A new study published in The American Journal of Ophthalmology has uncovered troubling disparities in how patients with keratoconus (KCN) receive treatment—revealing that race, gender, insurance status, and even neighborhood play a role in who gets access to procedures like corneal cross-linking (CXL) or corneal transplant.

Who Was Less Likely to Receive Treatment?

Using records from over 1,600 keratoconus patients at a large health system, researchers found that:

• Women were less likely to undergo corneal transplant (keratoplasty) than men.
• Black individuals were less likely to receive corneal cross-linking (CXL) than White individuals.
• Patients with Medicaid or no insurance were significantly less likely to undergo CXL than those with commercial insurance.
• People living in socially vulnerable neighborhoods were less likely to receive both CXL and keratoplasty.
• Black women were the most vulnerable group, receiving fewer procedures than both White women and Black men.

Why Does This Matter?

Keratoconus can be progressive and lead to significant vision loss if left untreated. Cross-linking can help stop the disease from getting worse, but if patients don’t get access to this treatment early, they may eventually need a corneal transplant. The earlier keratoconus is diagnosed and managed, the better the chances of preserving vision and avoiding more invasive procedures.

This study shows that access to timely care isn’t equal—and that’s a problem we need to fix.

How Can We Create Change?

Researchers point to multiple barriers that might explain the differences in care: lack of insurance coverage, transportation issues, provider bias, and mistrust in the healthcare system. But no single factor explains everything, and more research is needed.

What we do know is this: the keratoconus community deserves better.

At NKCF, we believe every person with keratoconus should have access to early diagnosis, quality care, and accurate information about their options. That’s why we work every day to raise awareness, support patients, and advocate for earlier diagnosis and equitable care—no matter a person’s background. But, we can’t do it alone. It takes a community of advocates, volunteers, and donors to help ensure that no one is left behind.

How You Can Help

Whether you’re a patient, caregiver, clinician, or friend of the keratoconus community, you have the power to make a difference. Share your story to raise awareness. Volunteer your time to support others. Contribute funds to help expand our reach. Every act—whether it’s time, treasure, or talent—moves us closer to a future where everyone with keratoconus gets the care they deserve. Together, we can close the gap. To support our mission, visit nkcf.org/donations.