Keratoconus: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Keratoconus?
An ophthalmologist, an eye doctor who treats eye disease and does eye surgery, usually treats keratoconus. Mild cases may be corrected with eyeglasses or soft contact lenses, while later stages often need special hard contact lenses or other treatment. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is keratoconus?
Keratoconus is an eye disease that changes the shape of the cornea. The cornea is the clear, dome-shaped window at the front of the eye. In keratoconus, the cornea thins out and bulges like a cone.
The new shape brings light out of focus. This makes vision blurry and distorted. In most people, these changes get worse over time.
The eye changes typically begin in the teen years. They slowly worsen until mid-adulthood, when the shape of the cornea stays stable.
Symptoms
Early symptoms can include:
- Mild blurring of vision, which glasses may not fully correct.
- Slightly distorted vision, where straight lines look bent or wavy.
- More sensitivity to light and glare.
- Eye redness or swelling.
In later stages, vision becomes more blurry and distorted. Nearsightedness or astigmatism, a focusing problem, often increases. You may need new eyeglass prescriptions often. Contact lenses may no longer fit properly or may feel uncomfortable.
Keratoconus often affects both eyes, and the two eyes can have very different vision. For some people it gets worse quickly. The cornea can swell suddenly and start to scar.
Causes and who gets it
The exact cause is unknown. Researchers think a mix of genes and outside factors is involved. Most people with keratoconus have no family history of it, but having a relative with the condition raises the risk. About 1 out of 10 people with keratoconus have a parent who has it too.
Allergies and eye rubbing may speed up the damage. About one-third of people with keratoconus have an allergic disorder. Allergies might trigger eye rubbing, which can make eye problems worse.
Keratoconus is also linked to Down syndrome and to connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome. The condition may be due to a defect in collagen, the tissue that gives the cornea its shape and strength.
How doctors diagnose it
Keratoconus can be found during a routine eye exam. The eye doctor examines the cornea and may measure its curve. The doctor may also map the surface of the cornea with a special computer.
The most accurate test is called corneal topography, which makes a map of the curve of the cornea. A slit-lamp exam, which uses a special microscope, can find the disease in later stages. A test called pachymetry measures the thickness of the cornea.
Treatment
Contact lenses are the main treatment for most people. Rigid gas-permeable lenses, which are hard lenses that hold their shape, can usually correct vision. The lenses can give good vision, but they do not treat or stop the condition.
Corneal cross-linking uses eye drops and special UV light to strengthen the cornea. It keeps the cornea from bulging further. In most cases, it prevents the condition from getting worse.
Intacs are small curved devices placed in the cornea during surgery. They help flatten the curve of the cornea to improve vision.
A corneal transplant may be suggested when symptoms are severe. The surgeon replaces all or part of the diseased cornea with healthy donor tissue. Results are very often good, but recovery can be long, and many people still need contact lenses afterward. Rejection of the donor cornea is a risk, but it is much lower than with other organ transplants.
Try not to rub your eyes. Rubbing can damage the thin cornea and make symptoms worse. If itchy eyes make you rub, ask your eye doctor about medicines to control allergies.
When to see a doctor
Young people whose vision cannot be corrected to 20/20 with glasses should be checked by an eye doctor who knows keratoconus. Parents who have keratoconus should consider having their children screened starting at age 10.
Keratoconus can get worse quickly in some people. Tell your eye doctor about any fast change in your vision. Untreated, the cornea may thin until a hole develops in its thinnest part.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. They can review your symptoms, refer you to an eye doctor, and help coordinate follow-up care.
Common questions
Will keratoconus get worse?
In most people, yes, it gets worse over time. The eye changes usually begin in the teen years and slowly worsen until mid-adulthood, when the shape of the cornea stays stable. Corneal cross-linking prevents it from getting worse in most cases.
Can keratoconus be prevented?
No, there is no way to prevent it. Most health care providers believe people should take steps to control allergies and avoid rubbing their eyes.
Is keratoconus passed down in families?
Sometimes, but most cases are not inherited. About 1 out of 10 people with keratoconus have a parent who has it too. Having a relative with the condition raises the risk.
Can I have LASIK if I have keratoconus?
No, LASIK should not be done if you have any degree of keratoconus. In rare cases, a different laser procedure called PRK may be safe for mild keratoconus. Ask your eye doctor what fits your eyes.
Sources
- MedlinePlus - Keratoconus
- MedlinePlus Genetics - Keratoconus
- American Academy of Ophthalmology - What Is Keratoconus?
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
