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Colour Blindness

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Kids’ eye health: understanding keratoconus

Having your child’s eyes checked regularly is essential to support their development and learning. At Dr. Sam Dhaliwal & Associates, we’re focused on helping families ensure that their children’s eyesight is healthy by offering a full range of pediatric services.

We recommend bringing your baby for their first visit at six months of age, then again around 3 years and before they begin school. Yearly visits throughout childhood can support optimal vision, although some children may require more frequent appointments with an optometrist.

Unfortunately, many parents discontinue regular vision checks if their child doesn’t require corrective lenses. Some conditions may not appear until later in a child’s development and can go undetected if they aren’t seen by an optometrist.

Keratoconus is an irregular astigmatism caused by a thinning cornea. The condition causes the eye to bulge outward in a cone-like shape and can cause blurred vision and sensitivity to light, among other symptoms. It’s not usually detected until a child reaches puberty, with typical onset between that ages of 10-25 years of age.

Because keratoconus is a progressive eye disease, early diagnosis is vital to prevent further degradation of your child’s vision. Although it’s a poorly understood condition, it affects about one in 2000 people, and there’s no cure. Catching it early can help us ensure your child’s eyesight isn’t unnecessarily compromised. There is no way to reverse the damage caused by keratoconus.

What to look for

Although you can’t prevent keratoconus, risk factors include a family history, rubbing your eyes vigorously, or experiencing frequent inflammation. Some conditions (like retinitis pigmentosa, Down syndrome, Ehlers-Danlos syndrome, hay fever, and asthma) can also increase the risk. The cause isn’t well understood but it’s believed to be a combination of both genetic and environmental factors.

Regular visits to see our optometrists can help identify risk factors and symptoms early, so that we can take measures to slow the progression of keratoconus. Your child might experience blurred vision, sensitivity to light or glare, or a sudden worsening or clouding of vision. Another indication may be the need for frequent eyeglass prescription adjustments. 

If your child is entering their teenage years and experiencing any distorted vision or concerns with their eyesight, book an appointment with one of our optometrists so that we can help support healthy vision for a lifetime.

How it’s diagnosed

We’ll begin your visit by ensuring that we have a complete and accurate medical history. If we are concerned about risk factors or symptoms of keratoconus, we may recommend specific tests to help us identify the condition.

A computerized image called a corneal topography can create a map of cornea curvature. Your cornea is the outer clear dome at the front of the eye, behind which lies the coloured iris. An astigmatism is when the cornea is not perfectly round, and typically remains stable. Keratoconus is an irregular and progressive astigmatism that eventually causes a visible bulge of the cornea, distorting vision. We regularly do mapping of the cornea right in our office to rule out keratoconus.

A slit-lamp exam can also identify abnormalities, and a pachymetry enables us to measure the thinnest areas of the cornea. It’s a painless and quick way to make an assessment if irregularities are suspected. Our optometrists can discuss these exams with you and your child in more detail.


While keratoconus can’t be cured, treatment options can help slow the progression of the disease and improve vision. That’s why regular eye exams and early intervention are key. Usually, both eyes will have some degree of keratoconus in affected individuals, although the severity may differ.

Early on, glasses or soft contacts may be sufficient to correct vision, but as the condition progresses, rigid contacts or scleral lenses are preferred. Scleral lenses are larger in size, covering the whites of eyes, and are more stable on the eye’s surface (which is particularly important for active teenagers). We’re one of only a handful of clinics in Alberta certified in EyePrint Prosthetics specialized scleral lenses and can work to ensure the best and most comfortable fit.  

In serious or significantly progressed cases, a corneal transplant may be considered. Our team works closely with a corneal surgeon in Edmonton. 

Another newer and non-invasive way to stabilize the progression of keratoconus is corneal collagen cross-linking. This treatment involves the application of a vitamin B solution which is activated by UV light. It can stimulate the formation of new collagen bonds, strengthening the cornea and preserving its shape.

Our optometrists can discuss the options with you and determine what’s best for your particular circumstances. Active individuals should carefully consider protective measures including lenses and helmets if participating in contact sports. Scleral lenses are often a suitable option to provide stable correction that stays put while being active.

Book your appointment

Our team of highly-trained optometrists are skilled at identifying risk factors and signs of eye abnormalities. Don’t neglect your child’s eyesight after early visits. Bringing your children regularly throughout their development and into their teenage and early adult years can help preserve their eyesight for years to come. Book online and come see us today!