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Corneal Cross Linking

Division of tasks:

  • Keratoconus can be corrected by an optometrist with glasses or contact lenses.
  • The progression of keratoconus is assessed and treated by an ophthalmologist.

What does the ophthalmologist do?

Keratoconus can be measured very well with the Pentacam. The Pentacam measures the curvature of the front and back of the cone and the thickness of the cornea at the cone. The Pentacam also has software to accurately track the progress of the cone. The software makes it possible to assess changes of the cone very specifically and accurately. This allows an ophthalmologist to show progression. Corneal crosslinking (CXL) is a treatment of the cornea that can very effectively stop the progression of keratoconus. This prevents further loss of contrast sensitivity and vision. Since CXL has been applied, the number of corneal transplants in people with keratoconus has already decreased considerably. Especially in young people under 40 years it is advisable to have the progression of the keratoconus assessed by an ophthalmologist.


  • Is a treatment that stops or slows the progression of keratoconus
  • Further loss of contrast sensitivity and vision is prevented.
  • Can be applied when progression has been demonstrated in the past year
  • Can prevent a cornea from having to be transplanted

What is Corneal Crosslinking?

Corneal Crosslinking (CXL) is a treatment of the cornea that is performed by a specialized ophthalmologist. The aim of the treatment is to make the cornea firmer. The cornea is made up of highly refined fibrils (collagen fibres). These fibers form a strong network, which, due to their special structure, gives the cornea clarity. CXL gives these fibrils interconnections, making the cornea more rigid.

Do you still need contact lenses or glasses after CXL?

Yes, usually. In some cases, making the cornea more firm also goes hand in hand with flattening the cornea. For some people this may mean that they no longer need glasses or lens corrections.

When will CXL be performed?

CXL is performed if there is evidence of progression within one year. Young people under the age of 40 are especially suitable for this treatment. Keratoconus usually stabilizes on its own after age 40.
The cornea does need a minimum thickness to be eligible for this treatment. The ophthalmologist will inform you about this.

Can I prevent progression of the keratoconus myself?

People with keratoconus who rub their eyes are more likely to be progressive compared to people who don’t. So stop rubbing. Sometimes rubbing the eyes has become a habit. Then it can be useful for housemates to point out that you rub your eyes. The tendency to rub the eye is strongest for many when getting up and at the end of the day.

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