Are there eye drops that treat keratoconus?

No. No eye drop strengthens the cornea, flattens a cone, or halts keratoconus. Drops manage the ocular surface \u2014 dryness, irritation and allergic itch \u2014 which is worth doing, but it is symptom management rather than treatment of the disease. Anything sold as a drop that treats keratoconus is making a claim the evidence does not support.

What are the best eye drops for keratoconus?

It depends on what is actually bothering you. For dryness and irritation, a preservative-free artificial tear. For itch, an antihistamine or mast-cell stabiliser prescribed for allergic conjunctivitis \u2014 which matters more than it sounds, because itch drives rubbing. For lens wearers, only preservative-free saline goes in the bowl of a scleral lens. There is no single best drop, and the right one follows what your ocular surface exam shows.

Can eye drops stop keratoconus getting worse?

Not directly. The only treatment shown to halt progression is corneal cross-linking. But there is an indirect route worth taking seriously: if an allergic itch is making you rub your eyes, treating the allergy reduces the rubbing, and eye rubbing is the most consistently reported association in the keratoconus literature. That is not the same as a drop treating keratoconus, and it is still worth doing.

What about riboflavin eye drops?

Riboflavin drops are used during cross-linking, where they are applied in a controlled clinical setting and activated with ultraviolet light. They are not a take-home treatment, and riboflavin on its own does nothing to the cornea without the UV step. Vitamin B2 supplements and over-the-counter riboflavin drops do not cross-link a cornea.

Should I avoid any eye drops with keratoconus?

Be wary of redness-relief drops, the ones that promise to get the red out. They work by constricting blood vessels and tend to produce rebound redness when you stop, which encourages more frequent use. They treat the appearance rather than the cause. If your eyes are persistently red, that is worth having looked at rather than masked.

Can I use eye drops while wearing scleral lenses?

Some, with rules. Only preservative-free saline goes inside the bowl of the lens before insertion \u2014 that fluid sits against your cornea all day. Preservative-free artificial tears can generally go over the top of the lens during wear. Preserved drops are a different matter, and medicated drops need to be timed around lens wear rather than dropped in over a lens. See drops compatible with scleral lenses .

Eye Drops For Keratoconus: What They Can And Cannot Do

Start with the part that saves you money: no eye drop treats keratoconus. Nothing you can buy or be prescribed will strengthen the cornea, flatten a cone, or stop the disease progressing. If a product claims otherwise, that claim is not supported.

That is not the same as saying drops are pointless. They have a real role in keratoconus — it is just a different role from the one most people are searching for. This page sets out what drops genuinely do, the one indirect way they may help the disease itself, and what to steer clear of.

Why no drop can treat keratoconus

Keratoconus is a structural problem. The collagen scaffolding inside the cornea weakens, the tissue thins, and the shape gives way into a cone. Vision blurs because the surface light passes through is no longer regular.

Drops act on the surface of the eye — the tear film, the epithelium, the inflammatory environment sitting on top. They do not reach into the corneal stroma and rebuild collagen, and nothing applied as a drop at home has been shown to.

The only treatment shown to halt progression is corneal cross-linking, which works precisely because it does something a drop cannot: riboflavin is driven into the stroma and then activated with ultraviolet light to form new bonds. That combination is the active part, and it happens in a clinical setting.

Which leads to a question we get often.

Riboflavin drops are not a home treatment

Because riboflavin is the drop used during cross-linking, riboflavin drops and vitamin B2 supplements get sold as a do-it-yourself alternative.

They are not one. Riboflavin without the ultraviolet activation step does nothing structural to the cornea. The drop is a photosensitiser — it is there to make the light work, not to work by itself. Buying riboflavin and putting it in your eyes is not a scaled-down cross-linking.

What drops genuinely help with

Dryness and irritation

Keratoconic corneas are frequently uncomfortable, and specialty lens wear can add to that. A preservative-free artificial tear is the sensible default — preservative-free because keratoconus patients tend to use drops often, and preservatives applied repeatedly to an already irritated surface can make things worse rather than better.

A comfortable surface is not cosmetic here. It affects how well a lens sits, how long it stays comfortable, and how clear your vision is by the afternoon.

Allergic itch — and this one matters more than it sounds

Here is the part that usually does not get explained.

Eye rubbing is the most consistently reported association in the keratoconus literature. People with keratoconus report rubbing far more often than people without it, with pooled odds around six and a half times higher. The same analysis is careful to say the direction of causation cannot be established from the data — an already-changing cornea may simply itch more.

But follow the practical chain: allergy causes itch, itch causes rubbing, and rubbing is the one thing in this disease you can personally change.

So if you have allergic conjunctivitis, treating it properly — an antihistamine or mast-cell stabiliser drop, prescribed for that purpose — is not a side issue. It removes the reason your hands keep going to your eyes. For an atopic patient with keratoconus, that is arguably the most useful thing a drop can do.

It is still symptom control rather than treatment of keratoconus. It is also worth doing.

Cold compresses instead of rubbing

Worth mentioning because it costs nothing: for the itch you get anyway, a cold compress does what rubbing feels like it does, without the mechanical force. If you take one habit from this page, make it substituting that.

What to be careful with

Redness-relief drops. The ones marketed to get the red out work by constricting the blood vessels in the conjunctiva. Stop using them and the redness often comes back harder than before, which nudges you toward using them more. They change how the eye looks without touching why it is red. If your eyes are persistently red, that is worth having examined rather than masked.

Preserved drops used many times a day. Fine occasionally. Less fine as a regular habit on a surface that is already struggling, which describes a lot of keratoconus patients.

Anything promising to reverse, cure or reshape. Keratoconus is a structural change in the cornea. No drop reverses it, and neither do eye exercises, supplements or vision-training programmes.

Drops if you wear scleral lenses

Different rules apply once there is a lens involved, and they are worth getting right.

Inside the bowl, before insertion: preservative-free saline only. That fluid sits against your cornea for the entire wearing day, so preservatives held there are a genuine irritant rather than a theoretical one.
Over the lens during wear: preservative-free artificial tears are generally fine and help with front-surface dryness.
Medicated drops: timing matters. A drop instilled over a scleral lens does not reach the cornea underneath in any predictable way. These usually need to go in before insertion or after removal, and that should be decided with whoever prescribed them.

More detail in our guide to drops compatible with scleral lenses.

What actually changes the outcome

To put drops in their place:

To stop the disease progressing — cross-linking, if your keratoconus is documented as progressing. That question is answered with serial corneal topography, not with a single scan. Dr. Kresch is an optometrist and does not perform cross-linking; we establish whether you are progressing and fit the lens afterwards.

To see clearly — a lens that replaces your irregular corneal surface with a smooth one. That is what scleral lenses do, and it is why vision that cannot be corrected past a blur in glasses is often sharp in a lens.

To protect what you have — stop rubbing, and treat the thing making you want to.

Drops support all three by keeping the surface healthy enough for the lens to work and the eye to be comfortable. That is a real job. It is just not the job people hope they are buying.

Not sure whether your drops are helping or getting in the way?

Dr. Shira Kresch, OD, MS, FAAO sees keratoconus patients from across Metro Detroit at our Southfield office. Bring whatever you are using — a first specialty consultation is free and includes an ocular surface assessment alongside corneal topography.

Book a Free Consultation or call (248) 545-2800

Frequently Asked Questions

Are there eye drops that treat keratoconus?: No. No eye drop strengthens the cornea, flattens a cone, or halts keratoconus. Drops manage the ocular surface \u2014 dryness, irritation and allergic itch \u2014 which is worth doing, but it is symptom management rather than treatment of the disease. Anything sold as a drop that treats keratoconus is making a claim the evidence does not support.
What are the best eye drops for keratoconus?: It depends on what is actually bothering you. For dryness and irritation, a preservative-free artificial tear. For itch, an antihistamine or mast-cell stabiliser prescribed for allergic conjunctivitis \u2014 which matters more than it sounds, because itch drives rubbing. For lens wearers, only preservative-free saline goes in the bowl of a scleral lens. There is no single best drop, and the right one follows what your ocular surface exam shows.
Can eye drops stop keratoconus getting worse?: Not directly. The only treatment shown to halt progression is corneal cross-linking. But there is an indirect route worth taking seriously: if an allergic itch is making you rub your eyes, treating the allergy reduces the rubbing, and eye rubbing is the most consistently reported association in the keratoconus literature. That is not the same as a drop treating keratoconus, and it is still worth doing.
What about riboflavin eye drops?: Riboflavin drops are used during cross-linking, where they are applied in a controlled clinical setting and activated with ultraviolet light. They are not a take-home treatment, and riboflavin on its own does nothing to the cornea without the UV step. Vitamin B2 supplements and over-the-counter riboflavin drops do not cross-link a cornea.
Should I avoid any eye drops with keratoconus?: Be wary of redness-relief drops, the ones that promise to get the red out. They work by constricting blood vessels and tend to produce rebound redness when you stop, which encourages more frequent use. They treat the appearance rather than the cause. If your eyes are persistently red, that is worth having looked at rather than masked.
Can I use eye drops while wearing scleral lenses?: Some, with rules. Only preservative-free saline goes inside the bowl of the lens before insertion \u2014 that fluid sits against your cornea all day. Preservative-free artificial tears can generally go over the top of the lens during wear. Preserved drops are a different matter, and medicated drops need to be timed around lens wear rather than dropped in over a lens. See drops compatible with scleral lenses.

Eye Drops for Keratoconus: What They Can and Cannot Do