Keratoconus Treatments

Overview

What is keratoconus?

Keratoconus is an eye condition in which the cornea, or clear tissue covering the front of the eye, becomes weaker. As a result, the shape of the cornea changes from a normal gentle slope to a conical shape causing blurred and distorted vision. If you have keratoconus that can no longer be corrected with contact lenses, consider one of the many treatment options available to restore your vision.

Cost of keratoconus treatment

The cost of keratoconus treatment can range widely depending on the treatments chosen.

• Contact lenses: $55-95 per box (8 boxes/annual supply)
• Hard contact lenses: $75-325 per lens (2 lenses/annual supply)
• Hybrid lenses: $300 to $500 every 6 to 12 months
• Scleral lenses: $1,500 to $2,500 per lens
• Corneal collagen cross-linking: $2,500 to $4,000 per eye
  
• Corneal transplant: $13,000 to $25,000
• Intacs: $1,500 to $2,500 per eye

Is the cost covered by insurance?

Keratoconus treatments may or may not be included in your insurance coverage, and this depends on various factors:

• Type of Insurance: The kind of insurance you have is a key factor. Health insurance plans, whether they’re private, Medicaid, or Medicare, can vary in what they cover. Some policies encompass a broad range of eye-related treatments, while others may offer more limited coverage.
• Medical Necessity: Insurance companies often require documented evidence showing the medical necessity of keratoconus treatment for improving your vision and overall eye health.
• Type of Treatment: The specific keratoconus treatment can vary widely. It might involve prescription eyeglasses, contact lenses, procedures like corneal cross-linking, the use of Intacs (corneal implants), or, in more severe cases, corneal transplant surgery. Coverage can vary depending on the treatment method.
• Pre-authorization: Prior approval from your insurance company is usually required before going ahead with treatment. This entails submitting detailed documentation from the ophthalmologist, outlining the patient’s symptoms.

Insurance may cover all or a portion of the cost, however it is common for patients to have some out-of-pocket expenses, such as deductibles and co-pays. To learn more about insurance reimbursement requests visit the National Keratoconus Foundation website.

Symptoms of keratoconus

Some common symptoms and signs of keratoconus include:

• Progressive myopia (nearsightedness)
• Irregular astigmatism
• Distorted and blurred vision
• Glare and light sensitivity
• Sudden worsening or cloudy vision
• Frequent eyeglass prescription changes

How is it diagnosed

To diagnose keratoconus, an eye exam should be performed by an ophthalmologist or optometrist. Some of the tests they may use include:

• Eye refraction test
• Slit-lamp examination
• Keratometry test
• Computerized corneal mapping

Can it be reversed?

Unfortunately, keratoconus cannot be reversed, but it can be slowed down and stabilized with various treatments.

Keratoconus treatments

There are a number of different treatment options available. Your specific treatment will depend on the severity of your condition and how quickly the condition is progressing.

Lenses:

Mild to moderate keratoconus cases can be treated with contact lenses or eyeglasses.

• Eyeglasses or soft contact lenses. Used for correcting blurry or distorted vision in early keratoconus
• Hard contact lenses. Hard (rigid, gas permeable) contact lenses are typically the next step in treating more-advanced keratoconus. .
• Piggyback lenses. If rigid lenses are uncomfortable, your ophthalmologist may suggest “piggybacking” a hard contact lens on top of a soft one.
• Hybrid lenses. As an alternative to hard contact lenses, these have a rigid center with a softer ring around the outside for increased comfort.
• Scleral lenses. Useful for very irregular shape changes in your cornea in advanced keratoconus.

Surgery:

• Corneal Transplant
  • Penetrating keratoplasty. Surgeon removes a full-thickness portion of your central cornea and replaces it with donor tissue.
  • Deep anterior lamellar keratoplasty (DALK). This procedure preserves the inside lining of the cornea which helps avoid the rejection of the inside lining that can occur with a full-thickness transplant.
• Intacs: Thin, plastic, semi-circular rings surgically inserted under the surface of the cornea. When inserted they flatten the cornea, changing its shape.
• Corneal collagen cross-linking. This procedure involves an application of a riboflavin solution to the eye which is then activated with a UV-A light, causing new bonds to form within the collagen in the cornea. This method causes the cornea to strengthen, preventing the keratoconus from progressing.

These procedures are generally performed on an outpatient basis using anesthetic eye drops, sometimes accompanied by conscious sedation. Patients are awake during the procedure, but their vision is blurred.

The procedures usually take about an hour to perform and patients leave the eye doctor’s office the same day.

To learn more about keratoconus, visit the American Academy of Ophthalmology (AAO) website.

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