Q. Is surgery necessary for keratoconus?

Answered by
Dr. Asha Juliet Barboza
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 15, 2022 and last reviewed on: Dec 02, 2022

Hello doctor,

My friend visited an ophthalmologist for itchy eyes and slightly blurry vision. She has been diagnosed with keratoconus and acute allergic conjunctivitis in both eyes. I have attached the reports and the scans. The doctor has recommended a surgical procedure for the keratoconus. I wish to seek a second opinion on the surgery requirement and other suitable advice for the patient. Kindly help.



Welcome to

I read your query and can understand your concern.

I looked at her corneal topography report (attachments removed to protect the patient's identity).

Certain factors need to be considered in her case. But please note that as I have not examined her on the slit lamp biomicroscope, I can only give you feedback based on her history and the scans you sent.

1. If she has keratoconus, it tends to stop progressing around 35 yrs of age.

2. Her pachymetry (corneal thickness) is 500 micrometer plus in both eyes. We might recommend surgery if it is below this level.

3. Her keratometry in the right eye is above 50 mm, which might make us suspect keratoconus. Her left eye is below that range.

4. I recommend surgery only if there is a progression of astigmatism. Ideally, I would call my patient for a follow-up every three to six months and evaluate if there is any drastic change in her power.

5. She has a history of allergic conjunctivitis. Usually, these patients rub their eyes frequently, which can cause warping of the cornea, hence astigmatism. So, she needs to stop doing that.

My recommendation would be to wait. Then, let her repeat the scan after six months.

My questions are, has her power changed in the last six months, and is her allergic conjunctivitis under control?

Awaiting your reply.

Thank you and take care.

Hello doctor,

Thank you for the reply.

Her power has not changed in the last six months. And she has been having this issue for a considerably long time. During her earlier visits to a clinic, she was told that the irritation was due to pollution and was prescribed some eye drops. Only now, when her vision became blurry, she visited this eye hospital.



Welcome back to

I read your query and can understand your concern.

She will likely have to continue using Olopatadine eye drops indefinitely as it is a preventive measure for allergic conjunctivitis. As I said, unless I examine the status of the cornea, I cannot confirm for sure. But let her get re-examined after six months.

I hope this helps.

Thank you and take care.

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