Keratoconus:
understand and manage it
Keratoconus is not a sentence. We explain what it is, how it progresses and what options exist to recover your vision — including scleral lenses, which work even in advanced cases.
What is keratoconus?
A progressive corneal disease that distorts vision and does not correct well with standard glasses.
The cornea is the transparent dome at the front of the eye. Normally it has a regular spherical shape. In keratoconus, the cornea thins progressively and deforms into a cone shape — shifted downward or toward the center.
This deformity creates irregular astigmatism: light does not focus at a single point, but scatters. The result is blurry, distorted, double vision with halos, especially at night — even with the "right" prescription glasses.
Keratoconus usually appears in adolescence or young adulthood and progresses until around 40-45 years of age, when it tends to stabilize. In some cases it progresses rapidly; in others slowly.
Symptoms to watch for
These signs don't always appear together. If you have two or more, it's worth getting a topography exam.
Frequently changing prescription
Glasses prescription changes from visit to visit and never fully stabilizes.
Halos and glare at night
Lights appear with halos or starbursts. Night driving becomes difficult.
Distorted or blurry vision
Straight lines appear wavy. Vision is blurry even with the "correct" prescription.
Better vision with one eye closed
Each eye sees differently. One is much more distorted than the other.
Intolerance to contact lenses
Standard soft contacts become uncomfortable or don't correct vision well.
Eye rubbing
Frequent rubbing — a known accelerating factor of keratoconus progression.
How is it detected?
Corneal topography: the essential test
Corneal topography is a painless, contact-free test that creates a detailed color map of the cornea's curvature. It's the primary tool for detecting and monitoring keratoconus.
A healthy cornea shows a symmetric pattern. Keratoconus shows an area of excessive curvature displaced downward — the "cone" — which is immediately recognizable on the map.
The test takes less than 5 minutes for both eyes. If you wear contact lenses, you'll usually be asked not to wear them that day (a few days for rigid lenses) to avoid temporarily distorting the corneal shape.
Standard eye exam is not enough: A visual acuity test measures how well you see but cannot detect the corneal shape. Only topography confirms or rules out keratoconus.
Stages of keratoconus
Classified using the Amsler-Krumeich system based on corneal curvature, thickness and visual acuity.
Stage I — Mild
Slight curvature. Vision correctable with glasses or soft toric lenses. Monitoring is key.
Stage II — Moderate
Increasing irregularity. Rigid or scleral lenses recommended. Cross-linking if progressing.
Stage III — Advanced
Significant curvature. Glasses are usually insufficient. Scleral lenses are the main option.
Stage IV — Very advanced
Possible corneal scars. Scleral lenses in many cases; corneal transplant in others.
Two different objectives
Understanding this distinction is key to making informed decisions.
🛑 Stop progression
Corneal cross-linking (CXL) is the only proven method to stop keratoconus from progressing. It strengthens corneal tissue using UV light and riboflavin. It doesn't improve existing vision, but prevents further damage. Recommended when the disease is still progressing — usually in younger patients.
👁️ Improve vision
Scleral lenses are the most effective option for recovering vision in keratoconus. They vault over the irregular cornea, creating a fluid chamber that acts as an optically perfect new cornea. They don't stop progression but achieve visual acuities that glasses cannot reach. Both strategies can be used together.
Management options
From least to most invasive. Not every patient needs all of them.
Where can I get keratoconus diagnosed and treated in Tijuana?
Ópticas Jarmar in Zona Urbana Río, Tijuana (David Alfaro Siqueiros #2795 local 101) offers corneal topography and scleral lens fitting for keratoconus with over 10 years of experience. Director Optometrist Jorge Aranda Tello specializes in keratoconus management and scleral lens adaptation. The team speaks both Spanish and English. WhatsApp: +52 664 579 1970.
Has keratoconus affected your vision?
Scleral lenses can recover visual acuity even in advanced cases. Schedule your evaluation — no commitment required.
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