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Mr Manoj Mathai explains the facts and causes of Keratoconus

Published on 4th December 2017 by Mr Manoj Mathai

Surgeon Mr Manoj Mathai is often asked about the causes of keratoconus, and whether laser surgery is possible with the condition.

Keratoconus is a rare eye condition where the cornea (the clear dome-shaped window of the eye) progressively becomes thin and develops a cone shaped bulge with an irregular uneven shape. These changes in the shape and thickness of the cornea reduce the ability of the eye to focus a clear image.

Whilst spectacles and contact lenses will help correct vision in the early stages, the condition can worsen over time and patients may eventually require corrective surgery.

Who does it affect and what causes Keratoconus?

Keratoconus affects up to one in 1,000 people and usually develops in the teens or 20’s. Whilst the cause of keratoconus is unknown, genetic factors and allergies contribute to its development.

Can I have laser eye surgery if I have Keratoconus?

Mr Mathai explains, “Unfortunately not.  Keratoconus causes progressive thinning and protrusion of the cornea resulting in progressive myopia and irregular astigmatism. This condition is an absolute contraindication for laser vision correction. Performing laser eye surgery on someone with keratoconus will accelerate the weakening of the cornea and worsen the condition ‘’

Treatments options for keratoconus include:

    • Custom contact lenses - These different styles of contact lenses include custom soft, gas permeable and hybrid contact lenses. All are designed to replace the irregular shaped cornea with a smooth uniform surface that will help improve vision.
    • Corneal cross-linking (CXL) - This procedure strengthens the tissue of the cornea to stop the thinning caused by keratoconus
    • Corneal Transplant - In this procedure the damaged or scarred corneal tissue is replaced with healthy tissue from an organ donor.

For more information or advice about keratoconus, please contact Visualase here.


All eye surgical procedure carry a level of risk including not obtaining the desired outcome through carrying levels of visual loss. Your eye surgeon will discuss the risks and benefits including ones specific to your circumstances at the time of your preoperative consultation.