If your glasses no longer seem quite right, letters have a faint shadow, or lights look more scattered at night, it is worth finding out why. These can be signs of keratoconus, a condition in which the cornea, the clear front surface of your eye, thins and changes shape. Some people still see well with glasses in the early stages of keratoconus, so symptoms alone cannot tell you if you have it. 1
To diagnose keratoconus, we combine an eye examination with scans of your cornea’s shape and thickness. These include corneal topography and tomography. Comparing reliable scans over time helps us check whether the condition is changing. 2 At Vision Camberwell Optometrists in Melbourne’s inner east, we explain what your results mean and help you understand the next step.
Contents
What are the early signs of keratoconus?
Changes worth having checked include:
- Blurred or distorted vision, even with your current glasses.
- Ghosting or shadow images around text and objects.
- Increasing glare, halos or difficulty seeing clearly at night.
- Repeated changes in your glasses prescription, particularly astigmatism.
- Increased sensitivity to light or one eye seeing noticeably less clearly.
These symptoms can have other causes, including ordinary prescription changes or dry eye. Keratoconus often becomes apparent in adolescence or young adulthood, but age alone cannot rule it out. It usually affects both eyes unevenly, so the better eye can mask changes in the other. 1
Who should consider keratoconus screening?
Let us know if keratoconus runs in your family, if you rub your eyes often, or if you have ongoing eye allergies. These details help us decide whether you would benefit from corneal screening, even if your vision seems fine. 1
Eye rubbing has been linked with keratoconus in a systematic review involving researchers from the Centre for Eye Research Australia (CERA) and the University of Melbourne. That association does not mean rubbing alone caused your condition. If your eyes itch, ask us about managing the irritation so you are less tempted to rub them. Having a risk factor is a reason to discuss screening, not a diagnosis. 3
How is keratoconus diagnosed?
We start by asking what you have noticed and how your vision has changed. We then assess your prescription, examine your eyes and interpret your corneal scans together. A single number or coloured patch on a scan does not tell the whole story. 2
Vision testing and eye examination
We check each eye separately and measure how clearly you can see with the best glasses prescription. Using a microscope called a slit lamp, we look closely at your cornea for thinning, scarring and other signs. These signs may be absent in early keratoconus. 6
Corneal topography: mapping surface curvature
Corneal topography creates a map of the curve at the front of your eye. It helps us spot uneven steepening and irregular astigmatism. Because early changes do not always show clearly on this map, we consider it alongside our other findings. 2
Corneal tomography: examining shape and thickness
Corneal tomography gives us a more complete picture of your cornea’s front and back surfaces and how its thickness varies. This helps us assess subtle changes. You may also hear the term pachymetry: it simply means measuring corneal thickness and can be part of the same scan. 2
Interpreting the results together
We explain whether your results show keratoconus, need monitoring or suggest another cause. Contact lens wear can temporarily change corneal shape, while other conditions, such as pellucid marginal degeneration, can also produce irregular maps. If the result is borderline, we may need to repeat the scans or arrange further assessment before giving you a firm answer. 2,6
How do we know if keratoconus is progressing?
To find out whether keratoconus is getting worse, we compare your results over time. Your first scan gives us a starting point. At later visits, we look for meaningful changes in corneal shape and thickness alongside your vision and prescription. Small differences can reflect measurement variation, so a changed number does not automatically mean deterioration. 5
Younger age and steeper corneas are associated with greater progression risk. A systematic review of 11,529 eyes supports closer follow up for higher risk patients. 4 We will recommend review intervals based on your results and risk of change. Children, teenagers and anyone with suspected progression may need to return more regularly than a routine annual visit. If your vision changes in the meantime, get in touch rather than waiting for your next appointment.
What happens after diagnosis?
If you have keratoconus, we will discuss both how to help you see more clearly and whether treatment is needed to protect against the condition advancing. Glasses or specialised contact lenses, including rigid gas permeable (RGP) and scleral lenses, can improve vision. Corneal crosslinking has a different purpose: it aims to slow or stop disease progression. 5
Vision Camberwell Optometrists provides ongoing monitoring and specialty contact lens care, and works with ophthalmologists when surgical assessment is needed. Read our keratoconus treatment guide for the next steps, or explore our keratoconus care overview.
Your keratoconus assessment in Camberwell
Whether you have just been told you might have keratoconus or are looking for a clearer explanation of changing vision, we can help you work through the next steps. Your assessment includes vision testing, an eye health examination and corneal imaging suited to your individual needs. We will talk you through the results, including anything that needs another look, and discuss monitoring, vision correction or an ophthalmologist’s opinion where appropriate.
Before your appointment:
- Bring your current glasses, contact lens details and any previous prescriptions or corneal scans.
- Tell us about previous crosslinking, eye surgery, allergies and family history of keratoconus.
- If you wear contact lenses, ask whether to leave them out before scanning. The advice depends on your lens type and the purpose of the assessment.
Vision Camberwell Optometrists is at 784 Burke Road, Camberwell, serving patients from Melbourne and nearby areas such as Hawthorn, Balwyn, Kew, Canterbury and beyond. Consultations with Jue Wang are available in English and Mandarin.
To arrange an assessment, call 03 9882 5666 or contact our team. Mention suspected keratoconus or changing astigmatism when booking.
Questions about keratoconus symptoms and testing
Does astigmatism mean I have keratoconus?
No. Having astigmatism does not mean you have keratoconus. If it keeps changing, becomes irregular, or your glasses no longer give you clear vision, it is worth checking the shape of your cornea. 6
Can a routine eye test detect keratoconus?
An eye test can pick up signs that need investigating, but early keratoconus may need corneal scans to become apparent. Tell us if your vision has changed or someone in your family has keratoconus, so we can choose the right tests for you. 6
Can I check for keratoconus at home?
Not reliably. An online vision test or a look in the mirror cannot confirm or rule out keratoconus. If one eye seems less clear than the other, tell us about it. An examination and appropriate scans are the way to find out what is causing the difference. 6
Is keratoconus painful?
Keratoconus usually affects how you see rather than causing pain. However, sudden loss of vision, a painful eye or new cloudiness at the front of your eye needs same day assessment. A complication called acute corneal hydrops can cause swelling, and other urgent eye problems can cause similar symptoms. Do not wait for your routine appointment if this happens. 5
References
- Bui AD, Truong A, Pasricha ND, Indaram M. Keratoconus Diagnosis and Treatment: Recent Advances and Future Directions. Clinical Ophthalmology. 2023;17:2705-2718. doi:10.2147/OPTH.S392665.
- Ambrosio R Jr, et al. Multimodal diagnostics for keratoconus and ectatic corneal diseases: a paradigm shift. Eye and Vision. 2023;10:45. doi:10.1186/s40662-023-00363-0.
- Sahebjada S, et al. Eye rubbing in the aetiology of keratoconus: a systematic review and meta-analysis. Graefe’s Archive for Clinical and Experimental Ophthalmology. 2021;259(8):2057-2067. doi:10.1007/s00417-021-05081-8.
- Ferdi AC, et al. Keratoconus Natural Progression: A Systematic Review and Meta-analysis of 11,529 Eyes. 2019;126(7):935-945. doi:10.1016/j.ophtha.2019.02.029.
- Deshmukh R, et al. Management of keratoconus: an updated review. Frontiers in Medicine. 2023;10:1212314. doi:10.3389/fmed.2023.1212314.
- Abou Said AG, et al. Strategies for Early Keratoconus Diagnosis: A Narrative Review of Evaluating Affordable and Effective Detection Techniques. Journal of Clinical Medicine. 2025;14:460. doi:10.3390/jcm14020460.
Reviewed by Dr Shonit Jagmohan, B.Optom (Hons), FIAOMC, IACMM, Ophthalmic Medicines Prescriber, Fellowship Chair for the International Academy of Orthokeratology and Myopia Control (Oceania). Last reviewed October 2026.
Visit us in Camberwell
T. (03) 9882 5666
E. vision@visioncamberwell.com.au
Find Us at:
784 Burke Rd, Camberwell
Victoria 3124, Australia
Opening Hours:
Monday, Tuesday and Friday. 9am – 6pm
Wednesday. 9am – 5pm
Thursday. 10.30am – 7.30pm
Saturday. CLOSED
Book your appointment with one of our friendly team members today
T: (03) 9882 5666
Serving Camberwell and the Surrounding South Eastern Suburbs
An independent practice in Camberwell since 1951, we are experts in keratoconus and specialty contact lenses. We welcome keratoconus patients from Hawthorn, Deepdene, Surrey Hills, Balwyn, Kew, Canterbury, Box Hill, Glen Iris, and across greater Melbourne.
