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Is your Optometrist geared to screen for Keratoconus & What’s important to know about Keratoconus progression?

Pieterse Optometrists focus on all kinds of ocular problems and it is shocking to see how often Keratoconus is missed and only detected in the late stages when vision presents to be poor with spectacles. It is a sad fact that often spectacles are given without the screening for Keratoconus by doing corneal topography.

Did you know that corneal topography can detect the presence of keratoconus  4-5 years before it effects the spectacle vision and that there is now a treatment available to stop progression of the corneal changes? Corneal Topography screenings are currently done at a small additional cost of R 180 to accommodate everyone.

It is crucial to screen for Keratoconus if there is a family member with Keratoconus, and children from the age of 6 years can be screened by doing corneal topography.

We are now sure that the inflammatory components of keratoconus are often caused by allergies and eye rubbing  which form part of the main driving factors causing the progression of Corneal changes.

Keratoconus can be broken down into the word “Kera” –which means cornea (front structure of the eye)  and “cone” which suggests a sharp cone structure. Keratoconus result from changes within the cornea, causing the structural fibres to weaken and changing its orientation.

Most untreated Keratoconus patients will present with a cornea that continues to thin, change shape over time and has inadequate spectacle vision.The keratoconic cornea might continue to thin even more and develop complication called a corneal hydrop which we often still see in South Africa. Hydrops occur when the cornea has thinned so much that the inner membrane tears leaking fluid into the cornea, causing great haze and permanent scarring affecting vision dramatically.

Luckily we have a new option to stop corneal changes and progression called corneal cross linking surgery. As mentioned cross linking will stop the progression of keratoconus but does not improve the vision. Early detection is key!

Most patients can also be fitted with the new option called scleral contact lenses. These scleral lenses gives great comfort and significant improvement of vision compared to spectacles. Scleral lenses is a specialised option and is certified as the number one choice for advanced keratoconus.

The main problem in South Africa is that most Keratoconus patients are detected far too late, since the general optometrist can miss the presence of corneal changes if the spectacle refraction is done without doing a corneal Topogrpahy screening. It is vitally important not to wait until your child has poor vision symptoms but to rather be pro active doing a corneal topography screening every 3 years.

Visiting an optometrist who focuses on speciality solutions for Keratoconus is important if there is keratoconus in the family. At Pieterse Optometrists Screening with corneal Topogrpahy for keratoconus is essential for detection and monitoring of progression over time.

If corneal cross linking is done at an early stage; it is possible to avoid the need for high prescription spectacles, corneal transplant surgery and even hard contact lenses all together.

For more information call the practice at 010 1003824 or send a email to

-written by Willem Pieterse –