Keratoconus Facts, Treatment Options & CXL

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Keratoconus is a common eye condition where the eye’s outer tissues begin to bulge outward.

There are approximately 200,000 cases of keratoconus per year in the United States, and likely much more throughout the world.

The actual cause of this progressive eye disease remains unknown at the moment, which makes treatment slightly challenging. 

However, due to recent developments in the medical industry, a new treatment option might be able to stop keratoconus in its tracks.

By using what’s called a corneal crosslinking procedure, doctors can effectively stop the cornea from continuing to bulge outwards.

This is a very important development in treatment, because in the past it wasn’t uncommon for patients with keratoconus to need a full corneal transplant. 

Below we delve into the details regarding CXL (corneal cross-linking), as well as some more facts about keratoconus. 

Keratoconus Quick Facts

  • Cornea transplants are often used in advanced cases of keratoconus. 
  • Symptoms typically start earlier in life (usually during preteen or teenage years), and they progressively get worse. 
  • Keratoconus carries the risk of becoming progressively worse over time. This means that if it’s left untreated, it may cause blindness. The level of blindness depends on the overall health of the patient, however this makes keratoconus a serious issue that should immediately be taken care (if you have it).
  • After most forms of treatment, patients will be required to wear some type of eye correction (i.e. contact lenses or glasses). The specific type of vision correction depends entirely on the health/history of the patient. It’s recommended to consult with a dedicated eye doctor after receiving treatment for keratoconus. 
  • Using GP (gas permeable) lenses might help lessen the symptoms of keratoconus. However, this is not true in all cases. Other options include using hybrid lenses, as well as “soft” lenses. Soft lenses do not stop the cornea from bulging, however they do provide a greater level of eye relief (from a vision standpoint).

Keratoconus Treatment Options

One of the main treatment options for keratoconus is the use of custom contact lenses. These lenses typically come in one of three varieties; soft, rigid gas permeable, or hybrid. 

  • Soft lenses don’t do much to stop the bulging of the eye that’s caused by keratoconus, however they do allow the patient to have better overall vision. 
  • Gas permeable lenses (i.e. GP lenses) essentially form a protective barrier over the cornea, in an attempt to stop it from bulging. 
  • Hybrid lenses are unique in that they are specifically designed to aid in the treatment of keratoconus. They are essentially a mix between soft lenses and GP lenses. 

Another type of lens design used to treat this progressive eye disease are prosthetic lenses.

This type of lens is usually reserved for treating very advanced forms of the disease.

Prosthetic lenses require a lot of effort to manufacture, and are always completely custom made to fit the patient’s eye/lens shape. 

If keratoconus advances past the stage where lenses can be of any help, then doctors typically turn to a treatment known as “intacs.”

Intacs are a special insert placed into the eye/cornea that are designed to basically give the cornea a more effective shape (for clearer vision).

Intacs can slow down keratoconus, however they cannot prevent a corneal transplant (especially if the disease has progressed past a certain point). 

CXL (Corneal Cross-Linking)

Corneal cross-linking is a relatively new development in the medical field, and has made the treatment of keratoconus much more accessible and effective (more so than ever before). 

How Does CXL Work?

CXL treatment is performed by utilizing UV therapy as well as specialized eye drops. The end goal of the treatment is to strengthen the tissues of the eye that contribute to the acceleration of keratoconus. CXL is known as one of the only (if not the only) treatment option that can actually stop keratoconus from progressing. 

Is CXL Invasive? Does it Hurt?

CXL is not invasive, and most treatments can be performed right in your doctor’s office. The length of the treatment varies, but it’s typically anywhere from one hour, up to 90 minutes. There is virtually no pain at all during the treatment, due to the eye being numb.

Is CXL the Right Treatment Option for Me?

CXL is typically recommended for those who have been recently diagnosed with keratoconus.

This is because CXL is designed to stop the disease from progressing. CXL doesn’t reverse the negative changes that keratoconus has caused to the eye, which is an important note to consider. 

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