Can Keratoconus Cause Blindness?

Treatment Options Before Surgery

Before turning to surgery, ophthalmologists use several non-surgical or minimally invasive treatments to help patients retain useful vision.

Specialty Contact Lenses

• Rigid Gas Permeable (RGP) lenses: Correct irregular astigmatism by creating a smooth refracting surface.
• Scleral lenses: Larger lenses that vault over the cornea and rest on the sclera (white of the eye). They are often the last non-surgical option before a corneal transplant, especially in end-stage keratoconus.
• Hybrid lenses: Combine a rigid center with a soft skirt for better comfort.

These specialty contact lenses often restore functional vision and improve quality of life.

Corneal Collagen Cross-Linking (CXL Procedure)

• The CXL procedure strengthens the cornea by using riboflavin (vitamin B2) drops activated with ultraviolet light.
• Its main purpose is halting progression of keratoconus rather than reversing it.
• When done early, CXL can prevent the disease from advancing to stages that require surgery.

Intacs (Intracorneal Ring Segments)

• Intacs are small, crescent-shaped plastic inserts placed within the cornea.
• They help flatten the cone, reduce distortion, and improve visual acuity.
• Often used in combination with CXL for moderate-to-advanced keratoconus.

Surgery for Keratoconus: Advanced Treatments

When lenses, CXL, and Intacs are no longer effective, patients may need surgery for keratoconus. The goal is vision restoration in cases of severe vision loss.

Corneal Transplant (Keratoplasty)

Keratoplasty—commonly known as a corneal transplant—is the ultimate solution for patients with advanced keratoconus.

There are different types:

• Penetrating Keratoplasty (PKP): A full thickness transplant where the entire diseased cornea is replaced with donor tissue.
• Deep Anterior Lamellar Keratoplasty (DALK): A partial thickness transplant where only the damaged front layers are replaced, leaving the patient’s healthy endothelium intact.

Both procedures aim to provide clearer vision, but DALK is often preferred when possible because it lowers the risk of graft rejection.

Outcomes and Vision Restoration

Most patients experience significant improvements in visual acuity after surgery. While not everyone achieves perfect eyesight, many regain the ability to work, study, and enjoy daily activities.

The success of keratoplasty makes blindness from keratoconus increasingly rare in modern practice.

Prognosis Today — Why Blindness Is Rare

In past decades, many keratoconus patients progressed to blindness or severe disability. Today, however, with:

• early diagnosis,
• CXL to halt progression,
• specialty contact lenses for visual rehabilitation, and
• advanced surgical techniques like DALK and PKP,

…the risk of total or even legal blindness has dropped significantly.

For patients in the Philippines, access to advanced keratoconus treatment is growing. Trusted centers like Shinagawa Lasik & Aesthetics provide world-class technology and skilled surgeons, ensuring patients receive the same high standard of care found internationally.

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