What is Keratoconus?
Keratoconus is an eye condition in which the cornea progressively thins, and its normal dome-shape develops a cone-like bulge. This results in major visual impairment that can prevent one from performing basic tasks, like driving, working on a computer, or reading a book. The cornea is the transparent, outermost lens of the eye’s surface. Along with protecting the eye from dust and other debris, it controls focus and the entry of light into the eye.
What Are the Early Symptoms of Keratoconus?
In its earliest stages, keratoconus causes a slight blurring or cloudiness and/or distorted vision, along with, an increased sensitivity to light. These symptoms typically first appear during a patient’s late teens or early twenties. Symptoms may progress for, as much as 20 years, before slowing down and stabilizing. Each eye can react differently.
What Causes Keratoconus?
The cause is not entirely understood, however, keratoconus may is believed to be, in part, associated with eye rubbing and likely has a genetic component, although only 13% to 15% of those who are afflicted with keratoconus, a family member with the disease.
Keratoconus Treatment Options
Treatment depends on both the severity of the disease and how rapidly it’s progressing. The options include:
Contact Lenses
In its earliest stages, keratoconus, may be treated with glasses or various contact lenses. Initially, soft contact lenses are used, but as the condition progresses, and the corneal shape changes, rigid gas permeable (RGP) lenses are often required to improve vision.
Intacs
This treatment involves the placement of inserts on the cornea, that may help to reshape the cornea and slow the disease’s progression.
Corneal Transplant
A corneal transplant is a last-line treatment option, reserved for patients with advanced keratoconus who it’s determined would not benefit from glasses, contact lenses or corneal collagen crosslinking.
Corneal Collagen Crosslinking
This is an innovative new, yet simple and totally pain-free procedure that can stop the progression of keratoconus, and in about 50% of patients, can actually help flatten out the corneal bulge, resulting in improved vision. The procedure is performed under a local anesthetic. In the first step, a surgeon removes the cornea and applies riboflavin (Vitamin B2) drops directly to the eye. Next, UV light is applied to the cornea. Once these two steps are completed, a temporary contact is placed on the eye to protect it for the next few days. During this time, the patient continues to administer B2 eye drops at home.
Candidacy for Corneal Crosslinking
Candidates for corneal crosslinking are at least 14 years old and have mild to moderate keratoconus. Candidates should have a minimum corneal thickness of 400 microns. Candidates should not have any active eye infections, ocular surface diseases such as dry eye or autoimmune disorders. Severe corneal scarring is also a contraindication for corneal crosslinking.
Benefits of Corneal Crosslinking
- Slows or halts the progression of keratoconus and related vision loss
- FDA-approved for candidates as young as 14
- Can prevent corneal scarring
- Can minimize or eliminate the need for invasive treatment options such as corneal transplant
- May make it easier and more comfortable to tolerate contacts
- Backed by decades of scientific research
- One-time procedure
Preparing for Corneal Crosslinking
Corneal crosslinking does not require extensive preparation, but taking a few simple precautions can improve the safety and efficacy of treatment.
Do not wear contact lenses for the two weeks immediately prior to your keratoconus treatment. Arrange for someone to drive you home from your treatment and be available to run any necessary errands. We will write you a prescription for eye drops to use on the day of and the days following your treatment; please fill this ahead of time so you have the drops ready.
On the morning of your procedure, please do not apply eye makeup, aftershave products or perfumes. You may drink fluids and eat a light meal prior to the procedure. Bring a pair of sunglasses to wear on the ride home in case your eyes are sensitive to light.
We will give you a specific timeline for your treatment, but plan to be at the office for at least two hours. The treatment itself takes between 30 and 90 minutes.
Post-treatment Guidelines and Recovery
Our team will provide you with comprehensive instructions for aftercare. In general, you can resume most of your normal activities the day after treatment, as long as you do not expose your eyes to water for the first week. When you go outside, avoid exposing your eyes directly to the sun; instead, shield them by wearing wraparound sunglasses and a wide-brimmed hat for added protection.
iLink® Corneal Cross-Linking
iLink® is the first and only FDA-approved corneal cross-linking procedure that slows or halts the progression of keratoconus and helps preserve vision.
Watch this video for unique patient and doctor perspectives about progressive keratoconus and learn how this underserved patient population with a rare and sight-threatening condition is treated with iLink® corneal cross-linking.
Hybrid Contact Lenses
Hybrid contact lens options for patients with keratoconus include SynergEyes KC, ClearKone and UltraHealth.
UltraHealth lenses are the most advanced hybrid lens. While indicated for keratoconus, the ‘Continuum of Care’ sweetspot is for patients with mild to moderate keratoconus. UltraHealth is designed to vault the corneal ectasia, providing well-centered, gas permeable vision along with comfort from the soft skirt.
Highlights:
- Most advanced hybrid lens for keratoconus
- Prescribed to thousands of keratoconic patients
- Made from high-Dk materials.
Scleral Contact Lenses
The SynergEyes VS™ lens is an innovative scleral lens with a distinctive bi-tangential periphery designed to accommodate a wide variety of corneal conditions.
This lens completely vaults the cornea and limbus landing entirely on the sclera. The lens has two adjustable landing zones to accommodate for the toricity of the sclera. The toricity in the landing area is independent of the central portion of the lens.
Each parameter may be adjusted independently, without affecting other parameters.
Available in Single Vision and Multifocal.
Risks
Our top priority is patient safety. As with many medical procedures, there is a slight risk of complications that can happen with corneal crosslinking. Working with our knowledgeable doctors can mitigate some of the risks and give you peace of mind.
Possible complications of corneal crosslinking include the following:
- Sensitivity to light after treatment
- Eye discomfort after treatment
- Eye infection
- Prolonged corneal healing
Serious complications from corneal crosslinking are rare.
Frequently Asked Questions about Corneal Crosslinking
Are both eyes treated at the same time?
Usually one eye is treated at a time.
Is corneal crosslinking painful?
No. We care about your comfort during treatment, and will numb your eyes so you do not experience pain.
Is corneal crosslinking a cure for keratoconus?
No. Keratoconus is a chronic degenerative disease and there is no cure. Corneal crosslinking has been shown to halt or slow the progression of keratoconus and related vision loss. Corneal crosslinking can also reduce or eliminate the risk of needing more invasive treatment such as corneal transplant.