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Treatment Options

Corneal Collagen Crosslinking

Corneal Collagen Crosslinking with Riboflavin (CXL) is a developing keratoconus treatment.  CXL works by increasing collagen crosslinks which are the natural “anchors” within the cornea. These anchors are responsible for preventing the cornea from bulging out and becoming steep and irregular.

During the corneal crosslinking treatment, custom-made riboflavin drops saturate the cornea, which is then activated by ultraviolet light. This process has been shown in laboratory and clinical studies to increase the amount of collagen cross-linking in the cornea and strengthen the cornea.

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Contact Lens Options for Keratoconus by Dianne Anderson, OD

There are many different types of contact lenses available for keratoconus. Depending on the degree of clinical significance, lifestyle and ocular health, the optimal contact lens can be determined for each patient. This article describes the different design options currently available, along with the goals to keep in mind when fitting these patients. Continue Reading
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Contact Lens Options for Keratoconus

Author:  Dr. Anderson, OD, FAAO

Keratoconus is a bilateral, progressive corneal thinning disorder which manifests as irregular, asymmetric astigmatism. Symptoms include blurred, subacute distorted vision which is usually more pronounced in one eye than the other. Refraction is often difficult and patients may not be adequately corrected with spectacles. Contact lenses are the best form of visual correction in most cases of clinically significant keratoconus. There are many different types of contact lenses available for keratoconus.

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Keratoconus Treatment Options

By Dr. Brandon Ayres, MD

Keratoconus causes progressive thinning and distortion of the cornea that affects approximately 1 in every 2000 people.  It tends to affect younger people sometimes starting in the early teen years and progresses most rapidly through the fourth decade.  As the dystrophy progresses the cornea takes on an irregular cone like shape and may develop scar tissue.  The changes in the cornea seen in keratoconus lead to “irregular astigmatism.”  

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Keratoconus Causes and Treatment Options

By: Clark Chang, OD, MS, FAAO

Keratoconus Causes

Keratoconus is a non-inflammatory, progressive corneal condition associated with corneal thinning, weakening, and steepening, resulting in corneal optical irregularities (cone shape) and poor vision. An incidence rate of 1:2000 has been reported with no known sexual or ethnic predilection. In addition, familial inheritance has been reported in 6-24% of cases and co-morbidities such as atopic disease and connective tissue diseases have also been reported in the literature.

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Contact Lenses vs. Surgery for Keratoconus

Contact lenses with a rigid surface are the undisputed gold standard for restoring vision in keratoconus.  Despite recent advances in surgical treatment — including collagen cross-linking, intracorneal ring implants (Intacs), and partial-thickness corneal transplants — none of the currently available surgeries can make the distorted keratoconic cornea quite as smooth as the surface of a rigid contact lens.  The uniform surface of a rigid lens masks the distorted, irregular cornea in keratoconus, allowing light to properly focus into the eye. 

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Non-surgical Treatment Options for Keratoconus

Treatment strategies for the management of keratoconus are expanding as new technologies are being developed. The choice of what treatment to consider is based on the severity of the disease. As stated previously, early or mild cases of keratoconus can be easily treated with traditional eye glasses. Many of these patients can achieve clear 20/20 vision with spectacles. New spectacle technologies that correct for what are termed “high order aberrations” that are common in keratoconus may play a role for slightly more advanced cases.

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Surgical Treatment Options for Keratoconus

Medical and surgical options for the treatment of keratoconus are also expanding and improving. Corneal transplantation (penetrating keratoplasty or “PK”) has been utilized for the surgical management of keratoconus for many decades. The criteria for PK surgery typically is either the development of corneal scaring that reduces best corrected vision (even with contact lenses) or intolerance to contact lens wear (due to poor comfort or the inability to achieve a stable fit). Modification and improvement in surgical techniques has made PK much more successful.

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