Understanding Keratoconus

Keratoconus is a vision disorder of the eye in which the cornea (the clear front of the eye) becomes weaker and thinner, taking on a more cone-like shape than its normal dome-like curve. Patients with keratoconus gradually develop a progressively blurrier vision. Symptoms typically begin in the late teens or late twenties. Because the cornea bulging has an irregular shape, glasses and conventional soft contact lenses cannot provide clear vision.

Causes of Keratoconus

The exact causes of keratoconus are uncertain, but various studies have shown contributions of genetic, environmental, and cellular factors. The root cause is thought to be weakening of the fine structures that typically strengthen the cornea, which leads to bulging of the cornea in keratoconus.

Treatment for Keratoconus in Orange County, CA

  • In the early stages of keratoconus: glasses or soft contact lenses can correct mild astigmatism.
  • In moderate stages of keratoconus: rigid gas-permeable contact lenses (RGPs) provide a good level of vision correction but do not slow the progression of the condition. These lenses create a smooth front surface for the eye.
  • In advanced stages of keratoconus: In the past, when rigid contact lenses failed, the only other option for treating keratoconus was a corneal transplant. Corneal transplant is often needed in very advanced keratoconus when other treatments have failed. This procedure requires a recovery period of 6-18 months before a stable vision can be achieved. After recovery, many patients still require rigid contact lenses to see well.

Intacs Corneal Implants

Closeup of an Intacs Implant on the Tip of a FingerAn alternative to a corneal transplant is the insertion of FDA-approved corneal ring segments called Intacs. Made of tiny rings, Intacs are placed between the layers of the cornea to add structural integrity and improve the architecture of the cornea.

The segments push out against the curvature of the cornea, flattening the peak of the cone and returning it to a more natural shape. The procedure, carried out on an outpatient basis under local anesthesia, is reversible and is even potentially exchangeable. The recovery period is typically short.

The details of this procedure along with the risks, benefits, and alternatives will be discussed with you during your consultation. Contact us today to schedule an appointment with one of our cornea specialists.

The Intacs Procedure

  • Step 1: A small incision and a channel (tunnel) are made in the periphery of the cornea to a depth of approximately 80% of the corneal thickness using a precisely calibrated instrument with a blade made of diamond, a precise laser (femtosecond laser).
  • Step 2: Through this incision, the surgeon creates channels (tunnels) through the corneal tissue for the rings to be placed.
  • Step 3: The Intacs (two thin arcs of polymethyl methacrylate) are slid between the layers of the stroma on either side of the pupil before the incision is closed. When in place, these rings alter the cornea’s shape, creating a more normal surface contour.

A thorough eye examination by a corneal specialist is necessary to determine if an individual is a candidate for the Intacs procedure. Contact us today to schedule an appointment with one of our corneal specialists.


AvaGen™ is the genetic eye test that provides answers on your risk for keratoconus and other corneal diseases—helping you and your doctor make confident eye care decisions now.

The AvaGen™ test is unique because it’s:

  • Personalized: AvaGen™ uses DNA to accurately assess your individual genetic risk or likelihood of keratoconus, and determine if you have a corneal dystrophy.
  • Preemptive: As a genetic test, AvaGen™ relies on your DNA and not physical changes in your eye, so you may be tested before symptoms of keratoconus or corneal dystrophies occur, allowing for earlier detection and proactive management and treatment.
  • Painless: A DNA sample is simply taken from the inside of your cheek with a cotton swab.


Genetic eye conditions including keratoconus and corneal dystrophies are progressive, meaning they will get worse over time if left untreated. In the past, keratoconus and corneal dystrophy eye diseases could only be diagnosed by a doctor physically examining the shape and appearance of your cornea, meaning conditions often went undiagnosed, worsened over time, and permanently affected vision.

Now, AvaGen™ can help your doctor take immediate actions to help protect and preserve your vision or to evaluate treatment decisions, including whether or not you can undergo vision-correcting procedures such as LASIK.

With AvaGen™, you will have the peace of mind of knowing you’re doing the utmost to protect your vision.


The AvaGen™ test only requires a simple, in-office cheek swab to gather a sample of your DNA. The test is then sent to a special lab for analysis. After processing, your doctor will inform you of the results, answer questions, and discuss potential next steps.

Comprehensive genetic counseling sessions are available for patients who have undergone testing with the AvaGen™ genetic eye test. Genetic counselors are available to help you understand your genetic eye test results and implications for your family members.


  • You have a family history of certain corneal problems or corneal dystrophy, vision changes, or a family member who had a corneal transplant for unknown reasons.
  • Your doctor sees corneal thinning, or suspicious signs such as protein deposits on your corneas.
  • You have high or progressive nearsightedness or astigmatism.
  • You are considering refractive surgery such as LASIK.