Dr. Griffiths goes above and beyond in her care, making sure her patients feel comfortable and well-informed every step of the way. If you are looking for an outstanding ophthalmologist, look no further, Dr. Griffiths is fantastic!
Jagdish J
Keratoconus Treatment Options
How We Diagnose and Monitor Keratoconus
Accurate diagnosis and consistent tracking are the foundation of good keratoconus care. Our eye doctors use advanced imaging tools to detect even subtle corneal changes and guide every treatment decision.
Corneal topography is a painless computerized test that creates a detailed, color-coded map of your cornea's surface, revealing areas of irregular steepening or bulging. Advanced tomography systems go further, imaging both the front and back surfaces and producing precise thickness maps that give us a complete picture of corneal health. Comparing these maps over time allows us to determine whether your condition is stable, progressing, or responding to treatment.
Pachymetry uses ultrasound or optical scanning to measure how thick your cornea is at multiple points. This measurement is critical because keratoconus causes progressive thinning that we need to track closely, and corneal thickness also determines whether certain procedures are safe options for you.
- Identifies areas that have thinned to a potentially unsafe level
- Helps determine candidacy for corneal cross-linking
- Tracks whether thinning is progressing or has stabilized
A slit lamp exam uses a specialized microscope with a focused beam of light to examine the front of your eye in fine detail. Our eye doctors look for signs of keratoconus such as corneal scarring, stress lines called Vogt's striae, or a ring of iron deposits at the base of the cone. We may also assess your tear film, refraction, and contact lens fit to build a complete picture of your eye health.
We classify keratoconus into stages ranging from mild to severe based on corneal curvature, thickness, and best-corrected vision. Staging guides treatment recommendations and helps predict how your condition may evolve. If your keratoconus is actively changing, we typically schedule follow-up exams every three to six months. Once it stabilizes or after a stabilizing procedure, annual visits may be sufficient, though we will always repeat imaging to confirm that changes are not occurring.
Vision Correction with Lenses and Eyeglasses
For many patients, the primary goal is achieving clear, comfortable vision while protecting the cornea from further damage. The right lens option depends on how far your keratoconus has progressed and how much your cornea has changed in shape.
In the earliest stages, before the cornea has bulged significantly, standard eyeglasses can correct nearsightedness and mild astigmatism well enough for daily activities. As the condition advances, glasses become less effective because the irregular corneal surface creates distortion that a flat lens cannot fully neutralize. We will monitor your cornea at each visit and let you know when it is time to consider specialty contact lenses.
Some patients with mild keratoconus can wear specially designed soft contact lenses that are thicker than standard options and can manage mild irregular astigmatism. These lenses are more comfortable and easier to adapt to than rigid options, making them a reasonable starting point for patients new to contact lens wear. They tend to work best when the cone is small and corneal thinning is minimal.
Rigid gas permeable lenses, commonly called RGP lenses, are one of the most widely used contact lens options for keratoconus. The firm lens vaults over the irregular corneal surface while a layer of tears fills the space underneath, creating a smooth optical surface that corrects distortion far better than glasses or soft lenses. Our eye doctors custom-fit each lens to your unique corneal shape, and most patients adapt comfortably within a few weeks of consistent wear.
Scleral lenses are large-diameter rigid lenses that vault completely over the cornea and rest on the white of the eye, called the sclera, rather than on the sensitive cone itself. The reservoir of fluid behind the lens keeps the eye moist and provides sharp vision correction even in moderate to advanced keratoconus. We often recommend scleral lenses for patients who find smaller rigid lenses uncomfortable or who have very steep, irregular corneas that are difficult to fit with traditional options.
Hybrid lenses combine a rigid optical center with a soft outer skirt, offering the clarity of an RGP lens with some of the comfort of a soft lens. They work well for patients who need better vision than soft lenses provide but struggle to adapt to a fully rigid lens. Our eye doctors will evaluate your corneal shape and lifestyle to determine whether a hybrid lens is a good match for your needs.
Fitting specialty contact lenses for keratoconus is a detailed process that typically requires multiple appointments. We take precise corneal measurements, trial diagnostic lenses, and then order custom lenses based on how they align and perform on your eye.
- Plan for two to four visits to achieve the best fit and visual result
- Expect some initial awareness or mild discomfort as you adapt
- We will teach you proper insertion, removal, and cleaning techniques
- Follow-up visits confirm that your eyes stay healthy under lens wear
- Your prescription may need updating as your cornea changes over time
Corneal Collagen Cross-Linking to Stop Progression
Corneal collagen cross-linking, commonly called CXL, is the only proven treatment to slow or halt the progression of keratoconus by strengthening the cornea from within. We offer this procedure for eligible patients whose condition is actively changing and who still have enough corneal thickness to be treated safely.
During CXL, our eye doctors apply riboflavin (vitamin B2) drops to your cornea and then expose it to a carefully controlled beam of ultraviolet-A light. This activates the riboflavin and creates new chemical bonds between collagen fibers, making the corneal tissue firmer and more resistant to further bulging. Cross-linking does not reverse the cone shape or restore vision already lost, but it can reliably stop the condition from getting worse in many patients.
We typically recommend CXL for patients whose keratoconus has shown measurable progression on topography, thickness scans, or prescription tracking over a period of six to twelve months. The procedure requires that the cornea be thick enough to absorb the treatment safely, generally at least 400 microns at the thinnest point. Younger patients with actively changing corneas tend to benefit the most, and early intervention preserves more options down the road.
Patients with corneas that are too thin, heavily scarred, or already stable on their own may not be suitable candidates. Our eye doctors will review your full history and imaging before making any recommendations.
CXL is performed in an outpatient setting using numbing drops so you remain comfortable throughout. The thin outer layer of the cornea, called the epithelium, is gently removed to allow the riboflavin solution to penetrate deeply. After the cornea is saturated with riboflavin drops over about 30 minutes, ultraviolet-A light is applied for an additional period of time, depending on the protocol selected for your case.
The full procedure takes approximately one hour per eye, and most patients have one eye treated at a time. You will be awake and asked to look at a fixed light during treatment. We will discuss the specific approach best suited to your cornea, including whether a standard or accelerated protocol is appropriate.
Your eye will feel scratchy and sensitive to light for several days after CXL as the epithelium heals. A protective bandage contact lens is placed on your eye at the end of the procedure to improve comfort during this period. Vision is typically blurry for the first week and may continue to fluctuate for several weeks to months as the cornea heals and stabilizes.
- Expect mild to moderate discomfort for three to five days
- Use prescribed antibiotic and anti-inflammatory drops as directed
- Avoid rubbing your eyes and wear sunglasses to reduce light sensitivity
- Vision gradually improves over one to three months in most cases
- Most patients return to normal daily activities within one week
Following our instructions closely after CXL helps protect the treated area and reduces the risk of complications. We will prescribe antibiotic drops to prevent infection and anti-inflammatory drops to support healing. The bandage contact lens stays on for several days until the surface of the cornea has healed sufficiently.
- Avoid swimming and hot tubs for at least two weeks
- Wear sunglasses outdoors to protect against UV light and glare
- Do not wear contact lenses until we confirm the surface has healed
- Avoid eye makeup for the first week or as directed by your eye doctor
- Contact us immediately if you notice worsening pain, increasing redness, discharge, or sudden vision changes
CXL is considered a safe and effective procedure, but like any treatment, it carries potential risks that we will discuss with you in full before proceeding. The primary goal is stopping progression rather than sharpening vision, so most patients still need specialty contact lenses or glasses after the procedure.
- Temporary corneal haze that typically resolves over weeks to months
- Delayed surface healing that extends the recovery period
- Sterile infiltrates or infection requiring prompt treatment
- Risk of inner corneal cell damage in very thin corneas
- Possible reactivation of herpes-related eye infections in patients with a relevant history
Surgical and Procedural Treatments for Keratoconus
When contact lenses no longer provide adequate vision or when corneal shape needs to be addressed directly, procedural options can make a significant difference. Our team offers several in-office and surgical treatments depending on the stage and nature of your keratoconus.
Intacs are small, curved plastic ring segments surgically placed in the outer portion of the cornea to gently flatten the cone and reduce irregular astigmatism. By reshaping the cornea from within, Intacs can improve vision and make contact lens fitting easier for patients who struggle to achieve clear sight with lenses alone. This option is often considered for moderate keratoconus when other measures are no longer sufficient.
The procedure is performed under local anesthesia and involves creating small channels in the cornea where the segments are positioned. Recovery takes a few weeks, and we frequently combine Intacs placement with cross-linking to both reshape and strengthen the cornea at the same time.
- Intacs do not prevent progression on their own, so cross-linking is often recommended alongside them
- Glasses or contact lenses are usually still needed after the procedure
- Possible side effects include glare, halos, or inflammation
- Segments can be repositioned or removed if needed in select cases
Phototherapeutic Keratectomy, or PTK, uses a laser to remove damaged or irregular tissue from the surface of the cornea. It is used in keratoconus patients when there is surface scarring that reduces vision or contact lens tolerance. Superficial keratectomy involves manually removing abnormal surface tissue and is sometimes used to treat irregular corneal surfaces before other procedures.
Both approaches work at the surface level and are not intended to correct the underlying cone shape. They are most valuable when surface irregularities or scarring are a key contributor to poor vision or lens discomfort, and our eye doctors will determine whether either technique is appropriate based on your specific corneal findings.
Amniotic membrane tissue, derived from placental tissue, has natural anti-inflammatory and healing properties that support corneal recovery after procedures or during episodes of surface breakdown. We may use amniotic membrane treatment to promote healing after keratectomy procedures or to help manage corneal surface instability in keratoconus patients whose surface is compromised. This is a targeted adjunct therapy used in specific clinical situations, not a standalone treatment for keratoconus itself.
In advanced cases where keratoconus has caused severe scarring or thinning that cannot be managed with lenses or the procedures we offer, referral for corneal transplant surgery may be the appropriate next step. Transplantation is considered a last resort, typically reserved for patients who cannot achieve functional vision through any other means. Our eye doctors will guide you through this decision and connect you with a trusted specialist if that level of care is needed.
Living Well with Keratoconus
Managing keratoconus day to day involves more than appointments and procedures. The habits you develop at home play a real role in protecting your corneas and getting the most from your treatment.
Eye rubbing is one of the most damaging things a person with keratoconus can do. The mechanical pressure weakens the collagen structure of the cornea, accelerating thinning and bulging. Addressing the root cause of the urge to rub, whether it is allergies, dryness, or habit, is one of the most protective steps you can take.
Our eye doctors can help identify what is triggering your discomfort and recommend appropriate treatments such as allergy medications, lubricating drops, or cool compresses that relieve itching and irritation without harming your corneas.
Wearing quality sunglasses with full UV protection outdoors reduces glare and light sensitivity, which are common in keratoconus. Managing environmental allergens also helps reduce the urge to rub your eyes and keeps inflammation at a lower level overall.
- Wear wrap-around sunglasses year-round for maximum protection
- Keep windows closed during high pollen seasons
- Use air purifiers to reduce indoor allergens
- Take prescribed allergy medications consistently as directed
Specialty contact lenses require careful, consistent care to protect your eyes from infection and to extend lens life. Always wash your hands before handling lenses, use only the recommended solutions, and never rinse lenses with tap water or store them in anything other than fresh solution. Replace your lens case every three months and follow the replacement schedule your eye doctor provides for the lenses themselves.
If your eyes become red, painful, or produce discharge while wearing lenses, remove them immediately and contact our office. Never sleep in lenses unless we have specifically prescribed extended-wear options for you.
Your corneal shape can continue to shift gradually even after keratoconus has largely stabilized, which means your specialty lens prescription may need updating every year or two. Wearing an outdated prescription strains your eyes and delivers poor vision quality. If your lenses feel less comfortable or your vision seems less clear between scheduled visits, book an appointment rather than waiting for your next routine exam.
Frequently Asked Questions
These answers address common questions we hear from patients, with practical guidance to help you make informed decisions about your care.
There is currently no cure that returns the cornea to its original shape, though some patients experience partial flattening or stabilization following cross-linking. The focus of treatment is on stopping progression, preserving the vision you have, and keeping you in specialty lenses comfortably for as long as possible. Many patients manage their condition successfully for decades with the right combination of monitoring and treatment.
Without treatment, progressive keratoconus can lead to significant vision loss that interferes with reading, driving, and recognizing faces. Over time, the cornea may become so thin and scarred that even scleral or rigid lenses can no longer provide functional vision, and surgical referral becomes necessary. Early diagnosis and appropriate intervention dramatically reduce the chance of reaching that advanced stage.
Many people with keratoconus drive safely as long as their vision with correction meets the legal standard for driving. Night driving can be more challenging because of glare and halos around headlights, and some patients find it safer to limit driving after dark. If you are uncertain whether your vision is adequate for driving, we can assess your best-corrected visual acuity and provide guidance specific to your situation.
Specialty contact lens fittings and lenses for keratoconus are often covered at least partially by medical insurance because they are considered medically necessary, not cosmetic. Coverage for corneal cross-linking varies by insurer, though many plans now include it when documented medical necessity criteria are met. We recommend contacting your insurance provider in advance, and our team can also help clarify what to expect before you commit to treatment.
LASIK is not appropriate for people with keratoconus. The procedure removes corneal tissue to reshape the eye, which would further weaken a cornea that is already structurally compromised, potentially accelerating the cone and causing rapid vision loss. If you have been diagnosed with keratoconus or have signs of early corneal thinning, our eye doctors will never recommend LASIK, and we will explain which vision correction options are safe for you instead.
Progression is determined by comparing serial corneal topography maps, thickness measurements, and prescription changes over time, not by symptoms alone, since many patients do not notice gradual changes until they are significant. This is why consistent follow-up appointments are so important, even when you feel your vision is stable. If you notice faster-than-usual changes in vision, increased distortion, or more frequent prescription adjustments between visits, let us know so we can evaluate sooner rather than later.
Personalized Keratoconus Care at NewView Eye Center
NewView Eye Center has been caring for patients with complex eye conditions across Northern Virginia since 1999, and our team brings deep experience in every stage of keratoconus management, from early diagnosis and specialty lens fitting to corneal cross-linking, Intacs, and advanced surface procedures. We take the time to understand your vision goals, explain your options clearly, and build a care plan that fits your life. If you have been diagnosed with keratoconus or have concerns about your corneal health, we invite you to schedule a consultation with our team and take the first step toward protecting your sight.
What our Patients Says
Explore More
Find more information about our doctors, services, and technology that keep your eyes healthy and your vision at its best.
When to Start Corneal Cross-Linking and Why Timing Matters
What to Expect During Corneal Cross-Linking
Keratoconus: Causes, Symptoms, and Treatment Options
Signs and Symptoms of Keratoconus
Keratoconus Progression: How Fast Does It Get Worse?
Keratoconus and Astigmatism: Why Your Vision Keeps Changing