Managing keratoconus

Management of keratoconus is tailored to each patient, according to the stage of the disease, its progression and its impact on vision. It has two goals: to stabilize the cornea to prevent worsening, and to restore the best possible vision.

At the early stage, the goal is to correct vision and monitor theprogression. At more advanced stages, or when the disease progresses, stabilization and visual rehabilitation solutions are offered. Since each situation is different, it is the complete work-up that guides the choice.

• Glasses, sufficient at early stages to correct moderate astigmatism.
• Custom-fitted contact lenses (rigid lenses, scleral lenses…), which restore clear vision when glasses are no longer enough. Fitting these specialized lenses is an area of expertise of the practice.
• Stopping eye rubbing and treating allergies, essential at every stage.

When the disease progresses or vision is no longer sufficiently corrected, several techniques can be considered: cross-linking (CXL) to stabilize the cornea, intracorneal ring segments to improve its shape, or topography-guided PRK combined with cross-linking. These options are detailed on the page surgical treatments for keratoconus.

Keratoconus is managed over the long term. Regular follow-up makes it possible to adapt the management to each patient’s progression and to intervene at the right time. In very advanced forms, when other solutions are no longer enough, a corneal transplant may be necessary; it is then performed in a hospital setting, to which the patient is referred.