Imagine waking up one day, opening your eyes and all the sudden everything looks blurry, you rub your eyes, blink several times, and that annoying glare is still there. Well, that’s what happened to me, or at least the way I remember it.
I was 25 and had been wearing eyeglasses for about 10 years due to a mild nearsightedness. This impromptu change in my vision called for an immediate visit to my ophthalmologist. After going through the routine checks he prescribes a corneal topography telling me that he suspects my condition being keratoconus. I was still confused and a bit shocked when he started explaining to me that keratoconus is a condition where the cornea starts thinning and bulges into a cone shape.
At that point at I wasn’t very concerned, I was confident or naïve enough to think it was going to be just some unusual progression of my current myopia, however, the two-page topography revealed a mild case of keratoconus.
My first reaction was to ask my doctor if Lasik was an option to fix it, he sat down and gave me an answer that made me realize the seriousness of this condition. He gave me a detailed explanation, but to put it in simple words his message was: there is no fix or cure, is not clear what causes it, progresses till about the age of 40, the rate of progression is different in every case, patients should stick to use eyeglasses if they provide a decent amount of correction, if eyeglasses are not good enough, next step is to utilize hard contacts (RGP – Rigid Gas-Permeable), the last option and worst-case scenario is cornea transplant.
Back in 2006-2007 the cause of keratoconus was believed to be mostly genetic, nowadays, studies have confirmed that there are other associated causes such as eye allergies, excessive eye rubbing and connective tissue disorders, but the underlying mechanism is still not fully understood. Back then, there were a couple of treatments in early stages of approval such as cross linking and the corneal ring, scleral lenses where not very common, all these options are now standard practice. Being a rare condition, affecting only 1/2000 people, there is very little awareness and it’s hard to find the right doctor.
Coincidentally, about the same time of my diagnosis, I had just met a guy that has keratoconus, he even had a corneal transplant, being able to talk to someone who understood the condition helped me a lot, he’s one of my best friends. When sharing our keratoconus experience, we concluded that my keratoconus was most likely caused by excess eye rubbing. I had been doing lap swimming almost daily the two years prior my diagnosis, I had poor fitted googles most of the time, leading to rubbing my eyes frequently.
I kept using eyeglasses and for the next twelve years, I had an annual topography to keep my condition in check. I was very fortunate that my keratoconus just progressed for a couple of years and then stopped. It wasn’t up until 2018 when I started trying contact lenses, started with traditional RPG’s but never adjusted to those, I ended up settling with semi-scleral.
I encourage everyone who reads this to make sure your children and teenage kids are not rubbing their eyes frequently or at all, be on top the annual eye checks and spread awareness of keratoconus. I’ve added some useful links with general information including the National Keratoconus Foundation (NKCF) website which has good resources for keratoconus patients.
Links
Corneal Topography – https://primaryeyecarect.com/services/corneal-services/corneal-topography
What is Keratoconus, what causes it, symptoms, and risk factors – https://www.hopkinsmedicine.org/health/conditions-and-diseases/keratoconus#:~:text=What%20causes%20keratoconus%3F,of%20collagen%20in%20the%20cornea.
Causes – https://www.aao.org/eye-health/diseases/keratoconus-cause
Rare Disease Database – https://rarediseases.org/rare-diseases/keratoconus/
Corneal Collagen Cross-linking and Keratoconus Treatment https://www.youtube.com/watch?v=IJAkW_xfqzE
Scleral lenses – https://www.contactlenses.org/scleral.htm
National Keratoconus Foundation (NKCF) – https://nkcf.org/
Daniel Rodriguez CLVO 
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