Keratoconus Symptoms, Treatments & Surgery in NZ: What Every Kiwi Needs to Know

Keratoconus is a progressive eye condition that affects the structure of the cornea, leading to visual impairment. For many New Zealanders, early detection and appropriate management can significantly improve outcomes. In this guide, we explore keratoconus symptoms, treatment options, and surgical interventions available in New Zealand.

What is Keratoconus?

Keratoconus is a condition where the normally round, dome-shaped cornea becomes thin and gradually bulges outward into a cone-like shape. This distortion causes irregular astigmatism and myopia (short-sightedness), significantly affecting vision.

Keratoconus typically appears during the teenage years or early twenties and may progress for 10–20 years before stabilising. The severity can vary from mild to advanced, with each stage requiring different forms of treatment.

Common Symptoms of Keratoconus

Identifying keratoconus early is crucial for managing the disease effectively.

Key symptoms include:

• Blurred or distorted vision: Especially in low light conditions.
• Increased light sensitivity: Glare and halos around lights at night.
• Frequent changes in prescription: Needing new glasses or contact lenses more often than usual.
• Double vision in one eye: Even when the other eye is covered.
• Ghosting or streaking of images: Particularly in later stages.

As keratoconus progresses, glasses often become less effective, and patients may require more advanced corrective measures.

 Diagnosing Keratoconus in NZ

Diagnosis typically involves a comprehensive eye exam by an optometrist or ophthalmologist.

Diagnostic tools used in New Zealand clinics include:

• Corneal topography: Maps the surface curvature of the cornea to detect irregularities.
• Pachymetry: Measures the thickness of the cornea.
• Slit-lamp examination: Evaluates the shape and structure of the cornea.
• Keratometry: Measures the curvature of the anterior corneal surface.

Early diagnosis is key to preventing severe vision loss and guiding patients to suitable treatment options.

Non-Surgical Keratoconus Treatments in NZ

1. Glasses and Soft Contact Lenses

In the early stages, vision can often be corrected using prescription glasses or soft contact lenses. However, as the condition progresses, these may become less effective due to increasing corneal irregularity.

2. Rigid Gas Permeable (RGP) Lenses

RGP lenses provide a smooth optical surface, compensating for the cornea's irregular shape. Many Kiwi optometrists offer RGP fittings for patients with moderate keratoconus.

3. Scleral and Hybrid Lenses

Scleral lenses vault over the cornea and rest on the sclera, offering stability and comfort for advanced cases. Hybrid lenses combine the clarity of RGP lenses with the comfort of soft lenses.

4. Corneal Collagen Cross-Linking (CXL)

CXL is the only treatment currently available that can halt the progression of keratoconus. It involves applying riboflavin (vitamin B2) drops to the eye and activating them with UV light. This strengthens corneal fibres, helping to prevent further bulging.

CXL is widely available in New Zealand and is recommended for patients with progressive keratoconus, particularly in their teens or early twenties.

Surgical Treatments for Keratoconus in NZ

When non-surgical treatments are insufficient, surgical options may be considered.

1. Intracorneal Ring Segments (ICRS)

ICRS (e.g., Intacs or Kerarings) are small, curved implants inserted into the cornea to flatten its shape and improve vision. They are typically used in moderate cases and can delay or prevent the need for a corneal transplant.

2. Corneal Transplant (Keratoplasty)

In advanced keratoconus, where scarring or thinning is severe, a corneal transplant may be required.

Two main types are performed in New Zealand:

• Penetrating Keratoplasty (PK): A full-thickness corneal transplant.
• Deep Anterior Lamellar Keratoplasty (DALK): A partial-thickness transplant that preserves the endothelium, reducing the risk of rejection.

Both surgeries have high success rates in NZ, with access to donor tissue through the New Zealand National Eye Bank.

3. Topography-Guided Photorefractive Keratectomy (TG-PRK)

This is a laser procedure used selectively to reshape the cornea and improve visual function in cases of stable keratoconus. It is often combined with cross-linking to maintain corneal integrity.

Managing Life with Keratoconus

Living with keratoconus requires ongoing care and regular monitoring.

Here’s what to keep in mind:

• Regular eye exams: Essential for tracking progression and adjusting treatment plans.
• Avoid eye rubbing: This can accelerate corneal thinning.
• Sun protection: Wear UV-blocking sunglasses to protect your eyes.
• Support networks: Connect with others through NZ-based keratoconus support groups or forums.

For those with advanced keratoconus, assistive technologies and low vision aids can significantly improve quality of life.

Keratoconus Care in New Zealand: Access and Cost

New Zealanders can access keratoconus diagnosis and treatment through both public and private healthcare providers. 

• Public system: Some treatments, such as corneal transplants and CXL, may be covered if clinically indicated. Wait times can vary.
• Private clinics: Offer quicker access and a broader range of lens options. Costs will depend on the treatment type and provider.
• Health insurance: Many policies cover surgical procedures and specialist consultations, though it’s important to check your specific policy.

When to See a Specialist

If you or a loved one is experiencing any symptoms of keratoconus or have a family history of the condition, it’s vital to book an appointment with an optometrist. Early intervention is the most effective way to protect your vision.

Curtis Vision’s team of optometry professionals are experienced in detecting and managing keratoconus and can provide referrals to leading ophthalmologists when surgical care is required.

Final Thoughts

Keratoconus is a complex but manageable condition when diagnosed early and treated appropriately. With access to advanced diagnostics, contact lens technology, and surgical options in New Zealand, patients have an excellent chance of maintaining good vision and quality of life.

If you suspect keratoconus or are seeking expert guidance, contact us to schedule a comprehensive eye assessment today.

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