Scarring on the cornea Does a scar on the cornea in a keratoconus patient mean it is time for corneal transplant? Keratoconus we know can cause deterioration of vision due to the high nearsightedness and astigmatism brought about by the irregular corneal surface. You can imagine a road with a hilly peak. When keratoconus progresses, that peak can have scarring which makes the vision turn worse. Oftentimes patients would just see shapes and shadows and have difficulty recognizing images. At this time, it seems discouraging, but before jumping into the decision of a definite corneal transplant, why not try to have contact lenses fitted? In a more advanced condition, the contact lens of choice will be scleral lenses. Unlike small gas permeable lens which can pop out and be unstable in advanced cases, scleral lens vaults the entire cornea and so is stable and comfortable on eye. Scleral lenses make the cornea artificially smooth, allowing better quality of light r