Keratoconus

What is keratoconus?

Keratoconus is a congenital (condition from birth) disease of the cornea and it belongs to the large group of hereditary corneal dystrophies.

Keratoconus is a fairly uncommon condition that affects the cornea (the transparent window at the front of the eye). It is mostly congenital. It can also occur as a complication of LASIK when the condition is called ectasia.

Keratoconus causes changes within the structure of the cornea making it weaker and thin resulting in a ‘cone shaped’ forward bulge. Keratoconus leads to myopia (short sight) and, if the steepening is uneven, also astigmatism. With Keratoconus, visual distortion can become difficult to correct with spectacles, although contact lenses (usually rigid) can provide more functional visual performance.

At first, the protrusion occurs in the inferior parts (lower half) but later on it also affects the central part of the cornea.

Mechanism of corneal cross-linking

This treatment uses a combination of Riboflavin (Vitamin B) drops and ultra violet light that reacts with the collagen fibres in the cornea, strengthening them by creating more ‘cross-linking’ among them. The resulting increased strength of the cornea stabilises the progression of keratoconus.

This treatment does not provide a cure for keratoconus but in most cases prevents it from getting worse. Patients who previously had progressive keratoconus have now been treated and followed for up to five years without evidence of any further change in their condition.

Cross-linking procedure

An anaesthetic drop is placed in the eye. The epithelium is removed by softening it with a diluted form of alcohol called ethanol. Riboflavin vitamin drops are then applied to the corneas every 5 minutes for half an hour. 

The UV light is then applied to cornea for another half an hour in graded steps. Antibiotic and steroid drops are applied to your eye and a bandage contact lens is inserted in the treated eye for 3 to 5 days. The procedure itself is usually pain free.

Cross-linking recovery

The treated eye is usually painful for 3 to 5 days. The intensity of post operative pain experienced by patients can vary from patient to patient. Recovery time is about one week although most patients may find that it may be slightly longer.

Cross-linking recovery

1st Visit : 3-4 Days bandage lens removed
2nd Visit : 1 week
3rd Visit : Within 3 months
4th Visit : 6 months
5th Visit : 9 Months and discharge with a satisfactory result

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