contact lenses are typically needed to correct vision at this stage, as the irregular corneal surface cannot be managed with standard lenses.
Stage 3: Advanced Keratoconus
In the advanced stage, vision deteriorates significantly, impacting daily activities. Individuals often struggle with severe blurring, multiple images, and extreme light sensitivity. Night driving becomes very difficult, and regular tasks such as reading or recognising faces can become challenging.
The cone shape of the cornea is now more pronounced, and contact lenses are essential for achieving usable vision. Many people at this stage rely on custom-designed lenses, which sit over the irregular cornea to provide better focus.
Stage 4: Severe Keratoconus
In the most severe stage, the cornea becomes extremely thin and may develop visible scarring, which further impairs vision. Severe keratoconus causes significant vision loss, making it difficult to function without intervention. Many individuals cannot tolerate contact lenses at this stage due to discomfort or poor fit, and glasses offer little to no visual improvement.
The distortion of vision is so great that daily life is heavily affected, and surgery is often necessary to restore some degree of visual function.
What Are the Treatments for Keratoconus?
The appropriate management of keratoconus depends on the stage of the disease, symptoms, and the specific shape of the corneal cone. Treatments range from non-invasive options for mild cases to surgical procedures for more advanced stages.
Non-Surgical Options:
- Prescription spectacles or specialised soft contact lenses for mild keratoconus.
- Rigid gas-permeable (RGP) lenses or Scleral lenses for moderate to severe keratoconus, providing sharper vision by masking the irregular corneal shape.
Surgical Options:
- Transepithelial Collagen Cross-Linking with Oxygen Enhancement
A minimally invasive procedure that strengthens the cornea and halts progression. Vision Clinic Sydney is the only clinic in NSW offering this safer, less invasive cross-linking technique with oxygen enhancement, improving outcomes. - INTACS or KERARINGS
Semi-circular implants inserted into the cornea to flatten the cone shape and improve vision stability. This modality of treatment is now rarely offered. - Femto-CAIRS (Femtosecond Laser Assisted Corneal Allogenic Intrastromal Ring Segment Implantation)
A minimally invasive cornea transplant where the corneal tissue is placed into laser-created channels to reshape and thicken the cornea, improving vision quality, especially at night. Can be performed alongside cross-linking. - Topography-guided PTK/PRK (Phototherapeutic/Photorefractive Keratectomy)
A laser procedure that remodels the corneal surface, enhancing both uncorrected and best-corrected vision. Often combined with or performed after cross-linking. - Corneal Transplant Surgery
- Penetrating Keratoplasty (PKP): A full-thickness corneal transplant for severe thinning or scarring.
- Deep Anterior Lamellar Keratoplasty (DALK): A partial transplant replacing up to 80% of the cornea’s outer layers while preserving healthy inner tissue.
Keratoconus Diagnosis at Vision Clinic Sydney
Accurate keratoconus diagnosis involves advanced imaging such as corneal topography and tomography and OCT scans. These allow us to detect even early changes in corneal shape and thickness. Vision Clinic Sydney provides detailed assessments to monitor keratoconus progression and guide treatment decisions tailored to your condition.
How To Book an Assessment
To request an appointment or if you have an enquiry, please contact us via the following ways:
Call or message us: +612 9222 9188
Email us: reception@visionclinicsydney.com.au
Book online via our website.
FAQs
What are the early signs of keratoconus?
Early keratoconus symptoms include blurred vision, frequent changes in glasses prescriptions, light sensitivity, and difficulty seeing at night. These signs are often mistaken for simple astigmatism.
How is keratoconus diagnosed?
Keratoconus diagnosis is made using corneal topography and other imaging tests that measure the curvature and thickness of the cornea. These help detect even mild forms of the condition.
What treatments are available for mild keratoconus?
In mild keratoconus, vision may be corrected with glasses or soft contact lenses. Collagen cross-linking is often recommended to halt progression, especially at Vision Clinic Sydney, where we use oxygen-enhanced transepithelial cross-linking.
What does severe keratoconus feel like?
Severe keratoconus causes significant vision loss, making daily activities difficult. Vision is often distorted, with double images, and patients may have poor tolerance to standard contact lenses.
Can keratoconus be stopped from getting worse?
Yes, treatments like collagen cross-linking can halt the progression of keratoconus, especially when diagnosed early. Regular monitoring and tailored interventions help maintain vision.
General Information Disclaimer: The content provided here is for informational purposes only and is not intended as medical advice, diagnosis, or treatment. Always seek the advice of your health professional with any questions you may have regarding a medical condition. The information on this site is general in nature and may not reflect current medical developments or research. Your reliance on any information provided by this site is solely at your own risk.
