Answer:

Keratoconus occurs when the cornea, the transparent front layer of the eye, gradually thins due to weakened small protein fibers (collagen) within the eye. This causes the cornea to deform, bulging forward into a cone shape instead of its normal, evenly curved form.

This condition typically affects both eyes, leading to double vision (diplopia), rapidly increasing myopia and astigmatism, or blurred vision even with correctly prescribed glasses. The disease progresses silently and can cause sudden vision loss, corneal scarring due to rapid corneal bulging, and even blindness if not treated promptly.

Comparison of a normal cornea (left) and a cone-shaped cornea (right). Illustration: Tam Anh General Hospital

Currently, no method can restore the normal shape and function of a cornea once it has become cone-shaped. However, early detection and timely treatment can control and halt disease progression, helping to preserve vision.

The current common and safe method is corneal cross-linking, which enhances corneal strength and helps restore vision. Doctors use eye drops containing riboflavin (vitamin B2) and ultraviolet A (UVA) light to strengthen the cross-links between collagen fibers in the corneal stroma, stabilizing the corneal structure. In severe cases where vision cannot be improved, the final solution is a corneal transplant.

Your child, diagnosed with 6 diopters of astigmatism due to keratoconus, requires a comprehensive examination to assess the progression, monitor corneal thickness, and evaluate its shape. Depending on the severity and condition, the doctor may recommend wearing prescription eyeglasses or rigid contact lenses (Ortho-K) for monitoring, or prescribe corneal cross-linking to prevent disease progression and avoid the risk of a future corneal transplant. Additionally, children should not rub their eyes, as this can rapidly deform the cornea and worsen the condition.

A corneal topography machine helps assess structure, thickness, and detect keratoconus. Illustration: Tam Anh General Hospital

Keratoconus often begins in adolescence and before the age of 30, with causes typically linked to congenital and genetic factors. Frequent and vigorous eye rubbing is one of the leading risk factors for developing or worsening the disease. If parents or relatives have keratoconus, children should undergo regular screening for the condition, starting from 10 years old or earlier if any abnormalities are observed.

Astigmatism can be a warning sign of keratoconus. If astigmatism is high, increases rapidly, or accompanies myopia, parents should take their child to an ophthalmology specialist at a hospital for corneal topography and corneal thickness measurement.

Dr. Duong Minh Phuc

High-Tech Eye Center

Tam Anh General Hospital, Ho Chi Minh City