Your cornea is supposed to be rounded. In people with keratoconus, it gradually thins and bulges outward into a cone shape, which changes the way light enters your eye and produces distortions that glasses and standard contacts often can’t fully correct.
Stephen Khachikian, MD, diagnoses and treats keratoconus for patients in and around Rapid City, South Dakota. Because the condition tends to progress slowly, many people don’t connect their symptoms to their cornea at all. Here are six signs Dr. Khachikian looks for that suggest something more than a routine prescription change might be going on.
Keratoconus blurriness has a different quality than that of typical nearsightedness. Images may look smeared, stretched, or wavy rather than simply out of focus, and the distortion tends to persist even with glasses on.
If Dr. Khachikian updates your glasses or contact prescription at nearly every visit without your vision stabilizing, that pattern is worth investigating. The cornea continues to change shape as the condition progresses, which means your correction struggles to keep up.
Rapid prescription changes are especially notable in younger patients, whose keratoconus tends to advance most quickly.
Keratoconus scatters light as it passes through the irregularly shaped cornea, which creates vision problems. Some examples include:
If you’ve started avoiding nighttime driving or squinting through well-lit spaces, let Dr. Khachikian know at your next visit.
Some people with keratoconus see a faint secondary image alongside the main one, a phenomenon called monocular diplopia.
Unlike double vision that disappears when you close one eye, this ghosting persists because it originates from the cornea’s irregular shape rather than how the two eyes work together. It tends to show up most when reading or looking at high-contrast images like text on a white screen.
Persistent irritation often triggers the urge to rub, but frequent rubbing puts mechanical stress on already-weakened corneal tissue and can accelerate thinning. If you find yourself rubbing your eyes constantly, it's worth mentioning to your doctor.
Eye rubbing is both a symptom of keratoconus and one of the factors that makes it progress faster.
Standard soft contacts sit on the surface of the cornea and conform to its shape. As keratoconus advances, the irregular contour makes it more difficult for soft lenses to fit properly. They may shift around, feel unstable, or stop correcting your vision adequately.
If you’ve worn contacts comfortably for years and are suddenly struggling to get a good fit, it’s a meaningful signal that your cornea's shape has changed.
Keratoconus tends to progress most actively during your teens and twenties, though it can develop at any age, and catching it early gives you the most options for slowing its progression.
Dr. Khachikian uses corneal topography and other specialized testing to map the surface of your eye and detect subtle shape changes that a standard exam might miss. If you’re experiencing any of these symptoms, call Stephen Khachikian, MD, at 605-203-4256 or schedule an appointment online.
