Discover Effective Keratoconus Treatment Without Surgery – Your Path to Clear Vision


What is keratoconus?

Keratoconus is a condition associated with a young age group. If one is involved, there is a likely chance that the other eye will get involved in the next 16 years. Although it is a progressive disease however there are many options for keratoconus treatment without surgery as well as many surgical procedures are also available.

Keratoconus is the outward protrusion of the transparent outer coating of the eye that is cornea associated with thinning of the same. In many people it can be a congenital problem associated with other disease conditions. While in others, it can be an acquired condition.

keratoconus treatment without surgery

Keratoconus ICD 10

The ICD code designated for keratoconus as per WHO protocol is H18.6.


What are the symptoms of keratoconus?

The common symptoms of keratoconus include decreased vision and frequent change of glasses. Some patients may complaint of sudden decrease in vision with associated pain, redness and photophobia. It is related to the damage caused to the Descemet membrane of the cornea.

keratoconus Causes

What is the pathogenesis of keratoconus?

Keratoconus is one of the hereditary conditions however the main pathological process of keratoconus is the disruption of the structural integrity of the cornea by proteolytic enzymes. The constant rubbing of the eyes can also disrupt the integrity as well.

keratoconus vs Astigmatism

The conical protrusion of the cornea is associated with different types of astigmatisms. As the condition is progressive, so the patient will complaint of frequent change of vision in the glasses.

Stages of keratoconus

What is the classification of keratoconus?

There are different systems of classification of keratoconus depending on specific parameter.

  1. Based on keratometry it is classified as mild, moderate and severe.
  2. Based on morphology on topography it is classified as nipple cone, oval cone, globus, symmetric and asymmetric bowtie
  3. Amsler classification

associations of keratoconus

What are the ocular associations of keratoconus?

These includes

  • Vernal keratoconjunctivitis
  • Aniridia
  • Leber congenital amaurosis
  • Blue sclera
  • Ectopia lentis
  • Retinitis pigmentosa
  • Retinopathy of prematurity

What are the non-ocular associations of keratoconus?

These includes

  • Marfan syndrome
  • Ehler Danlos syndrome
  • Down syndrome
  • Mitral valve prolapse
  • Osteogenesis imperfecta

Keratoconus Treatment

What is the best treatment for keratoconus?

There are few options for keratoconus treatment without surgery, which includes the following

keratoconus treatment without surgery

Keratoconus glasses

In initial stages of the disease, glasses can be used as keratoconus treatment without surgery

Keratoconus contact lenses

  1. Mild case: in mild conditions soft contact lenses can be used to overcome the ongoing astigmatism
  2. Moderate cases: In moderate cases rigid hard contact lenses are used.

keratoconus treatment eye drops

Riboflavin 5´-phosphate ophthalmic solution is the only FDA-approved medication to treat the progression of keratoconus. It is a photoenhancer indicated for use with ultraviolet (UV) A exposure in corneal collagen cross-linking (CXL).


Keratoconus Surgery

When the progression of keratoconus is documented in six months period and there is increase in the refraction and astigmatism of 1.5 to 2 Diopter, surgical options are the most common treatment options.

1. Collagen cross linkage – CXL

It is one of the procedures used for stopping the progression of keratoconus. The indications include

  • Being intolerant to contact lenses
  • No scaring of the cornea
  • Corneal thickness more than 400 micrometer
  • Age more than 21 years

The procedure includes peeling off the epithelial layer of the cornea after topical anesthesia. The bare cornea is then applied with 0.1 riboflavin drops every 2 minutes until aqueous flare is obtained in the anterior chamber. When the eye is ready, irradiation with ultraviolet A rays is given at a distance of 5mm. The total energy level is 5.4 mW/cm3 for about 30 minutes. There are different protocols used for the whole process, however the mentioned procedure is the conventional procedure. After the procedure topical antibiotics and steroids are used and contact lens is placed for about 3 days.

2. Keratoconus surgery

When the corneal surface is scared, then the surgical procedure used is keratoplasty. Various types of keratoplasty can be done such as penetrating keratoplasty or deep anterior lamellar keratoplasty. The procedure involves removal of the diseased and scared cornea with a donor normal cornea for visual rehabilitation.


How much Keratoconus surgery cost?

The cost of keratoconus varies from country to country. In some countries their insurance plans where many surgical procedures are done cost free.

Can keratoconus can be cured?

Yes, keratoconus can be cured if the disease process is recognized on time.

Is keratoconus genetic?

Yes, keratoconus can be congenital but, in some conditions, it can be acquired such as vernal keratoconjunctivitis.

Is keratoconus a disability?

In advance condition where there is severe visual loss, keratoconus can become disability.


In conclusion, managing keratoconus is a multifaceted journey that involves understanding its symptoms, causes, and available treatments. From non-surgical options like specialized glasses and contact lenses to advanced surgical procedures such as collagen cross-linkage and keratoplasty, individuals have a range of choices based on the severity of their condition. Early detection and intervention are key to successful outcomes. As we navigate the complexities of keratoconus, it’s essential to seek professional guidance, undergo regular eye check-ups, and explore personalized treatment plans. With the right approach, individuals can effectively address this condition, ensuring clearer vision and an improved quality of life.

Dr Sadia Ayaz
Dr Sadia Ayaz

I am an ophthalmologist and eye surgeon

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