Diagnosis of Keratoconus

Identifying moderate or advanced keratoconus is fairly easy. However, diagnosing keratoconus in its early stages is more difficult, requiring a thorough case history, a search for visual and refractive clues and the use of diagnostic equipment. Often, keratoconus patients have had several spectacle prescriptions in a short period, and none has provided satisfactory vision correction.

Keratoconus can result in extremely complex and variable topographical maps, most typically showing areas of inferior steepening. The cone can assume various shapes and sizes, and the apex can be at various locations in relation to the central cornea.


Keratoconus can be classified by cone shape, central keratometric reading, or progression. The simplest classification systems are based on keratometric reading or shape:

Based on severity of curvature

· Mild <48 D in both meridians

· Moderate 45-53 D in both meridians

· Advanced >53 D in both meridians

· Severe >55 D in both meridians

Based on shape of cone

· Small diameter (5 mm.); round shape; easiest to fit with contact lenses

· Large oval diameter (>5 mm.); often displaced inferiorly; more difficult to fit with lenses

· Largest diameter (>6 mm.); 75% of cornea affected; most difficult to fit with lenses

For more information visit Wikipedia.

For more information about keratoconus visit the American Keratoconus Association

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