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The first line of treatment for keratoconus is usually with rigid contact lenses, although some people with early keratoconus may be able to wear spectacles or soft contact lenses. There is a small risk of infection when wearing contact lenses and the risk becomes much greater if the lenses are not kept clean, so it is important to strictly follow the hygiene instructions given when the lenses are fitted.
Contact lenses do not, unfortunately, slow down the rate of progression of the cone, but they do give good vision during that period which could not otherwise be achieved. There is no medication available to treat the eye, but the condition does eventually stabilise, although it can take many years before that happens.
In about 10%-20% of keratoconus patients the cornea may become extremely steep, thin and irregular or the vision cannot be improved sufficiently with contact lenses. The cornea may then need to be replaced surgically with a corneal transplant or graft. Visual recovery after a transplant takes a long time – sometimes as long as 18 months – to settle down and there is a strong possibility that the eye will still need to be fitted with a contact lens afterwards in order to see properly. Surgery is therefore not a shortcut to perfect vision nor a way of avoiding contact lens wear. There is also a risk of the transplant rejecting afterwards, although over 90% of corneal transplants that are done for keratoconus are successful.
For patients of Moorfields Eye Hospital NHS Foundation Trust
If at any time your eye is uncomfortable or you think something is not right, do discuss it with your contact lens practitioner when you come to the clinic. If necessary, make an earlier appointment to attend the Trust or, in an emergency, the accident and emergency department is open 24 hours. Patients of the contact lens service can be seen in the department from 9am to 5pm Monday to Friday.
For more information, advice, or support, you can contact Moorfields Direct, our nurse-led helpline, on 020 7566 2345 (Monday to Friday 9am-4.30pm).
Further support is also available from:
The Keratoconus Group