Keratoconus is a vision disorder that occurs when the normally round cornea (the front part of the eye) becomes thin and irregular (cone) shaped.  Hereditary with One in 10 keratoconus sufferers has a close family relative with the disorder. In India 1 in 2000 cases incidence is recorded. Usually the disease process starts at the age of 5-6 and rapidly progresses in teen age. But progression follow ups to be done till late 30’s. Frequent eye rubbing, especially aggressive “knuckling”, history of asthma, allergies is a risk factor. Suspicion should arise when frequently glasses are changed and glasses are not improving the vision completely.

Corneal topography and pachymetry are used to diagnose the condition and its progression .Eyeglasses or soft contact lenses may be used to correct early stages of keratoconus. Corneal cross-linking surgery is indicated after diagnosis to stabilize the structure of the cornea and slow down the progression. As the disorder progresses and cornea continues to thin and change shape, rigid gas permeable contact lenses can be prescribed to correct vision adequately. In most cases, this is adequate.  In a few cases, a corneal transplant may be necessary. However, even after a corneal transplant, eyeglasses or contact lenses are often still needed to correct vision. Apart from full thickness corneal transplants lamellar procedures like DALK warranties better prognosis. Recently Bowman layer transplantation to strengthen the cornea and stop further progression has been done in advanced stages.