Corneal Cross-Linking: Treatment for Keratoconus

There are lots of different issues that can affect our eyes and vision. One of the lesser-known eye conditions is called keratoconus. Keratoconus occurs when the cornea, which is the clear dome covering the front part of the eye, begins to bulge outwards in a cone-like shape. This changes the way that light is refracted by our eyes, causing blurred vision. The bulging is a result of the fibers that usually hold the cornea in place becoming weaker and less effective at their role.

Exactly why some people experience keratoconus and others don’t isn’t always clear, but it is more common in those who have experienced a trauma to the eye. This could be anything from an actual incident, such as chemical burns or blunt force trauma, to continually rubbing and irritating your eyes. Without treatment, the symptoms of keratoconus are likely to get progressively worse. As of right now, there is only one viable treatment – corneal cross-linking.
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What is corneal cross-linking and how does it work?

Also known as CXL, corneal cross-linking is currently the only treatment considered to be successful for stopping the progression of keratoconus. Recent studies show that it is effective in halting progression in around 90% of cases.

As we know, keratoconus occurs when the fibers that usually hold the cornea in an evenly domed shape become weaker, making them less effective at holding the cornea in position. As a result, the cornea begins to bulge outwards in a conical shape. Cross-linking is designed to strengthen the fibers so that they can retain the cornea in place. The fibers are strengthened using a combination of medicated eye drops and UV light. These harden the fibers so that they are stronger, while also forming bonds between them. This creates the cross-lining that fortifies them even further.

What happens during a corneal cross-linking procedure?

Cross-linking is not a particularly common procedure, and so should only be carried out by trained and experienced professionals. It will be performed on an outpatient basis and usually under local anesthetic. If you are anxious or nervous about the treatment, it may be possible for you to undergo sedation to keep you calm and relaxed while it takes place.

After the anesthetic has taken effect, your eye doctor will administer eye drops. These are designed to help your eyes absorb light more effectively and take around half an hour to work. Once they do, you will be asked to lie back in your chair and look directly into a special UV light, which will form the second part of the treatment.

You can expect the procedure to take a maximum of two hours from start to finish. You’ll have a clear contact lens placed into your eye to cover the cornea while it heals so that you don’t accidentally irritate it in any way. You should arrange for someone to drive you home as your vision may be blurred for up to a few days. It’s normal to experience some discomfort, and this can be alleviated using pain medications.

Around a week after your procedure, you’ll be invited back to see your eye doctor who will assess the quality of your vision and ensure you haven’t experienced any complications.

If you would like to talk to someone about keratoconus, please don’t hesitate to get in touch with the Santa Barbara Eyecare team of eyecare specialists today.