Keratoconus and corneal cross-linking: stopping progression early

Why keratoconus is often found late

Keratoconus usually begins in the teenage years or early twenties. The cornea gradually thins and steepens, producing blurred and distorted vision that spectacle changes only partly correct. Repeated eye rubbing is a recognised risk factor.

A young patient whose cylindrical power keeps changing should have corneal tomography rather than another new spectacle prescription.

What cross-linking does

Corneal collagen cross-linking uses riboflavin drops and controlled ultraviolet-A light to strengthen the bonds within the corneal stroma. The purpose is to stabilise the cornea and reduce the likelihood of further progression.

It is a stabilising treatment. It is not primarily a vision-improving procedure, and spectacles or contact lenses are usually still needed afterwards.

Visual rehabilitation after stabilisation

Once the cornea is stable, options such as spectacles, rigid gas permeable or scleral contact lenses, topography-guided treatment in selected eyes, or intracorneal ring segments may be discussed. Advanced cases may need a corneal transplant.

Screening before laser vision correction

Every specs removal evaluation at Perfect Vision Laser Eye Hospital includes tomography specifically to detect keratoconus or a suspicious pattern. Laser correction is declined when the cornea shows these findings, because it can accelerate weakening.