Question 1

What is keratoconus?

Accepted Answer

Keratoconus is a progressive condition of the front of the eye (cornea) where it becomes thinner and weaker and changes from a round soccer ball shape to a pointed rugby ball/ cone shape. Keratoconus comes from the Greek words ‘kerato’ for cornea, and ‘konus’ meaning cone.
 
It often starts in the teenage years and progresses until the mid-late 20s. This is often due to eye rubbing and allergies. Allergies include hayfever, asthma and eczema.

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Question 2

Symptoms

Accepted Answer

The rugby ball/ cone shape of the cornea leads to blurry and distorted vision.
Other symptoms include:
 • Ghosting/ multiple images
 • Increased sensitivity to light/ glare at night
 • Frequent prescription changes to glasses and contact lenses

Question 3

Non-surgical treatment options for keratoconus

Accepted Answer

In the early stages or mild cases of keratoconus, glasses may provide adequate vision.

As the keratoconus progresses specialty hard contact lenses are required correct the vision as a medical device. These contact lenses are customised for the shape of the eye.

A Ministry of Health Contact Lens Subsidy is available to help with the cost of the lenses and appointment fee.

Medical Optometry

As keratoconus is often associated with allergies and eye rubbing, it is important to control these allergies.

Often this involves the use of anti-allergy eye drops and/or tablets.

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Question 4

Surgical treatment options for keratoconus

Accepted Answer

Corneal Collagen Cross-linking

The procedure is not a cure for keratoconus but is used to stop the keratoconus progressing. Cross-linking stabilises the cornea through the use of vitamin B2 (riboflavin) and UV light.
People often require the use of glasses or contact lenses following cross-linking.
This is available in public hospitals and privately. Our optometrists can refer you for this procedure if recommended.

Intacs/ Kerarings

Intacs or Kerrarings are small plastic semi-circular rings that are inserted into the cornea. The aim is to flatten and reduce optical distortion.  Results are variable and contact lenses and glasses may still be required following the surgery.

At present this is only available privately.

Corneal Transplant

In advanced, severe cases of keratoconus, a corneal transplant/ graft may be required.  This is required when contact lens fails to provide adequate vision or there is scarring on the cornea preventing good vision.

People often require the use of glasses or contact lenses following corneal grafts.

Frith and Laird do not offer surgical options but can assist in referring you to an ophthalmologist (either privately or publicly) if required.

Question 5

How much does it cost?

Accepted Answer

A contact lens subsidy is available from the Ministry of Health if you meet their criteria.

This covers most (sometimes all) of the cost of the lenses and appointments.

The optometrist will advise you if are eligible for the subsidy. You don’t have to do anything as we make the claim on your behalf.

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Question 6

Keratoconus at Frith and Laird

Accepted Answer

At Frith and Laird, we are contact lens experts and regularly fit contact lenses for keratoconus. All our optometrists are members of Cornea and Contact Lens Society (CCLS).

We have participated in keratoconus research (https://www.aaopt.org/detail/knowledge-base-article/aotearoa-research-keratoconus-ark-study-part-i-epidemiology-demographics-and-clinical)and our optometrist, Robert, teaches the contact lens clinic and keratoconus at the University of Auckland.

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