Keratoconus
A progressive eye condition that gradually deteriorates the quality of vision — appropriately selected treatment can slow or stop its progression.
What is keratoconus?
Keratoconus It is a chronic eye condition in which the cornea gradually thins and bulges, taking on an irregular, cone-shaped form. This leads to increasing astigmatism, image distortion and a deterioration in visual acuity, particularly after dark. The condition usually develops slowly and can be difficult to detect in its early stages, which is why early diagnosis and regular eye checks are so important.
What causes keratoconus and how can you recognise it?
The symptoms of keratoconus often develop gradually and may go unnoticed for a long time. This is why diagnosis requires a series of precise imaging examinations to assess the shape, thickness and stability of the cornea.
Causes
- genetic predisposition - Keratoconus is more common in people with a family history of keratoconus,
- eye rubbing - Chronic pressure weakens the structure of the cornea,
- allergic conditions and atopy - The itching of the eyes promotes their frequent rubbing,
- connective tissue disorders - Keratoconus more commonly occurs alongside with Marfan syndrome, Ehlers-Danlos syndrome and Down syndrome, among others,
- hormonal changes during puberty - The condition usually develops between the ages of 12 and 25,
- environmental factors - chronic exposure to UV radiation and irritation of the ocular surface.
Symptoms
- deterioration of vision, particularly in the dark or when driving at night,
- multiple images, blurring and image distortion,
- frequent changes in glasses or contact lens prescription,
- progressive and difficult-to-correct astigmatism,
- photophobia, frequent squinting and the habit of rubbing one’s eyelids.
Diagnostic tests
- Pentacam (topography and 3D tomography of the cornea) - the key examination for detecting even early-stage keratoconus
- Slit-lamp examination - assessment of the anterior segment of the eye,
- complementary examinations (e.g. OCT) - when medically indicated,
- full ophthalmological assessment and consultation.
- Corneal epithelial mapping — helpful for very early diagnosis of keratoconus.
Stadia stożka rogówki - od podejrzenia do zaawansowanej choroby
Keratoconus is not a „black-and-white" condition — it progresses in stages, and the stage of the disease determines the choice of treatment. Clinical classifications (e.g. Amsler-Krumeich) are based mainly on keratometry values, corneal thickness and best-corrected visual acuity.
In practice, four stages are distinguished:
- Subclinical stage (frusta form) - no obvious symptoms, detectable only on Pentacam imaging; affects people with a positive family history or irregular astigmatism found during a glasses prescription check,
- Early stage - Early stage — slight but progressive astigmatism, mild deterioration of vision after dark, spectacle correction still effective; tthis is the optimal time to consider cross-linking as a progression-stopping procedure,
- Moderate stage - pronounced corneal irregularities, frequent changes in spectacle power, difficulty achieving full visual acuity with glasses; specialist contact lenses are often introduced at this stage,
- Advanced stage - significant thinning and distortion of the cornea, lack of effective ocular correction, in selected cases, more invasive procedures may be considered, up to and including corneal transplantation.
Keratoconus treatment
The choice of treatment depends on the stage of the condition, the thickness and shape of the cornea, the rate of change and the individual needs of the patient. In many cases, the aim of treatment is to halt the progression of the condition and, in selected cases, also to improve the quality of vision.
Cross-linking (CXL, Avedro KXL)
Cross-linking (CXL) is currently the primary and best-documented treatment for keratoconus. It aims to strengthen the corneal structure and halt the progression of the condition. The procedure involves a combination of riboflavin (vitamin B2) and controlled UV light, which increases the number of collagen bonds in the cornea, making it more stable and resistant to further deformation.
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Cross-linking does not correct refractive error, but can prevent it from getting worse.
The method most commonly used is:
- In patients with early or progressive keratoconus,
- when imaging studies (e.g. Pentacam) indicate corneal deterioration,
- as a preventive procedure to reduce the likelihood of more invasive treatment in the future.
At BLIKPOL in Sopot, we use the Avedro KXLsystem, which allows the procedure to be carried out precisely and safely.
Price list
Collagen cross-linking using the Avedro KXL II system. The price includes follow-up appointments up to one month after the procedure, eye drops and a sleep cover.
PTK - Therapeutic photokeratectomy
Excimer laser treatment
Up to one month after the procedure - PLN 0
More than one month after surgery - PLN 150
More than one year after surgery - PLN 250
FAQ
We will answer all your concerns.
Does atopic eyelid dermatitis contribute to the development of keratoconus?
Yes, atopic eyelid dermatitis can increase the risk of keratoconus. Frequent eye rubbing — associated with itching — weakens the structure of the cornea, which can lead to corneal thinning and deformation. Chronic inflammation and changes in tear film composition may also weaken corneal tissue. Patients with atopic dermatitis should avoid rubbing their eyes and have regular eye check-ups.
Does keratoconus lead to blindness?
Corneal cone (keratoconus) does not in itself lead to total blindness, but it can cause significant deterioration in visual acuity. In advanced cases of keratoconus, when the cornea becomes very thin and distorted, traditional methods of vision correction, such as glasses or contact lenses, may no longer be effective.
How long does the cross-linking procedure take?
Cross-linking (CXL) for keratoconus usually takes approximately 60–90 minutes. The process involves applying riboflavin (vitamin B2) drops to the eye, followed by controlled UV light exposure to stimulate collagen bonding in the cornea — strengthening it and preventing further deformation. After the procedure, a therapeutic contact lens is placed on the eye to protect it and support healing.
What causes keratoconus?
Keratoconus is a progressive condition involving thinning and protrusion of the cornea, which leads to irregular refraction and deterioration in vision quality. In advanced cases, if other treatments are unsuccessful, a corneal transplant may be required. Regular monitoring of the cornea by an ophthalmologist is essential.
Will treatment stop keratoconus permanently?
The aim of treatment is to halt or slow the progression of the condition. The outcome depends on the stage of the disease and individual factors.
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