Keratoconus is a progressive eye disorder in which the normally round cornea gradually thins and bulges into a cone-like shape. This irregular shaped cornea causes aberrant bending of light, resulting in distorted vision. Keratoconus usually affects both eyes, however it is common for the degree of progression in each eye to be unequal, and for the condition to be significantly more advanced in one eye.
There are several treatment options for keratoconus, and this depends on the severity of the condition and whether your keratoconus is progressing.
These include corneal cross-linking with or without laser resurfacing, corneal implants and corneal transplants. Dr Joanne Goh is a very experienced ophthalmologist and keratoconus specialist located in Melbourne who is highly skilled at performing these treatments.
Glasses and Contact Lenses
For mild keratoconus, glasses or soft contact lenses may be sufficient to provide good vision. In more advanced disease, special rigid contact lenses are usually required to correct for the irregular astigmatism. Dr Goh works closely with specialist keratoconus contact lens fitters and we can help arrange an appointment to have you fitted with the appropriate lenses for your eyes.
Corneal cross-linking (CXL)
If your keratoconus is progressing, a minor procedure called corneal cross-linking (CXL) may be required. Corneal cross-linking is a treatment that strengthens the cornea and stops keratoconus from getting worse. Treatment is recommended to patients whose keratoconus is getting worse as demonstrated by corneal curvature scans or a change in your spectacle prescription. Keratoconus corneal cross-linking is also recommended for patients with post-LASIK ectasia and pellucid marginal degeneration.
The cornea is made up of layers of collagen fibres that are held together by cross-links. Corneal cross-linking increases corneal rigidity by increasing the corneal collagen cross-links, thereby strengthening the cornea. During corneal cross-linking, the cornea is soaked in Vitamin B2 (riboflavin) drops before UV light is shone onto the cornea to activate the riboflavin. This photochemical reaction strengthens the cross-links between collagen fibres in the cornea. Studies have shown that cross-linking increases corneal strength by up to 300% and is successful in stopping progression of keratoconus in over 90% of patients. In some patients, flattening of the cornea and an improvement in unaided visual acuity also occurs.
It is important to understand that corneal cross-linking is not a cure for keratoconus. For most people, this treatment stops the progression and stabilises the condition. You will still need to wear your glasses or contact lenses after surgery, although the prescription may change.