Close up portrait of young, attarctive, muscular man putting contact lenses in his eye over white background

Keratoconus is a chronic condition that affects the cornea; the transparent, dome like tissue located at the front of the eye. Keratoconus is characterised by progressive thinning and protrusion of the cornea. The protrusion of the cornea means it becomes an irregular, conical shape (like a traffic cone), as opposed to a regular, spherical shape (like a soccer ball). This unusual shape results in reduced vision.


Keratoconus is relatively common in New Zealand, estimated to occur in between 1 in 500 and 1 in 1000 of the general population. The condition usually develops in the early teenage years, followed by the disease getting progressively worse until age 30-40. The symptoms of keratoconus are non-specific; most patients simply experience blurry or fuzzy vision. In the earliest stages of keratoconus there may be no or minimal symptoms at all. Fortunately, a specialised imaging device called a corneal topographer, which maps the shape of the cornea, is used by the optometrists at Mortimer Hirst to detect keratoconus in these early stages. 


In the early stages of keratoconus, when the shape of the cornea is relatively normal, spectacles or soft contact lenses provide good vision. However, as the disease progresses and the corneal shape becomes more irregular, rigid (hard) therapeutic contact lenses are required to adequately compensate for the abnormal shape of the cornea. With proper care, regular replacement of the lenses as they degrade and regular eye exams to ensure the contact lenses do not compromise the health of your eyes; well-fitting contact lenses can provide lifelong visual rehabilitation for keratoconus.


Early detection of keratoconus is vital as if the condition is allowed to progress unchecked, the corneal shape can become too irregular for contact lenses to be worn safely and comfortably. Additionally in advanced keratoconus, corneal scarring can limit vision (often to the level of legal blindness). In these cases, transplantation of a human donor cornea is necessary and this occurs in about 20 percent of cases. Fortunately, a recently developed, relatively simple surgical procedure called corneal collagen cross-linking has been shown to stop or slow down disease progression and dramatically reduce the risk that a corneal transplantation is required. The clinical team at Mortimer Hirst work closely with Ophthalmologists (eye surgeons) in the public and private sector that perform corneal collagen cross-linking and corneal transplantation, so you can be assured that surgical options will be explored if required. 


All the members of our clinical team at Mortimer Hirst are highly experienced in fitting and maintaining the speciality contact lenses required for keratoconus. The history of contact lenses in New Zealand is very interesting and the founders of Mortimer Hirst were the first to use contact lenses in the country. In 1943 Gene Hirst accepted, with great success, a challenge made by an Auckland ophthalmologist to manufacture the first contact lenses in New Zealand for a patient with keratoconus. You can read more about the fascinating history of contact lens manufacturing at Mortimer Hirst on our home page. The technology used to fit and manufacture contact lenses has changed substantially since 1943, but one thing that has not changed is Mortimer Hirst’s commitment to being at the forefront of the developments in the assessment and management of keratoconus. We utilise the latest technology and research to provide you with the best possible eye care. These commitments from the clinical team include post-graduate study and research into keratoconus. 


Members of the clinical team teach contact lens fitting for keratoconus in the Bachelor of Optometry programme at the University of Auckland and have received scholarships for specialist training in the fitting of scleral lenses for keratoconus overseas. 


The clinical team at Mortimer Hirst can diagnose keratoconus, assess its severity and determine if it is progressing using the latest technology, and based on this, formulate a customised treatment plan that will provide visual rehabilitation so that keratoconus does not prevent you from doing the things you want to do. 



Words – Clinical Team at Mortimer Hirst