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Keratoconus is a condition in which the cornea, the clear front window of the eye, gradually thins and bulges into a cone shape, distorting vision. It used to be described as rare. A systematic review and meta-analysis published in the journal Cornea pooled studies from around the world to estimate how common it really is.

What the review included

The researchers searched three major medical databases up to January 2024 for studies of keratoconus in all ages, sexes, and regions. They included 55 studies, 53 of them in the combined analysis.

Key findings

• Prevalence: about 289 per 100,000 people overall (roughly 1 in 350), though the range of estimates was wide.
• New cases: about 4 per 100,000 people per year.
• Age: the 20 to 29 age group had the highest prevalence (about 526 per 100,000) and the highest rate of new diagnoses.
• Sex: men had slightly higher odds than women.
• Region: estimates were highest in studies from Africa and in West and South Asia, and lowest in East Asia.
• Over time: reported prevalence and incidence increased, with the highest prevalence in studies after 2020.

The authors estimate that more than 23.7 million people worldwide have keratoconus. Some of the increase over time likely reflects better detection with modern corneal mapping, and the wide confidence ranges mean the numbers are estimates, not exact counts.

What this means for families

• Keratoconus often starts in the teens and twenties. Blur that keeps changing, frequent prescription changes, astigmatism that increases, or ghosting of images are reasons to ask for corneal topography.
• Close relatives of someone with keratoconus may benefit from a screening scan.
• Eye rubbing is a well-known risk factor; treating itchy allergies helps.
• Early diagnosis matters because management options, from glasses and specialty contact lenses to corneal procedures, depend on the stage.

For more eye-health reading, see moorparklasik.com.

Source: Global Incidence and Prevalence of Keratoconus: A Systematic Review and Meta-Analysis (Cornea (PubMed), 09/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Benzalkonium chloride, or BAK, is a common preservative in multi-dose eye drops. Laboratory studies have suggested it can harm corneal nerves, depending on the concentration and how long it is used. A substudy of a randomized trial, published in 2026 in the Romanian Journal of Ophthalmology, asked whether six months of BAK at the concentration used in artificial tears is linked to detectable changes in the cornea’s subbasal nerve plexus in people with dry eye.

What was compared

This was a secondary, imaging analysis from a six-month, randomized, single-masked trial. The two drops had the same active ingredient, 0.15% sodium hyaluronate. One was preserved with 0.005% BAK; the other was preservative-free. Both were used as needed. Of 43 people who completed the trial, 32 had in vivo confocal microscopy of the central cornea at the start and at six months: 19 on the preservative-free drop and 13 on the BAK-preserved drop. Seven nerve measurements were analyzed with mixed-effects models that included both eyes.

What they found

• Baseline characteristics and all baseline nerve measurements were comparable between groups.
• Over six months, no nerve parameter showed a statistically significant difference in change between the two drops.
• For corneal nerve fiber density, the change in the BAK group was 3.52 fibers/mm² higher than in the preservative-free group, but the 95% confidence interval ran from -2.32 to 9.37 and was not statistically significant.

The authors noted that this design avoids a common problem in glaucoma research, where the active glaucoma drug can confound the effect of the preservative. They also said the estimates are imprecise and that the study cannot prove the two drops are equivalent. In short, this small imaging substudy did not detect a between-group difference in corneal nerves after six months, and it should not be read as a green light or a ban on preserved tears. If you use artificial tears many times a day, or you already have a vulnerable ocular surface, it is still reasonable to discuss preservative-free options with your eye doctor.

Source: BAK-preserved hyaluronate and corneal nerves (Romanian Journal of Ophthalmology (PubMed), 2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Type 2 diabetes can affect more than the retina. A systematic review and meta-analysis published in 2026 in Frontiers in Endocrinology looked at the cornea’s inner cell layer, the endothelium, across different stages of diabetic retinopathy and lengths of disease.

How the review was done

The authors followed PRISMA and MOOSE guidelines (PROSPERO CRD420261473313) and searched five databases from inception through July 15, 2026. They included cross-sectional studies that compared endothelial cell density (ECD), the coefficient of variation (CV, a measure of cell-size irregularity), and the percentage of hexagonal cells (HEX) in people with type 2 diabetes versus controls, or between diabetes subgroups. Twenty-two studies, covering 5,878 eyes, were included. Quality was graded with an AHRQ checklist.

What they found

• Compared with controls, people with type 2 diabetes had significantly lower endothelial cell density, higher cell-size variation, and a lower percentage of hexagonal cells.
• Eyes with diabetic retinopathy had lower density, higher variation, and fewer hexagonal cells than diabetic eyes without retinopathy.
• There were no significant differences between proliferative and non-proliferative retinopathy.
• Diabetes lasting 10 years or more was associated with lower cell density and a lower percentage of hexagonal cells.

The authors cautioned that several of these estimates were sensitive to individual studies or to possible publication bias, so the results should be interpreted carefully. They suggested that a preoperative look at the endothelium may be beneficial in people with diabetes, especially those with retinopathy or a long duration of disease. This review did not study any specific corneal implant or surgical technique, and it does not mean that every person with diabetes will have a problem with the cornea. If you have diabetes and are being evaluated for eye surgery, it is reasonable to ask whether the endothelium has been checked.

Source: Corneal endothelial changes in type 2 diabetes mellitus: a systematic review and meta-analysis with subgroup comparisons by diabetic retinopathy status and disease duration (Frontiers in Endocrinology (PubMed), 2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

The cornea is one of the most nerve-rich tissues in the body. Those nerves do more than sense touch; they help keep the corneal surface healthy. Neurotrophic keratitis is a degenerative corneal disease caused by impaired corneal nerve function. BostonSight’s chief medical officer called it a stubborn disease with a high risk of vision loss.

About this report

This news is based on a news release from BostonSight, which provides PROSE treatment, and a poster presented at the ARVO 2026 meeting by authors including BostonSight’s chief medical officer.

What PROSE is

PROSE is a custom-made scleral device: a large, rigid lens that vaults over the cornea and holds a reservoir of fluid against it. The idea is to protect the surface and keep it constantly moist so it can heal.

What the study reported

• The retrospective study reviewed records from November 2008 to September 2023 for 87 eyes of 87 patients with neurotrophic keratitis across all severity stages.
• Severity is graded with the Mackie classification, which uses three stages based on exam findings.
• After PROSE treatment, average Mackie stage and average visual acuity both improved significantly.
• On average, eyes reached their lowest (best) stage in about 31 days.

The trade report noted that the release did not describe comparison treatments, confidence intervals, or adverse events.

What this means for patients

A look-back study without a comparison group cannot prove PROSE works better than other options. Still, the results support scleral devices as one tool to consider. Care is individualized, and PROSE devices are fitted through PROSE treatment providers.

What to do

If you have been diagnosed with neurotrophic keratitis, or a corneal sore is slow to heal, ask your eye doctor whether a cornea specialist and a scleral device evaluation make sense for you. For more plain-language reading on eye health, see 1800realdoctor.com.

Source: PROSE treatment improves Mackie stage in neurotrophic keratitis in study (Optometry Times, 07/31/2026 (based on a BostonSight news release)). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

People with keratoconus often describe their eyes as tired, gritty, or irritated, not only blurry. Some of that discomfort may come from specialty lenses, but researchers have also wondered whether the eye surface itself is different in keratoconus. A systematic review and meta-analysis published in October 2026 in Frontiers in Medicine pulled together the available studies.

What the researchers did

A team in Changsha, China, searched four databases through September 1, 2026, for studies comparing people with keratoconus to people without it. They looked at symptom scores on the Ocular Surface Disease Index (OSDI), tear breakup time measured with dye and without dye, tear production (Schirmer test), and dry eye diagnoses. Seven studies qualified, with 359 people with keratoconus and 333 controls.

What they found

• Symptom scores were clearly higher in keratoconus, by about 19 points on the OSDI, and this finding held up in sensitivity checks.
• Tear breakup time with dye was shorter on average, but the difference was not statistically significant.
• All three studies that measured tear breakup time without dye found lower values in keratoconus, but the data could not be pooled reliably.
• Tear production results varied from study to study.

The authors’ cautions

The number of studies was small, and they measured things in different ways. The authors called for larger, multicenter studies with standardized tear testing.

What this means if you have keratoconus

If your eyes feel uncomfortable, you are not imagining it, and it is worth bringing up. Eye-surface problems can make lenses harder to wear and may lead to more rubbing, which is linked to keratoconus.

• Mention dryness, burning, or lens intolerance at your visits, not only blur.
• Ask whether your lens fit, solution, or wearing schedule could be adjusted.
• Preservative-free artificial tears and lid care may help; ask what fits your situation.
• Avoid rubbing your eyes, and treat allergies that make you want to rub.

Keratoconus care is provided by cornea specialists and specialty-lens fitters. For more plain-language reading on eye health, see best-lasik-surgeon.com.

Source: Ocular surface symptoms and tear-film parameters in keratoconus: a systematic review and meta-analysis (Frontiers in Medicine (PubMed), 10/15/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Healio Optometry reported that the FDA has warned about contaminated and counterfeit eye drops being sold in the United States. Contaminated drops can cause serious eye infections, and in past outbreaks some people have lost vision. Here is how to protect yourself.

Why this matters

Eye drops go directly onto the surface of the eye. If they contain bacteria or fungi, or are not made under proper conditions, they can cause painful infections. Counterfeit products may look almost identical to real brands, so it can be hard to tell the difference.

How to buy eye drops safely

• Buy from reputable pharmacies and well-known retailers.
• Be cautious about very cheap drops from unknown online sellers.
• Check that the seal is intact and the packaging looks professional.
• Check FDA recall notices if you are unsure about a product.
• Never let the bottle tip touch your eye, fingers, or any surface.
• Throw away drops after the expiration date or as directed after opening.

Special concern for keratoconus patients

People with keratoconus often use lubricating drops daily, especially with rigid or scleral lenses. Some have had corneal procedures such as Intacs. A thinner or treated cornea is especially important to protect from infection, so using safe, trusted products matters even more. Ask your eye doctor which drops to use with your lenses.

Warning signs of an eye infection

• Increasing pain or redness
• Discharge
• Light sensitivity
• Blurry vision

If you notice these after using any eye drop, stop using it and seek eye care right away.

Keratoconus care at Khanna Vision Institute

Khanna Vision Institute helps keratoconus patients with evaluation, specialty lens guidance, and treatment options. We serve Los Angeles, Beverly Hills, Westlake Village, and Thousand Oaks.

More eye-health articles at Laser Vision Cost.

Source: Contaminated, counterfeit eye drops being sold in US, FDA warns (Healio Optometry, 10/22/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

The History of Intacs Refuted

Multi-focal lenses deliver optimal distance and near vision to lessen the demand for glasses. The INTACS lenses are occasionally so effective an upcoming corneal transplant might be significantly delayed or might not even be needed in any way. They are basically reshaping the curvature of your cornea which is the part that is responsible for clear vision. They can be removed although they are usually placed in the eyes with the intention of not removing them later on. These lenses may also be utilised to restore vision after cataracts. Scleral lenses cover a bigger section of the sclera, whereas semi-scleral lenses cover a more compact area. Because fitting a gas permeable contact lens on a cone-shaped cornea can occasionally be uncomfortable for somebody with keratoconus, some eye care practitioners advocate piggybacking” two different forms of contact lenses on an identical eye.

Our eyes are among the most sensitive pieces of our whole body and thereby are definitely the most vulnerable to danger. More than 200,000 patient eyes are treated with the system outside america prior to FDA approval, as stated by the corporation. If you’ve distorted vision, it’s the opportunity to observe a great optometrist! Your vision is potentially the most important sense you’ve got. Very good vision is dependent upon a spherical cornea. You rely on good vision to secure you through every facet of your day.

Total cure hasn’t yet been found. Once diagnosed, treatment depends upon the phase of the disease. Early treatment is the secret to receiving the best results, as damage that has already occurred cannot be reversed. Keratoconus treatment usually is dependent upon glasses and soft contact lenses in the key stages.

Some patients might even be in a position to see well enough to return to simply wearing glasses. In case the patient wishes to get the Intacs removed, most frequently the cornea will return to its preceding curvature with time. Keratoconus patients that are not able to use contact lenses are advised to find INTACS lenses. Your health care provider may also provide you with some medication to assist you relax.

The process only takes around 15 minutes per eye, but intend to be at the surgery center for one hour or two. The genuine procedure for Intacs takes about thirty minutes. The surgery is designed to be permanent, but the Intacs can be removed if needed. This type could be treated by cataract surgeries, which could completely cure the issue. In some instances, refractive surgery may be required. If you decided that you will need an Atlanta lasik eye surgery, The Diamond Vision Laser Center is the proper place at which you will get premium quality service and will be confident your wellbeing and your eyes are in the correct hands. The Holcomb C3-R procedure is one that ought to be considered even in the early phases of Keratoconus to help preserve the present vision.

A comprehensive eye test is imperative to decide on the specific cause of the status. A preoperative exam will figure out whether a patient can undergo Intacs eye surgery for a treatment for myopia or keratoconus. Whether you are in need of a routine eye exam, treatment for eye infections, or another eye related issues, we are here in order to provide help.