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Is Keratoconus Genetic?

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A close up view of a person with Keratoconus in their eyes

Diagnosing Keratoconus

Many eye conditions and eye diseases can progress slowly, so many people don’t notice symptoms immediately. It’s crucial to see your optometrist regularly to protect your eye health and detect eye disorders like keratoconus. 

Regular comprehensive eye exams can help you and your optometrist keep a closer eye on changes to your eyes. The better we understand your eye health and any changes, the better we can prevent an eye emergency or vision loss. 

For patients with keratoconus, understanding the causes or risks can prevent the condition from progressing or developing harmful symptoms. 

What Is Keratoconus?

Keratoconus is a vision disorder affecting the quality and shape of the cornea, preventing light from entering the eye. The cornea is ordinarily dome-shaped, but keratoconus causes the tissue to thin and bulge outward like a cone.

When the irregular cornea cannot refract light, our vision quality is diminished. The eye condition can have similar vision impacts as refractive errors (also resulting from an irregular eye shape).

Minor vision changes caused by keratoconus can be corrected with prescription eyeglasses or contact lenses. However, keratoconus is a progressive condition, and vision can worsen with time. Regular eye exams can help assess vision changes and provide more up-to-date prescriptions.

Keratoconus is usually a bilateral condition (affecting both eyes), but each eye can develop with some variation. 

Symptoms of Keratoconus

The most common symptoms of keratoconus are:

Although less common, keratoconus can develop a tiny crack in the cornea due to swelling. The swelling can suddenly and significantly distort vision. However, the crack eventually heals, forming scar tissue and resolving the increased swelling.

Keratoconus can progressively worsen, typically for 10–20 years. Then, the condition tends to 

slow or stabilize.

Three males, each from a different generation lined up next to each other

The Genetics of Keratoconus

Research about keratoconus causes is still inconclusive about whether genetics play a significant role. However, 1 in 10 patients with keratoconus has a close relative with the eye disorder.

Studies attempting to understand the genetic causes of keratoconus typically focus on collagen structure. Collagen is a protein found in connective tissues and is responsible for:

Our bodies naturally make collagen. But when we experience collagen deficiencies, it can impact eye health, particularly the cornea and sclera

Other Causes of Keratoconus

In addition to shared family history, environmental factors and health conditions are linked to keratoconus. Other risk factors for keratoconus include:

Eye Rubbing

Aggressive eye rubbing weakens tissues with repeated corneal trauma. Knuckle rubbing, which uses the hardest parts of your hands, can be particularly abrasive.


Allergies can cause eyes to feel irritated and itchy, which increases how often you rub your eyes. Eye allergies can also cause:

  • Inflammation
  • Watery eyes
  • Light sensitivity
  • Burning sensation


Some research suggests medications for asthma may affect the cornea. Asthma can also cause inflammation, which may also impact corneal health. However, the link between asthma and keratoconus is still under review. There are too few studies to draw conclusive evidence.

Contact Lenses

Contact lens wearers touch their eyes more frequently. If the contact irritates the eye, it can lead to eye rubbing. Additionally, wearing contacts increases the risk of cornea damage, such as corneal ulcers or scratches.

Sun Exposure

UV radiation can damage our eyes, including the cornea. Notably, sun damage over time can weaken frontal eye tissue, making our eyes vulnerable to wearing thin.

Sleep Apnea

There is also a link between patients with sleep apnea and keratoconus, as both tend to rub their eyes more frequently. When floppy eyelid syndrome (FES) occurs alongside sleep problems, the strong correlation usually indicates patients should visit their optometrist for an eye exam.

Managing Keratoconus

Although there is no cure for keratoconus, there are ways to manage and treat symptoms of the condition. Some options include:

Keratoconus can affect individuals differently. Different levels of progression impact visual ability and eye health uniquely. Your optometrist will recommend a customized approach best for your comfort and eye health.

Contact Us for Supportive Eye Health

Understanding the overlapping causes of eye conditions and diseases can be challenging, as many have genetic and environmental factors. Although there’s much more we can learn about the background of keratoconus, many treatments and management options are available.

If you’re experiencing vision symptoms, visit us at the Perspective Eye Center. We can assess your eye health and recommend a personalized plan of action. Contact us for an appointment today!

Written by Dr. Stephen M. Gross

Dr. Gross earned his Bachelor of Science from the University of Alabama in 1977 and his Doctorate in Optometry in 1981. He is licensed in Alabama and holds a membership in the Alabama Optometric Association and American Optometric Association. Dr. Gross has more than 35 years of experience in the optometry field, and he specializes in specialty contact lenses, myopia control, Ortho-K, and scleral lenses.
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