If you’ve recently been diagnosed with keratoconus, you’re probably wondering about your treatment options and what lies ahead. One treatment you may have heard about is corneal crosslinking.
Corneal crosslinking is a relatively new procedure that’s changing how eye doctors approach this progressive eye condition. But is it really the best option for everyone with keratoconus?
Keep reading to learn what keratoconus is, the various treatment approaches available, and where corneal crosslinking fits into the picture!
What is Keratoconus?
The word Keratoconus means “cone-shaped cornea,” which describes exactly what happens to your eye. Instead of maintaining its normal dome shape, the cornea, which is the clear front surface of your eye, gradually thins and begins to bulge outward into a cone-like shape.
This change in shape creates significant vision problems. Think of it like looking through warped glass. The irregular surface distorts light as it enters your eye, leading to blurred and distorted vision that can’t be fully corrected with regular glasses.
The condition typically develops during the teenage years or early twenties, though it can appear later in life. What makes keratoconus particularly concerning is that it’s progressive, meaning it tends to get worse over time, especially in younger patients, where the progression can be quite rapid.
What Causes Keratoconus?
While researchers haven’t pinpointed a single cause, experts know that keratoconus results from a combination of genetic predisposition and environmental factors. If you have a parent or sibling with keratoconus, your risk increases significantly.
Environmental factors play a crucial role too. Chronic eye rubbing is strongly linked to keratoconus development and progression.
Other risk factors include certain genetic conditions like Down syndrome or Ehlers-Danlos syndrome, and excessive UV exposure without proper eye protection.
What Are the Signs of Keratoconus?
Early keratoconus can be tricky to identify because the symptoms often mimic other vision problems. You might notice:
- Gradually worsening blurred vision that doesn’t improve much with glasses
- Increased sensitivity to bright lights and glare
- Seeing halos around lights, especially at night
- Frequent changes in your eyeglass prescription
- Eye strain and headaches from trying to focus
As the condition progresses, these symptoms typically become more pronounced, and you may find that even your best-corrected vision with glasses isn’t as sharp as it once was.
What Treatment Options Are There for Keratoconus?
When it comes to treating keratoconus, there isn’t a one-size-fits-all solution. The best approach depends on several factors: how advanced your condition is, how quickly it’s progressing, your age, and your lifestyle needs.
Contact Lenses
For many people with keratoconus, specially designed contact lenses are the first line of treatment. Rigid gas permeable (RGP) lenses are particularly effective because they create a smooth, regular surface over the irregular cornea.
Newer specialty lenses, including scleral lenses that vault over the entire cornea, can provide excellent vision correction even in advanced cases. These lenses are larger and more stable than traditional contacts, making them comfortable for many patients who couldn’t tolerate smaller RGP lenses.
Surgical Options
When contact lenses aren’t sufficient, surgical interventions may be necessary. Intracorneal ring segments (ICRS) are small, arc-shaped implants placed in the cornea to help flatten its shape and improve vision. These can be particularly helpful for patients who can’t tolerate contact lenses.
In advanced cases where the cornea becomes too thin or scarred, a corneal transplant may be the only option to restore vision. While transplants have excellent success rates, they’re major surgical procedures with longer recovery times and potential complications.
Corneal Crosslinking
This is where corneal crosslinking comes into the picture as a revolutionary treatment option. Crosslinking is designed to do something that other treatments can’t: actually strengthen the cornea and halt the progression of keratoconus.
How Does Crosslinking Work?
The procedure involves applying riboflavin (vitamin B2) drops to the cornea, then exposing it to controlled UV-A light. This creates new bonds between the collagen fibers in the cornea, similar to how bridges are reinforced with additional cables.
The result is a stronger, more stable cornea that’s less likely to continue bulging outward. The procedure itself is relatively straightforward and typically takes about 60-90 minutes.
After numbing drops are applied, the thin outer layer of the cornea (epithelium) may be gently removed, then riboflavin drops are applied every few minutes for about 30 minutes. Finally, the eye is exposed to UV light for another 30 minutes while additional riboflavin drops are applied.
Is Crosslinking the “Best” Treatment?
The answer depends on what we mean by “best” and where you are in your keratoconus journey. The treatment is most effective when performed earlier in the disease process, while there’s still adequate corneal thickness and before significant scarring occurs.
However, crosslinking alone may not be sufficient if your primary concern is improving your current vision. If you’re struggling to see clearly for work, driving, or daily activities, contact lens fitting or other vision-correcting procedures might be more immediately beneficial.
For very advanced cases with significant corneal scarring or extreme thinning, crosslinking may not be an option, and corneal transplant might be the only way to restore functional vision.
Is Corneal Crosslinking Right For Me?
For many patients, especially those with progressive disease, it’s an excellent option that can prevent years of worsening vision and potentially eliminate the need for more invasive procedures later.
However, “best” treatment really means the most appropriate treatment for your specific situation. Factors to consider include:
- How rapidly your condition is progressing
- Your current vision quality and contact lens tolerance
- Your age and lifestyle requirements
- The thickness and health of your cornea
- Your comfort level with different treatment approaches
The most important step is having a thorough discussion with an experienced corneal specialist who can evaluate your individual case and help you understand all available options. They can perform specialized testing to determine if your keratoconus is progressing and whether you’re a good candidate for crosslinking or other treatments.
If you’ve been diagnosed with keratoconus or suspect you might have it, don’t wait to seek specialized care. The earlier the condition is detected and managed, the better your long-term outlook is likely to be.
Schedule an appointment at Dell Laser Consultants in Austin, TX, today!
