Keratoconus often progresses over time, especially in teenagers and young adults, but the rate of change varies between individuals. In some people the condition appears to stabilise without formal treatment, particularly later in life.
Natural Course
Progression tends to be fastest in the early years after onset and then slows. Around middle age, many corneas become more stable because natural cross-links in the collagen increase with time.
- Spontaneous stabilisation can occur but cannot be relied upon
- Rapid change is more likely in younger patients
- Regular monitoring is essential to detect progression
Role of Treatment
Because future behaviour is hard to predict for an individual eye, corneal cross-linking is often recommended when documented progression is seen. This actively strengthens the cornea rather than waiting for natural stabilisation.
Monitoring
Serial measurements of vision, corneal curvature, and thickness help determine whether keratoconus is changing. Patients should seek review if they notice rapid prescription changes or worsening distortion.
