Understanding if You Are a Good Candidate for Corneal Cross-Linking Submitted by Atlanta Vision Cataract and Laser Center on October 19, 2018

Keratoconus is an eye condition that typically occurs at a young age and progressively worsens, diminishing your vision along the way. Until recently, we didn’t have many treatment options for keratoconus, but now the US Food and Drug Administration has approved a procedure called corneal cross-linking.

We’re proud to offer our patients at Atlanta Vision Cataract and Laser Center this innovative procedure because it’s the only way currently available to stop keratoconus from worsening and causing severe vision loss.

Although many patients are excellent candidates for cross-linking, the decision isn’t always straightforward. Here’s some insight into keratoconus and how we determine if you’re a good candidate for corneal cross-linking.

Corneal cross-linking targets keratoconus

When you have keratoconus, your cornea undergoes gradual and progressive thinning. As the cornea thins, it’s shape changes.

Normally, the cornea is shaped like a rounded dome, a quality that’s essential to properly focus light, so you have a clear vision. As it thins, the middle of the cornea starts to bulge outward, forming a cone-like shape.

Keratoconus typically begins in adolescence and progressively worsens through your mid-30s before the thinning slows down or stops. But it progresses at a rate that varies for each patient.  

As the disease worsens, so does your vision. Although glasses correct your vision in the early stages of keratoconus, the disease can progress to the point where eyeglasses or contact lenses no longer help.

How corneal cross-linking works

Corneal cross-linking strengthens the cornea, which stops or significantly slows down progressive thinning. The procedure simply uses ultraviolet light and drops of riboflavin to build bonds between thin strands of collagen in the cornea.

Collagen cross-linking naturally occurs in your eyes as you get older; it’s one way your body maintains healthy eyes over the years. We essentially accelerate that process by triggering the chemical reaction that makes collagen bond.

At Atlanta Vision Cataract and Laser Center, we’re excited to offer corneal cross-linking to our patients with keratoconus. Here are some of the criteria we use to determine whether you’re a good candidate for corneal cross-linking.

Stage of keratoconus

Keratoconus progresses through four stages based on the severity of the corneal bulge, the degree of corneal thinning, and your visual acuity. The best candidates for corneal cross-linking are those with keratoconus that’s in an early stage.

Here’s the most important thing about corneal cross-linking: It can prevent further progression of keratoconus, but it doesn’t reverse thinning that has already occurred. As a result, being treated at an early stage produces the best results.

Your age and rate of corneal thinning

Your age and the rate of corneal thinning are important considerations when deciding if you’re a good candidate for corneal cross-linking. That’s why we closely monitor the progression of corneal thinning for keratoconus patients of all ages.

As a general guideline, young patients are strong candidates for corneal cross-linking. We can’t predict the rate of progression, but we know corneal thinning worsens, perhaps rapidly, when appears during adolescence or young adulthood.

If you’re diagnosed around the age of 30, you may not have further thinning. In that case, you’re not a good candidate for corneal cross-linking. If ongoing monitoring of your cornea shows disease progression, we can talk about the potential for undergoing the procedure.

Reasons you may not be a good candidate

There are a few reasons you may not qualify for corneal cross-linking. These contraindications include:

  • Cornea that’s already too thin
  • Corneal scarring
  • Eye disease affecting the cornea
  • Ongoing eye infection
  • History of herpes keratitis
  • History of poor epithelial wound healing
  • Autoimmune disorders

If you or your child develops the early signs of keratoconus — blurry or distorted vision, sensitivity to light, or eye redness or swelling — don’t wait to schedule an eye exam. Call our team at Atlanta Vision Cataract and Laser Center or book an appointment online.

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