When is visual acuity expected to improve after corneal cross linking “strengthening” procedure?

When is visual acuity expected to improve after corneal cross linking “strengthening” procedure?

Keratoconus is one of the most common diseases in the field of ophthalmology, where the cornea changes its normal spherical shape and bulges out assuming a conical appearance, leading to distortion of vision and drop of acuity.

Treatment of the condition is varying according to the condition, and in the following article we will outline some of the details about keratoconus, cross linking, the cost of corneal collagen cross linking and the best doctor for the treatment of keratoconus in Egypt. 

What is keratoconus?

this condition is one of the  most popular chronically or slowly progressive ocular conditions that takes years to affect and impair a person’s vision. In this condition the cornea, the clear window at the front of the eye loses its natural spherical contour, and becomes thinned out ,bulging out at weak points and assuming a conical shape. This abnormality of shape and contour affects the bending of light rays at the corneal interface , causing irregular bending and defocus of these rays when they fall onto the retina, leading to drop of visual clarity and acuity. The condition affects one or both eyes with varying degrees, and the average age of affection is between 15 -25 years . in early cases , visual distortion can be corrected by glasses or soft contact lenses, but as the condition worsens and advances, hard contact lenses and RGP lenses become a form of treatment , although they are not well tolerated. 

What causes keratoconus?

The actual cause is unknown yet, but  research has shed light that a deficiency of certain building enzymes within the corneal stroma.  The wear and tear that is constantly repaired by these enzymes is slowed down, causing excessive accumulation of diseased collagen fibers and oxygen free radicles, leading to weakening of the corneal stromal bridges, and hence weakness  and forward bulge of the cornea. Research has also linked the condition to certain hereditary factors and genetic conditions, such as Down syndrome and mitral valve prolapse which highlights the importance of family history in this condition. In addition, excessive unprotected exposure to sunlight and ultraviolet rays and constant eye rubbing have also been implicated. Also, the misuse of poor-quality contact lenses has also been added to the predisposing factors. Chronic eye rubbing and itching, and eye allergies are among the most popular causes too. 

What are the common symptoms for keratoconus?

Patient’s with this condition notice that their vision becomes gradually blurred and unclear with frequent change of their glasses prescription. This subtle symptom may progress over years or months and may affect both eyes and one eye more than the other . the most common early symptoms include 

  1. Blurring of distant and near vision despite wearing the proper optical correction
  2. Straight lines appear bent or skewed at different angles
  3. Increased sensitivity to ,light and increased sense of haloes around the light 
  4. Redness and swelling of the eye

Later symptoms become more ominous and include 

  1. Increased blur and visual distortion that does not respond to  any form of optical correction
  2. Intolerance to contact lenses, and their ineffectiveness in improving vision owing to the severe distortion of the corneal shape.
  3. Progression of myopia and astigmatism
  4. Increased sensitivity to light known also as photophobia

When should you see your ophthalmologist?

You should schedule an appointment  with your ophthalmologist if you notice a constant change or rapid deterioration of your vision, which could be caused by astigmatism. 

Diagnosis of keratoconus

During you visit your doctor will revise your medical and family history, and then carry out a complete eye examination, and a few investigations and corneal imaging procedures maybe needed such as:

  1. Refraction: in this examination the overall power of the eye is assessed, and the visual acuity of the eye is determined, the calculation of the required correcting lens is determined. 
  2. Slit lamp examination: your ophthalmologist focuses a slit of light onto the cornea to determine areas of thinning or bulging or scarring  
  3. Corneal imaging using computerized topography: through this highly advanced technology, computer algorithms are used to draw up a highly detailed and precise map of the corneal surface and  thickness Modalities of treatment

What is corneal collagen cross linking?

This is a relatively simple procedure used in moderate  advanced cases where corneal weakness is highly suspected. This procedure is performed under the effect [of topical anesthetic eyedrops, and uses ultraviolet light rays and concentrated vit B2 eye drops to create and strengthen the interconnecting bridges between the collagen fibers in the corneal stroma, making it stronger and less liable to bulge, and it can be used vitamin B2 drops are instilled onto the eye over a period of 30 minutes, this is followed by further 30 minutes of ultraviolet exposure.

It can also be used for cases with chronic and resistant corneal ulcers irresponsive to antibiotics, and some studies have shown that the newly formed collagen bridges help treat the inflammations. 

When does vision improve after surgery?

After the surgery, the doctor will prescribe antibiotic drops, steroid eye drops, and may place a temporary contact lens for 3-5 days, after which It is removed.

 intracorneal ring implantation

 these semicircular devices made of PMMA are inserted into tracks created within the stroma of the diseased cornea and help to restore visual clarity and acuity by flattening the cones and increasing corneal thickness therefore creating a smoother refractive surface and regular light refraction onto the retina.

Corneal transplantation: 

if the cornea is severely thinned out or damaged you might need to have it partially or fully replaced by  donor tissue. This surgery restores the natural anatomy of the cornea and may provide best visual outcomes for some cases

At optimistic eye clinics, Dr Ashraf Soliman provides the best options for the treatment of keratoconus, and he is a  consultant for corneal and laser refractive surgeries, cataract and glaucoma surgery. 

Dr. Ashraf Soliman  an associate professor at the department of ophthalmology, Ain shams university Faculty of Medicine

عن الطبيب

أستاذ طب و جراحة العيون م. طب عين شمس أستشاري جراحات تصحيح عيوب الابصار و المياه البيضاء و القرنية عضو الجمعية الامريكية لعلاج العيون و تصحيح العيون بالليزر زميل المجلس العالمي لجراحة و طب العيون زميل الكلية الملكية لطب و جراحات العيون بأنجلترا

أخر مقالات

روابط هامة

About the doctor

A consultant specializing in corneal, cataract and Glaucoma Surgery and Refractive surgery in Egypt, Assistant Professor of Ophthalmology – Ain Shams University, Consultant cornea, cataract, and Glaucoma Surgery and Refractive Surgery, Fellow of the Royal College of Physicians and Surgeons of Glasgow, UK.

Latest news

Important links

Powered by Be Digital Agency