Dear XXXXXXX

Thanks for the query.

Keratoconus is an eye condition affecting the cornea (the front surface) of the eye. It results in an irregular cornea causing distorted (blurred) vision. Generally keratoconus develops in the teenage years but may begin before the age of ten or not until adulthood.
The word keratoconus is derived from latin words, kerato- "cornea" and -conus meaning "cone shaped". This describes the normally round shaped cornea becoming cone-shaped with the progression of the condition. The keratoconic cornea also tends to thin with progression of the condition. Generally keratoconus is a painless condition although it can cause some ocular irritation in more advanced cases.

Contact lenses are generally considered to be the main-stay of keratoconus management. The main types are soft and RGP (rigid gas permeable) lenses. There are many variations of both soft and RGP lenses, some more suitable for early keratoconus and others for advanced keratoconus.

Collagen Cross linking (CCL):
CCL is a recently developed procedure designed to halt the progression of keratoconus. This is achieved by increasing the rigidity (stiffness) of the cornea preventing it from continuing to distort. The procedure involves removing the thin surface layers of the cornea (epithelium), saturating the cornea with riboflavin (vitamin B2) XXXXXXX then treating the area with UV light. The UV reacts with the riboflavin to increase the bonding between the collagen fibres that make up the cornea. The effect is a greatly increased rigidity and resistance to progression of the keratoconus. It does not cure the keratoconus but prevents it getting worse. Collagen cross linking is an exciting procedure that should reduce the numbers of patients requiring keratoplasty (corneal grafting).

Intacs:
These are small semi-circular plastic rings that are implanted into the cornea. The idea is to "stretch" the central cornea, causing it to flatten and reduce the visual distortion. The results tend to be variable and although they may improve the vision to some degree in mild cases, they do not usually eliminate the the need for contact lenses. They are seldom of benefit in more advanced cases of keratoconus. However, they can be removed should the need arise.

You can discuss these treatment options with your doctor. He will suggest you which one is best suited for you, as he has examined you.

Hope I have answered your query. Please accept my answer in case you do not have further queries.

Regards.

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Dear XXXXXXX

Collagen Cross Linking is extremely safe. The only side effect is that the patient can experience a mild haze in vision for a few weeks. There is no possibility of losing your vision. It costs about Rs.0000 per eye.

Hope I answered all your questions. Please accept my answer in case you do not have further queries. Wish you Good Health.

Best Regards,

Dr.Mihir Shah

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