Vitamin D Shown to Stabilise Keratoconus in Adolescent Patients

Potential for disease progression is higher in patients with insufficient dietary levels, study suggests.

Vitamin D may be able to reduce the progression of keratoconus by modulating inflammation and stabilising the corneal structure and ocular measurements. Click image to enlarge.

Corneal homeostasis can be disrupted by many factors, including the absence of crucial nutrients. In younger patients, insufficient intake of certain vitamins and minerals could be associated with ocular conditions like keratoconus. In these cases, patients have been found to have lower counts of vitamin D compared to healthier individuals.1 However, since multiple factors have been define mechanisms for the advancement of this corneal ectasia, it cannot be assumed that the vitamin alone plays a key role in disease progression. A recent study hypothesized the possibility of proper vitamin D levels acting as a modulator of systemic inflammation, which in turn could reduce the further development of keratoconus.2

Published in American Journal of Ophthalmology, the work by a research team from Italy reports findings from a 12-month pilot study observing the effects of vitamin D on keratoconus patients. A total of 40 subjects chosen for this study were instructed to take vitamin D supplements through a six-month period. Subjects’ ages ranged from 12 to 19 and each case presented with both insufficient levels of vitamin D and various stages of corneal ectasia (end-stage keratoconus patients were excluded). They had their best corrected visual acuity (BCVA), maximal keratometry (Kmax) and thinnest corneal thickness measured during the 12-month period, in addition to blood sample analysis at the start of the trial and six-month follow-up.

“We suggest that keratoconus is the local manifestation of a systemic disease, and we hypothesise that systemic inflammation, platelet activation and collagen degradation play a primary role in this process,” the authors proposed in their paper. Although considered a non-inflammatory corneal degeneration, keratoconus impacts the cornea’s structure and collagen’s organisation.

The researchers discovered that vitamin D stabilises the cornea and reduces keratoconus progression. Kmax progressed less than one diopter in 65% of patients, with BCVA and corneal thickness rates remaining stable. Blood sample analysis showed that vitamin D binding proteins, the primary transporter of the vitamin in blood plasma, were upregulated while inflammatory and platelet activation pathways were downregulated in stabilised patients. The team noted that as the mechanisms of inflammation are reduced, collagen degradation decreases in patients taking vitamin D supplements. Additionally, the expression of vitamin D receptors and its principal target gene, cluster of differentiation 14 (CD14), increased significantly.

“As expected, vitamin D supplementation affected the systemic inflammatory framework,” the authors wrote. “Our observation that the expression of soluble CD14 is increased after vitamin D supplementation corroborates these findings.” Although eye rubbing and vernal conjunctivitis have been established as factors associated with keratoconus progression, the study’s investigators believe further research into systemic treatment options has the potential to be beneficial. 

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Please Note: Our members in 2015 and 2016 have reported similar out comes, as well as the same being reported by our member who is the researcher that conduced the following study, which was published on the 5th of June 2018 and it was again reported on by us on the 20th of May 3023: Mcmillan Spectrum of Darkness, Agent of Light: Myopia, Keratoconus, Ocular Surface Disease, and Evidence for a Profoundly Vitamin D-dependent Eye. Cureus 10(6): e2744. DOI 10.7759/cureus.2744  

1. Gupta PC, Pathak M, Thakur B, et al. Association of keratoconus with serum levels of 25-hydroxyvitamin D and antioxidant trace elements: A systematic review and meta-analysis. J Ophthalmol 2022;70:8:2818-2824.

2. Bartolomeo N, Pederzolli M, Palombella S, et al. The effects of vitamin D on keratoconus progression. Am J Ophthalmol. April 15, 2025. [Epub ahead of print].