Your cornea is the clear, dome-shaped surface at the front of your eye. It plays a key role in focusing light so you can see clearly. A regular cornea is smooth and evenly curved, allowing light to focus properly on the retina (the back of your eye).
An irregular cornea means that the shape or surface of your cornea is uneven or distorted. This can cause blurred, wavy, or double vision because light doesn’t bend evenly as it enters the eye. It can be caused by several different conditions or events, including:
- Keratoconus (a progressive thinning and cone-like bulging of the cornea)
- Scarring from infections, injuries, or past surgeries
- Post-surgical changes, like after LASIK or RK
The good news is: there are many ways to manage an irregular cornea, depending on the underlying cause and how it’s affecting your vision. These can include specialty contact lenses, corneal cross-linking, or—in more severe cases—surgical options.
These pages will help you understand:
- What can cause irregular corneas
- What symptoms to watch for
- What treatments are available
What Is Keratoconus?
Keratoconus is a condition where the normally round cornea gradually becomes thinner and bulges into a cone-like shape.
Causes
While the exact cause is unknown, keratoconus is believed to be linked to:
- Genetics (it sometimes runs in families)
- Frequent or vigorous eye rubbing
- Certain medical conditions like allergies or connective tissue disorders
Symptoms
Keratoconus usually develops slowly over several years. Early symptoms might include:
- Blurry or distorted vision
- Increased sensitivity to light
- Frequent changes in glasses or contact lens prescriptions
In later stages, vision may worsen significantly, especially at night or while reading.
Management
Treatment depends on the severity and progression:
- Glasses or soft contact lenses may help early on.
- Specialized contact lenses (like scleral or rigid gas permeable lenses) are often needed later for clearer vision.
- Corneal Cross-Linking (CXL) is a procedure that strengthens the cornea to stop further thinning and progression.
- In advanced cases, corneal transplant surgery may be needed.
Regular check-ups are important to monitor the condition over time.
What Is Corneal Scarring?
Corneal scarring happens when the cornea develops a spot or area of cloudiness. Depending on its location and severity, a scar can interfere with how light enters the eye and cause vision problems.
Causes
Scarring can result from many different things, including:
- Injuries or trauma to the eye
- Severe dry eye
- Contact lens overuse or misuse
- Surgery or complications from eye procedures
- Infections or inflammatory eye diseases
Symptoms
Symptoms vary based on the scar’s size and location, but may include:
- Blurry or hazy vision
- Glare and light sensitivity
- Ghosting or double images in one eye
- Dryness or eye discomfort
If the scar is off to the side, it may not cause any noticeable symptoms.
Management
Treatment depends on how much the scarring is affecting vision and daily function:
- Lubricating eye drops can help relieve dryness or irritation.
- Specialty contact lenses can improve vision by masking the irregular surface.
- Laser procedures like PTK (Phototherapeutic Keratectomy) may be used to smooth or remove superficial scars.
- In advanced cases, corneal transplant surgery may be needed.
An eye specialist can help determine the best approach based on your individual condition.
What Is Post-Surgical Ectasia?
Post-surgical ectasia is a complication that can occur after vision correction procedures like LASIK or Radial Keratotomy (RK). It happens when the cornea becomes thinner and begins to bulge outward. Though it shares features with keratoconus, ectasia happens after surgery, often months or years later.
Causes
The exact cause isn’t always clear, but post-surgical ectasia is usually linked to:
- Thinning or weakening of the cornea due to surgery
- Pre-existing corneal irregularities that weren’t detected before LASIK or RK
- Higher levels of correction during surgery
- Younger age or underlying eye conditions
With RK (a procedure mostly done in the 80s–90s), long-term weakening of the cornea may show up decades later.
Symptoms
- Blurry or distorted vision – even with glasses or contacts
- Eye strain or frequent changes in prescription
- Double vision
- Fluctuating vision throughout the day
- Glare or halos, especially around lights at night
- Increased light sensitivity
Management
There is no “cure,” but treatment can often significantly improve your vision and quality of life:
- Specialized contact lenses
- Corneal cross-linking (CXL)
- In some cases, topography-guided Photorefractive Keratectomy (PRK)
- In advanced cases, corneal transplant surgery may be needed.
Irregular corneas–whether due to keratoconus, corneal scarring, post-surgical ectasia–can significantly affect visual quality and may not be fully correctable with standard glasses or soft contact lenses. These conditions often involve progressive changes to corneal shape and clarity, which is why early diagnosis and appropriate intervention are essential.
This article is designed to provide a foundation for understanding your diagnosis and available treatment options. If you have not already done so, we recommend a consultation with a corneal specialist or contact lens practitioner experienced in irregular corneas. Coordinated care can help preserve your vision, stabilize progression, and improve day-to-day functioning.
For additional support and clinical guidance, refer to the resources listed below.
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Support and Resources
Connect with others and stay informed:
Keratonconus/Post-Surgical Ectasia
Corneal Scarring/Post-Surgical Ectasia
For assistance finding a scleral lens specialist, visit: https://sclerallens.org/find-a-specialist/