CXL and the treatment of keratoconus (C-100432)
    
    
        
                
            30 April 2020
            Spring 2020
            
         
        Consultant Ophthalmologist Damian Lake looks at the history of corneal collagen cross-linking in treating keratoconus, the current indications for its use, and the most up-to-date refinements to the procedure.
     
    
        
            
                
            
            
                    
                        Domains covered
                            
                
                    
                    Communication
                
                
                    
                    Clinical practice
                
    
                     
                
             
         
     
    
    
        
            
                
    
        Keratoconus, which causes the cornea to become thinner and steeper, is perhaps most commonly associated with eye rubbing. Regular, traumatic vicissitude of eye rubbing can weaken the cornea, creating bulging, thinning and structural failure. The likely pathogenesis 
is multifactorial, with a wide range of genetic loci suggesting the disease is dependent on external influences that lead to initiation and progression. 
Associated ocular and systemic conditions include, but are not limited to, atopic eczema, asthma, allergic eye diseases, Down’s syndrome, collagen vascular diseases and retinitis pigmentosa. Keratoconus is known to affect between one in 400 and one in 2000 – mainly young – people worldwide (Godefrooij et al, 2017). 
     
             
            
                
            
         
     
         
        
            
                
                
                    
    
    
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