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What is keratoconus?

Keratoconus is an eye condition that involves thinning of the cornea, leading to cone-shaped bulges on the surface of the eye. The misshapen cornea causes the eye to distort the images it processes, causing poor quality vision. Unfortunately, keratoconus is a progressive condition, meaning that it will get worse over time.

keratoconus diagram

What is cross linking?

Corneal cross linking, sometimes referred to as CXL, is a new and revolutionary treatment that can benefit patients with more severe cases of keratoconus. Quick, painless and minimally invasive, the procedure strengthens the cornea through the application of riboflavin (vitamin B2), to help new collagen bonds or ‘links’ to form. An ultraviolet light then illuminates the cornea to activate the riboflavin. After this, a bandage contact lens is applied to the affected eye, which can be removed a few days later when the eye has healed.

Traditionally, the cross linking procedure has taken up to an hour. However, a new, advanced procedure known as ‘advanced corneal collagen cross linking’ can be carried out in just a few minutes. See our Keratonus treatments page for more information.

When is it used?

Corneal cross linking for keratoconus is not always suitable for all patients:

  • If the condition is mild, it may not be required.
  • If the condition has progressed too far, the cornea may have become too thin to operate on safely.

You should speak to your specialist about cross linking to find out if it is a suitable procedure for you.

Risks and benefits of corneal cross linking

Cross linking is a relatively new procedure that was only developed in the late 1990s. However, it is a low-risk operation that carries few side-effects:

  • Around 3% of patients may experience a worsening of vision in the eye that has been treated. This can usually be corrected with a corneal transplant if necessary.
  • Without undergoing corneal cross linking, around 20% of patients with keratoconus would eventually require a corneal transplant.

The main benefit of cross linking is that it can halt the progression of keratoconus. It is important to note that not all patients who undergo the procedure will experience an improvement in their vision.


After undergoing corneal cross linking for keratoconus, patients may experience pain in the affected eye for 3-5 days. They can expect to experience extreme sensitivity to light.

The bandage contact lens will be removed at a follow-up appointment after a few days. Patients should take time off work and other strenuous activities for up to a week, to allow time to heal

woman after laser surgery

More information about the cross linking procedure

If you would like to know more about corneal cross linking for keratoconus and would like to discuss your treatment options, contact us to book a consultation.