Corneal Crosslinking


corneal-crosslinkingThe cornea is the transparent front layer of the eye that controls and focuses the entry of light into the eye. Normally it is round and dome-like in shape. However, if you have a medical condition known as keratoconus, your cornea takes on a cone-like shape. This distorts the way light enters the eye and is focused on the retina, compromising vision. Left untreated, keratoconus can make daily activities — such as driving, reading and texting — difficult. When keratoconus starts to affect your life, Dr. Jay Schwartz of Schwartz Laser Eye Center can help with an innovative treatment known as corneal crosslinking.


More About Keratoconus

Keratoconus is a progressive condition in which the cornea gradually thins and begins to bulge in a conical shape. It can affect one or both eyes and typically starts in a person’s teens or 20s (but can happen at any age). It often progresses for 10 to 20 years and then stops.

Experts believe it stems from an imbalance of enzymes in the cornea. Keratoconus can be the result of genetics, overexposure to ultraviolet rays, excessive eye rubbing, chronic eye irritation or poorly fitted contact lenses.

In its early stages, keratoconus causes blurred vision and frequent changes in eyeglass or contact lens prescription. It can also cause:
⦁    Sensitivity to light
⦁    Difficulty driving at night
⦁    Halos around light
⦁    Eyestrain
⦁    Headaches
⦁    Eye pain or irritation
⦁    Inability to wear contact lenses

corneal-crosslinking-1It is tricky to diagnose keratoconus simply based on symptoms, because these symptoms can indicate other eye problems, too. Keratoconus must be diagnosed by an ophthalmologist using special diagnostic equipment like a slit lamp microscope. A test called a keratometry may be performed, in which light is focused on the cornea and the reflection used to determine the cornea’s curvature. Or, computerized corneal mapping can be used to capture images of the cornea and produce a topographical map of the eye’s surface.


Corneal Crosslinking for the Treatment of Keratoconus

When keratoconus begins to affect everyday tasks, it is time to explore treatment options. One possibility is a procedure known as corneal crosslinking. Relatively non-invasive, corneal crosslinking combines riboflavin (vitamin B12) and UV light to strengthen the corneal tissue and halt the bulging of the eye’s surface. It has a high success rate — approximately 98 percent — and a low complication rate.

Corneal crosslinking can be performed with the outer portion of the cornea (the epithelium) intact or removed. Removing the epithelium allows the riboflavin to enter the cornea; once it has penetrated the cornea, it is activated with ultraviolet light. Leaving the epithelium on is typically less risky and leads to a quicker recovery; however it takes a little longer for the riboflavin to penetrate the cornea.

To begin the procedure, Dr. Schwartz applies the riboflavin eye drops to the cornea. Once the drops are absorbed, UV light is applied to the eye for approximately 30 minutes while it activates the drops (it also kills bacteria and parasites). This process strengthens the bonds between the collagen fibers, enhancing the cornea’s rigidity and resistance. The links between the collagen fibers prevent the cornea from bulging or distorting.

After treatment, a bandage contact lens is placed and antibiotic and anti-inflammatory eye drops are prescribed. If the epithelium was removed, it heals within five days; at that point, the contact lens can be removed.

Corneal crosslinking can also reduce nearsightedness or astigmatism associated with keratoconus. It can often reduce the risk of the need for more invasive treatments such as corneal transplant.

Contact Schwartz Laser Eye Center

To learn more about keratoconus and corneal crosslinking, please contact Schwartz Laser Eye Center by calling 480-483-EYES (3937) or 888-553-EYES, or by sending us an email.