Keratoconus and Cornea Collagen Crosslinking

Baltimore Washington Eye Center, Maryland

Tuesday, August 30, 2011

Keratoconus and Cornea Collagen Crosslinking

Keratoconus is a degenerative condition of the cornea, the clear dome over the colored part of the eye. In patients with keratoconus the cornea thins inferiorly.  As the cornea thins, pressure from the inside of the eye causes it to bulge and take on a steep, irregular cone-like shape.  Early symptoms of keratoconus are rapid changes in prescription often with high amounts of near sightedness and astigmatism, doubling of images, starbursts around lights and being unable to see 20/20 even with the best spectacle prescription.

In the past keratoconus was managed by trying to give the patient the best possible vision. Since the visual symptoms are due to the irregular corneal surface often being fitted with a rigid gas permeable contact lens is often the only way to achieve 20/20 vision. The rigid lens maintains its shape and does not conform to the irregular surface creating an artificially smooth surface that will better focus light.

Keratoconus tends to be progressive. Ten to twenty percent of patients with the disease will develop corneal scarring that impedes vision or will become intolerant of rigid gas permeable lenses. For these people the only way to restore vision is a corneal transplant. Transplants for keratoconus are successful 90 % of the time. However, the recovery is long and arduous and often contact lenses are needed afterward to achieve good vision.

A new procedure undergoing FDA trials is Corneal Collagen Crosslinking with Riboflavin. This is a simple 30 minute procedure where riboflavin is applied to the cornea and activated with an ultraviolet light stimulating crosslinking between the collagen fibers of the cornea. This greatly strengthens the cornea. Researchers believe the procedure may stop the progression of keratoconus permanently.

The advent of such a promising procedure is very exciting. Early diagnosis is critical. If you or someone you know has any of the signs of keratoconus a complete eye exam is warranted.

Guest Blogger: Shari E. Strier, O.D. with the Baltimore Washington Eye Center