2219 York Road, Suite 102, Lutherville-Timonium, MD 21093
(410) 469-7111

Understanding Keratoconus - A Closer Look

Keratoconus is a progressive eye condition that significantly impacts the cornea, the clear, dome-shaped surface of the eye. This condition is characterized by a transformation of the cornea from its normal, rounded shape to a more conical form, leading to optical distortions. As the cornea adopts this irregular shape, individuals experience a range of visual disturbances, including blurred vision, increased sensitivity to light, the appearance of halos around bright lights, and noticeable glare, which can severely affect daily activities and quality of life.keratoconus-treatment

This gradual change in the cornea’s shape can distort the way light enters the eye, directly impacting one’s ability to see clearly. The result is not just a simple blurring of vision but a complex distortion that standard eyeglasses or contact lenses cannot easily correct. The progression of keratoconus can vary significantly among individuals, with some experiencing a rapid advancement in symptoms, while for others, it may evolve more slowly.

One of the most challenging aspects of keratoconus is its effect on vision, often leading to High Order Aberrations (HOAs). These aberrations can manifest as glare, halos, double vision, and overall blurry and distorted vision, making everyday tasks like reading, driving, and recognizing faces increasingly difficult. However, with the advent of the latest technology, there are now treatment options available that have proven to be highly successful in managing these symptoms. Our practice specializes in these cutting-edge treatments, offering hope and improved vision to those affected by keratoconus.

As one of our patients, Janet S. from El Salvador, shared, “Dr. Azman is without a doubt the most knowledgeable doctor I have seen in the 37 years I have had Keratoconus, providing me with many more years of comfortable vision when others could not.” This testimonial underscores our commitment to providing exceptional care and achieving remarkable outcomes for our patients with keratoconus.

Causes, Risk Factors, and Diagnosis of Keratoconus

Causes and Risk Factors:

The exact cause of keratoconus remains a subject of ongoing research, but it is believed to be a combination of genetic, environmental, and hormonal factors. A defect in the corneal collagen, which provides strength and shape to the cornea, is thought to play a significant role in the development of this condition. Excessive eye rubbing is a known risk factor, as the constant mechanical movement can weaken the corneal structure.

Other risk factors include a family history of keratoconus, indicating a possible genetic predisposition. Atopic diseases, such as eczema, asthma, and allergies, have also been associated with an increased risk of developing keratoconus. Additionally, certain demographic factors, such as age and ethnicity, may influence the likelihood of developing this eye condition.


Keratoconus typically begins with subtle changes in vision that cannot be adequately corrected with glasses or standard contact lenses. Early symptoms may include mild blurring and distortion of vision. As the condition progresses, individuals may experience more pronounced visual disturbances, such as increased sensitivity to light, glare, halos around lights, and difficulty with night vision. In advanced cases, the cornea may become significantly distorted, leading to severe visual impairment and, in rare instances, acute corneal hydrops, where a sudden swelling of the cornea occurs due to a tear in the Descemet’s membrane.


Advancements in diagnostic technology have significantly improved the early detection of keratoconus. Corneal topography and aberrometry are now standard tools in diagnosing this condition. These non-invasive imaging techniques map the surface of the cornea and the entire optical system, providing detailed information about the shape and irregularities of the cornea. The data generated from these tests help in identifying the presence and severity of keratoconus, even before significant symptoms appear.keratoconus-diagnosis

Specular microscopy is another valuable diagnostic tool, especially for examining the endothelium, the innermost layer of the cornea. This technique can detect early signs of corneal edema and other abnormalities that may not be visible during a routine eye examination. Early diagnosis is crucial for timely intervention and management of keratoconus, helping to preserve vision and prevent further progression of the disease.

Managing and Treating Keratoconus

Treatment Objectives: Enhancing Quality of Life through Vision Improvement

The overarching aim of our keratoconus management strategy is to significantly improve our patients’ quality of life by providing them with clear, crisp vision. Keratoconus, a condition that leads to the distortion of the cornea’s natural shape, can severely impact one’s ability to see the world as it truly is. This distortion results in a variety of visual aberrations, most notably High Order Aberrations (HOAs). HOAs are complex refractive errors that go beyond the common issues of nearsightedness, farsightedness, and astigmatism. They manifest as haloes around bright lights, blurred images, glare, ghosting, and double images, significantly complicating everyday visual tasks.

Our primary treatment objectives focus not just on halting the progression of keratoconus, but also on meticulously addressing and correcting these HOAs to restore high-quality vision. Early and proactive intervention is crucial in preventing further deterioration of the cornea and in maintaining or enhancing visual function. By leveraging the latest advancements in eye care technology, we aim to minimize and, wherever possible, eliminate/correct the HOAs, thus providing our keratoconus patients with the opportunity to experience the world through clear, undistorted vision.

To achieve these goals, we employ a comprehensive and personalized approach to keratoconus. This may include advanced contact lens technologies specifically designed to correct the corneal irregularities caused by keratoconus and innovative surgical options that offer new hope for those with advanced cases. Each patient’s treatment plan is tailored to their specific needs, focusing on reducing or removing the poor vision caused by keratoconus and improving their overall quality of life.

"From the first moment I tried on my new lenses, I knew it was the answer I had been searching for. They were super comfortable and I had a great vision. The inflammation in my eye resolved within 2 weeks. It was life-changing!"

In addition to employing state-of-the-art treatment modalities, we place a strong emphasis on patient education and support. Understanding the nature of keratoconus and the importance of ongoing management is vital for long-term success. Our team is committed to providing patients with the knowledge and resources they need to navigate their condition confidently.

Ultimately, our goal is to empower our patients with the ability to see the world more clearly, enabling them to lead more fulfilling lives without the constant challenges posed by keratoconus. Through personalized care, cutting-edge treatments, and a patient-centered approach, we strive to minimize the impact of keratoconus on our patients’ lives, focusing on enhancing their vision for a better quality of life.

Corneal Collagen Cross-Linking (CXL)

Corneal Collagen Cross-Linking (CXL) is a vital treatment in the management of keratoconus, particularly in its early stages. This minimally invasive procedure plays a crucial role in preserving vision and halting the progression of the disease. By applying riboflavin (vitamin B2) eye drops to the cornea and then exposing it to ultraviolet A (UVA) light, CXL strengthens the collagen fibers within the cornea, increasing its rigidity and stability. This reinforcement helps to maintain the cornea’s shape and prevent the characteristic bulging and thinning associated with keratoconus.

While CXL is effective in stabilizing the cornea and slowing the progression of keratoconus, it is important to note that some patients may still require vision correction after the procedure. In many cases, specialized contact lenses or scleral lenses are needed to provide optimal visual acuity. These lenses are designed to correct the irregularities in the corneal surface caused by keratoconus, offering clear and comfortable vision even after the corneal structure has been stabilized by CXL.

The combination of CXL and customized contact lens fitting is a powerful approach to managing keratoconus. By halting the progression of the disease with CXL and addressing the remaining visual aberrations with tailored lenses, patients can achieve significant improvements in their vision and overall quality of life.

It’s essential for patients to have regular follow-up appointments after CXL to monitor the cornea’s response to the treatment and to assess the need for vision correction with contact lenses. Our practice is committed to providing comprehensive care, from the initial diagnosis and treatment of keratoconus to the ongoing management of visual function with advanced contact lens solutions.

Corneal Collagen Cross-Linking (CXL) is a critical early intervention for keratoconus, offering hope for stabilizing the disease and preserving vision. While CXL addresses the structural integrity of the cornea, customized contact lenses or scleral lenses may still be necessary to correct residual visual distortions and provide patients with the best possible vision.

Specialty Contact Lenses: Precision Solutions for Exceptional Vision

For individuals with keratoconus, achieving optimal vision goes beyond just correcting nearsightedness or astigmatism. High Order Aberrations (HOAs) are a common challenge, leading to symptoms like glare, halos, and blurry vision. Specialty contact lenses, specifically designed for keratoconus, offer a way to minimize or even completely correct these aberrations, providing sharp and clear vision.

Keratoconus Scleral Lenses


Scleral Lenses: Scleral lenses are a cornerstone in the management of advanced keratoconus. These large-diameter lenses vault over the cornea, resting on the sclera, and create a smooth optical surface that corrects irregularities and HOAs. When designed and fitted properly, scleral lenses offer not only excellent vision but also superior comfort, making them a preferred choice for many patients with keratoconus.

PVR PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem): Similar to scleral lenses, PVR PROSE is designed to replace the ocular surface and provide functional vision for complex corneal conditions. Utilizing advanced imaging techniques like Optical Coherence Tomography (OCT), we obtain precise measurements down to the micron level to design a PROSE lens that perfectly matches the individual’s ocular surface. This level of customization ensures optimal vision correction and comfort, even in cases where traditional lenses fall short.

EyePrint PRO: For the most challenging cases, where standard and even custom-fit lenses are unable to provide adequate vision correction, EyePrint PRO offers a groundbreaking solution. This technology involves creating an impression-based mold of the cornea, capturing its exact contour and irregularities. The resulting lens is a perfect match to the eye’s unique shape, providing unparalleled vision correction and comfort. EyePrint PRO is especially beneficial in conditions where other options have failed, offering hope to those with the most difficult ocular surfaces.

Specialty contact lenses for keratoconus, including scleral lenses, PVR PROSE, and EyePrint PRO, are designed to address the unique challenges of each individual’s eyes. By minimizing or correcting HOAs, these lenses provide sharp, clear vision and enhanced comfort. Our practice is committed to utilizing the latest technologies and personalized fitting techniques to ensure that patients with keratoconus can achieve the best possible visual outcomes.

A Destination for Excellence in Keratoconus Care

At our practice, we are proud to serve as a leading destination for keratoconus care, attracting patients from across Maryland, Virginia, and beyond. Our commitment to providing the highest quality of care has made us a preferred choice for individuals seeking effective solutions for their vision challenges. From the bustling streets of Baltimore to the scenic landscapes of Virginia, our patients come from diverse backgrounds and locations, including cities such as Owings Mills, Pikesville, Towson, Hunt Valley, Harrisburg, Lancaster, Shrewsbury, York, Alexandria, Fairfax, Leesburg, Manassas, Reston, Tysons Corner, and Vienna.

Under the expert guidance of Dr. Benjamin Azman and Dr. Irwin Azman, our practice specializes in the diagnosis, management, and treatment of keratoconus and other irregular corneal conditions. With a deep understanding of the complexities of keratoconus, our team employs the latest advancements in eye care technology and personalized treatment approaches to achieve optimal outcomes for our patients.

Dr. Irwin Azman, a renowned specialist in the field of contact lenses for keratoconus, brings over four decades of experience to the practice. His dedication to staying at the forefront of research and development in keratoconus management has established him as a respected authority in the field. Dr. Irwin Azman’s contributions extend beyond patient care, as he actively engages in lecturing at vision conferences and publishing articles in professional contact lens journals.

Dr. Benjamin Azman, alongside his uncle and father, continues the legacy of excellence in eye care. Together, they ensure that every patient receives personalized attention and care tailored to their specific needs. Whether it’s through advanced contact lens fittings, innovative treatments like Corneal Collagen Cross-Linking (CXL), or comprehensive management plans, our goal is to provide each patient with the best possible vision and quality of life.

our practice stands as a beacon of hope for individuals with keratoconus and other corneal irregularities. With the combined expertise of Dr. Benjamin Azman and Dr. Irwin Azman, we are committed to delivering exceptional care and achieving life-changing results for our patients.

At our practice, we are more than just a destination for keratoconus care; we are a home for personalized, concierge-level service. Dr. Benjamin Azman and Dr. Irwin Azman lead a team that is deeply committed to working with each patient on a personal level. Our approach is not just about treating an eye condition; it’s about understanding the individual behind the eyes and their unique needs and aspirations.

This personalized care is the cornerstone of our success. By taking the time to listen and connect with our patients, we can tailor our treatments more effectively, ensuring that each person receives the most appropriate and effective care. Whether it’s through advanced contact lens fittings, innovative treatments like Corneal Collagen Cross-Linking (CXL), or comprehensive management plans, our focus is always on the individual.

Our commitment to a patient-centered approach means that we’re with you every step of the way, providing support, guidance, and expertise to help you achieve the best possible vision and quality of life. It’s this dedication to personalized, concierge care that sets our practice apart and makes us a trusted partner in the journey to better vision for those with keratoconus and other corneal irregularities.