The cornea is the clear, rounded layer on the front of your eyes.
Your corneas focus light entering your eye so you can see clearly.
Like the windshield of a car, they are the crystal-clear barrier between your eyes and
the world.
The cornea is supposed to have a round shape, but keratoconus is a disease in which the
cornea becomes progressively cone-shaped.
When the cornea becomes distorted like this, light can’t focus on the back of your eye,
blurring your vision over time.
In advanced cases, the cornea becomes cloudy, which would feel like trying to drive with
snow on your windshield.
The first signs of Keratoconus typically appear in your preteen or teenage years.
This disease has a strong association with Down syndrome, affecting up to 1 in every
3 people with Down syndrome.
Other risk factors include excessive eye rubbing, chronic allergies and eyelid inflammation,
and having a family history of keratoconus.
Your pediatric ophthalmologist or optometrist will look for early signs of keratoconus during
your eye exam.
Keratoconus is a progressive eye disease, meaning once it starts it will continue to
get worse.
Glasses and hard contacts might help blurry vision for now, but neither will stop the
cornea from continuing to become more and more cone-shaped, eventually leading to vision
loss.
Early surgical intervention helps to stop the progression, preserving your vision.
Corneal collagen cross-linking is a minimally invasive surgery that stops the progression
of keratoconus by making the cornea more rigid.
Corneal cross-linking is a preventative surgery, so it will not improve vision that is already
blurry from keratoconus.
The goal of the procedure is to protect your current level of vision by locking the cornea
in its current shape, which will prevent future vision loss and prevent more invasive procedures,
such as a corneal transplant, down the road.
Children’s Hospital Colorado is one of the few hospitals in the nation to offer corneal
collagen-crosslinking for kids and teens, and our care team has the specialized skills
to protect your vision.
To start the procedure, younger patients are typically put to sleep under general anesthesia.
Older patients may be awake for the procedure.
The cornea has layers, and corneal cross-linking works by strengthening some of those layers.
Your surgeon begins by placing a ring on the cornea and applying alcohol eye drops to loosen
the outermost layer, called the epithelium.
The epithelium is wiped away, exposing a thick layer called the stroma, which contains a
binding protein called collagen.
Vitamin eye drops are applied for about 30 minutes until they have soaked all the way
through the stroma.
The drops are repeated until your cornea is thick enough for the next step.
Next, your surgeon will shine a special UV light on your cornea.
This UV light and the vitamins absorbed from the eye drops perform a chemical reaction
that strengthens the collagen bonds in the stroma, making the cornea more rigid so it
will be locked into its current shape and will not continue to become more cone-shaped.
Finally, numbing eye drops and a soft contact lens are applied to act as a bandage while
your eye heals.
For patients with keratoconus in both eyes, the procedure is usually done in two separate
surgeries.
A shield will be placed over your eye before you go home, which should be the same day.
You will need to return for multiple visits so your ophthalmologist can check to make
sure your eye is healing properly.
Once at home, you will need to apply antibiotic and steroid eye drops at least four times
per day for the first week, then just the steroid drops for the next month.
Your eye may feel uncomfortable right after the procedure.
Use over the counter pain relievers and avoid of bright sunlight to feel more comfortable
as you recover.
Your eye doctor will continue to monitor your vision during your regular vision checkups.