Keratoconus is a degenerative non-inflammatory disease of the cornea that causes the cornea to become thinner and more convex with disease progression. That first signs that should alert you to the possibility of keratoconus are worsening visual acuity and rapid changes in your dioptre. Keratoconus is successfully treated with a procedure called "corneal crosslinking", during which the cornea is soaked with special vitamin B2 drops and exposed to UV light – triggering a chemical reaction that increases its rigidity.

The consequence of many years of rubbing the eyes

Keratoconus is a corneal disease that usually occurs between the 20th and 40th year of age. It is sometimes difficult to diagnose in its early stage because it frequently doesn't bother the patient. In its final stage, a corneal transplantation is necessary. The causes of this disease are not entirely known. It is partially hereditary and frequently appears in people who have, due to allergies, been rubbing their eye for a number of years. Signs that can lead you to suspect this disease also include seeing double when looking with one eye, experiencing glare and sensitivity to light.

The early stage does not affect vision

The diagnosis for keratoconus is determined using reliable examination methods such as corneal topography and pachymetry, which use computer analysis to analyse the surface curvature of the cornea and its thickness, allowing us to define the stage and progression of disease. In the early stage of this disease, called forme fruse keratoconus, most patients can see relatively clearly with prescribed eyeglasses. This stage is most frequent among patients and usually does not further develop. Keratoconus is most commonly discovered by chance and does not cause major trouble for patients in its early stages.

Corneal transplantation in the final stage

In progressive forms of keratoconus, it is difficult to improve the patient's vision using eyeglasses. Semi-hard contact lenses must normally be prescribed. These preserve the correct form of the cornea but are not well tolerated by some patients. The constant wearing of contact lenses, particularly semi-hard contact lenses, also results in many other problems and contributes to the damage of the cornea in the long-term. A substantially better solution is to treat keratoconus with a method called 'crosslinking'. This is a surgical procedure that, along with a special solution of vitamin B2 (riboflavin) and exposure to UV light, triggers a chemical reaction that creates new connections between collagen fibres. The procedure allows us to significantly enhance the rigidity of the cornea and prevent the further progression of disease. Although the method is relatively new – it has been used to treat keratoconus for only the past 10 years – there already exist many studies which prove that the treatment can be used to stop the progression of disease not only in the short, but also in the medium-term. In many cases, the procedure also enables us to achieve significant improvement in vision. Given the research on the effectiveness and safety of this treatment, crosslinking is today recommended during the early stages of disease. By undergoing early treatment, we can expect visual acuity to be completely preserved.

Surgery and recovery

The surgery is performed as an outpatient procedure under local anaesthesia and takes approximately 45 minutes. At the end of the procedure, a therapeutic contact lens that protects the cornea during the first several days after surgery is inserted into the eye. Immediately after surgery, temporary redness of the eye can occur due to healing of the epithelial surface of the cornea, which can take several days. Vision may be blurred for some time after surgery, glaring is also possible, particularly during the first several months. The quality of sight after surgery depends primarily on the extent of corneal impairment. Vision may remain unchanged but improves in many cases. It is important to understand that the first signs of healing become apparent only after eight weeks, while the final treatment success can be evaluated only after one year.

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    Although contact lenses are used by millions of people every day, they can be the cause of permanent eye damage if they are inadequately maintained and as a result of poor hygiene and/or skipping regular ophthalmologist check-ups.

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    The cornea is like a kind of window in the anterior part of the eye which receives light and enables clear vision. There are different diseases that can affect the cornea and cause blurriness, visual impairment and in extreme cases, also blindness. These include keratoconus, keratitis, corneal ulcer and corneal scarring (macula).


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