By Published On: 22 April 20163.6 min read

Keratoconus

This is an eye condition that occurs when the structure of the cornea degenerates. The cornea is the clear tissue that covers the front of the eye. It is normally round but when you have this eye condition, it slowly transforms to a conical shape.  This article is very specific to a number of treatments but keratoconus has many treatments, which depending on the severity require careful thought and planning by a specialist in keratoconus.

When you are suffering from keratoconus, your goal would be to improve your vision. Fortunately, advances in technology over the years allowed the development of new treatments of this eye condition to improve one’s vision and to stop the progression of the disease.  In Sydney and in Australia we are lucky enough to have many of these procedures well before other parts of the world.

Here’s a look at some of these treatments:

INTACS or Kera Rings

With the INTACS or Kera Rings treatment, tiny lenses are placed behind the iris to help transform the cornea into a rounder shape. This helps improve vision by clearing up the distortion or the transformation of the cornea into a cone shape caused by the keratoconus.

We have to admit that Intacs and Kera-Rings have on the whole been quite disappointing for most people.  Some get fantastic results so it is worth while considering if contact lenses have failed even when fitted by a contact lens expert.

Holcomb C3-R Cross Linking System or Transepithelial CXL

Holcomb C3-R Cross Linking System is a non-invasive procedure that makes use of a special solution containing Riboflavin and other natural vitamins to strengthen the fibers of the cornea and reduce its cone-like or steep shape over time. The solution is activated by an ultraviolet light that you are supposed to sit under for 30 minutes.

The Holcomb C3-R procedure strengthens your thinning corneal layers by increasing collagen cross linking of the cornea. This is essential because when the cross linking between the layers are weak, your cornea will tend to thin, bulge and be deformed. The weakening will likewise distort the images you see and it will change your vision. If left untreated, the fibers will continue to weaken and break down, thereby further damaging your corneal surface and worsening your vision. An advanced condition may warrant a corneal transplant. This is precisely the condition the Holcomb C3-R procedure wants to avoid.

This procedure may be combined and done simultaneously with other keratoconus treatments. It can be performed in both eyes simultaneously. 99.03% of patients registered full stabilization within a single treatment.

Success Rate

Note, however, that the Holcomb C3-R procedure does not completely reverse keratoconus. What it does is it slows down or halts the progression of the eye condition. It likewise might reduce the cone-like shape of the cornea that causes the distortion in vision. The likelihood of this is small though.

This is a relatively new procedure.  Long-term results are not available.  Currently in Australia we continue with the original CR-3 treatment, which involves removal of the epithelium and wearing a bandage contact lens for a few days.  This older procedure even though has some disadvantages has long term study and results that you can bank on.  In our opinion it is much better than the Holcomb version.

Benefits

Here are some reasons why Holcomb C3-R may be a good option for treating keratoconus:

•    It is a quick and safe way to improve vision as it does not involve removal of the epithelium.

•    The procedure is non-invasive and it is done in your doctor’s office.

•    It is pain free.

•    No risks are associated with the procedure save perhaps for a mild irritation that may occur a couple of hours after the procedure.

•    It only takes approximately 30 minutes and it continues to improve your vision for two to three months following the procedure.

•    It strengthens and stabilizes the cornea and it can even reverse the damage done to the cornea.

•    PLEASE NOTE: This procedure is as the NOT as effective as the more traditional collagen crosslinking.

If you are suffering from keratoconus, you should at least consult someone that understands thus technology in order to treat your condition.

If you have keratoconus, call us on (02) 9290 1899 and make an appointment. Keratoconus is our specialty.

Comments

91 Comments

  1. Luana Dvorak 7 February 2013 at 9:16 am - Reply

    What would be the approximate cost of surgery for keratoconus?

    My daughter who is 22 years old, may have this condition and I would like to get an idea of what it could cost for the procedure.

    Your earliest reply would be appreciated

    Kind regards

  2. Andrew 24 August 2013 at 11:08 am - Reply

    Hi Jim,

    I have been told that CXL wouldn’t work with myself as my corneas are too thin, although I`m reading details that Holcomb C3-R is different where success is had with thin corneas as well.

    Is this the case? I am from Brisbane.

    Andrew

  3. Gillian Flynn 12 February 2014 at 12:15 am - Reply

    Is your treatment considered appropriate for someone who has been diagnosed with keratconus who would like to join the ADF

  4. Abdullah 12 February 2014 at 12:41 pm - Reply

    I am 15. I have advanced keratoconus in my left eye whereas a slight glare and irritation in my right eye.
    Can thus disease be stopped and a satisfactory vision achieved.

  5. arun 25 February 2014 at 6:12 pm - Reply

    hi jim…I m arun..i m 25 years old..i m from india…..I m suffering from kerotoconus…my left eye is -3 and right eye is -3, I want to knw that wats the cost of holcomb C3-R test..plzz tell me as soon as poszible

  6. Vincent 20 May 2014 at 9:58 pm - Reply

    Hi Dr. Jim,

    I’m 53 and have been diagnosed with keratoconus last year. I’ve tried contact lenses, but they irritate too much and I cannot get used to them. Can you recommend someone in Melbourne that I can visit. I am not keen on a transplant and have read about Steve Holcomb being legally blind and was cured using non invasive techniques. Hoping this can apply to me as well.
    Cheers,
    Vincent

  7. Simran 2 June 2014 at 12:07 pm - Reply

    Hello Dr.Jim. I am having keratoconus in left eye only with -2.25 . And the other eye is fine. I wanted to know dat if both the defects are treatable . I mean to say simultaneously lasik laser and c3R can b done or not. And can u pls tell me the total cost of procedure in australia.. Thank you

  8. Kris Herewini 24 August 2014 at 12:31 pm - Reply

    Hi Dr.JIm,

    I had an eye test around 6-8months ago and was told I have Keratocounus.I wasn’t told how serious it was but it is in my left eye,my right eye is fine.I am from Brisbane could you please refer me to a specialist that can help as I am looking to get this under control!!.I have noticed it since my early teens around 17-18 and did get it checked by the optometrists and they did nothing they just told me what it was and said come back for your next check up in a few months so I left it at that and I am now 22 and I can’t go on not doing anything.Please help.

  9. Eve 30 August 2014 at 1:47 pm - Reply

    Could you please give me an approximate cost for intacs to treat keratoconus?

  10. Hamish 31 August 2014 at 4:43 pm - Reply

    Hi Jim, im 29 and have advanced keratoconus in both eyes. I developed hydrops already about 7 years ago and have corneal scares in the left eye. I am currently fitted with a scleral lens in my right eye but vision is still poor with lens ie 20/80 or around there. Left eye cannot be fitted with a lens as it’s too sensitive and vision improvement isn’t that great. Without lens my vision would be about 20/800. Very blurry and distorted. Can cxl help the vision correction or will it only stabilize the cornea from getting worse and not improve my vision? I want to try everything before a corneal transplant. Can you recommend anyone in Brisbane that is good or I will fly down to syd if my vision can be improved.

  11. Stuart 14 September 2014 at 10:29 am - Reply

    Hi Dr Jim.
    I live in Adelaide & was wondering if the procedure is available to me in South Australia or would I have to travel interstate to get it done?
    My right eye is much worse than my left eye. I work nights & am required to drive around to government buildings. If my left eye gets as bad as my right eye I will no longer be able to work nights. So I could benefit greatly from this procedure.

  12. Jay Ratna 21 September 2014 at 10:40 pm - Reply

    Dear Dr Jim
    My son (23 y) has been diagnosed with Keratoconus recently. Would you please recommend a doctor in Brisbane whom services can be obtained to cure his condition.
    thanks

  13. harmeet 3 October 2014 at 4:11 pm - Reply

    Hi..I m harmeet..I want to get rid of eye glasses..my right eye no. Is -6.00 and left eye is -8.00..bt I m diagnosed with keratoconus in both eyes..doctor says lasik laser is not possible..is there any solution in which lasik laser may b possible in keratoconus condition..I want to send u my keratoconus reports..provide me ur email pls..

  14. harmeet 3 October 2014 at 4:15 pm - Reply

    Pls send infomation on my email also..”[email protected]

  15. Joseph g. 21 October 2014 at 3:57 pm - Reply

    My name is Joseph. I live in Texas. Do you know of anyone here to help me with my karatoconus? I’ve been looking for just a short while now. Trying to find prices and locations. Thank you.

  16. manal 14 November 2014 at 8:11 pm - Reply

    I have a mild keratoconus. My age 47. Am very shortsighted.
    Need to know the cost of the intact and the holocomb

  17. Michael 26 November 2014 at 3:30 am - Reply

    Hi Dr Jim

    I am 41, live in Perth and was diagnosed with Keratoconus around 25 years ago. I have worn RGP lenses ever since and my vision has been fairly stable over the years (same script for lenses for at least the last 6 years possibly more). Is it a worthwhile exercise investigate any of these newer procedures and who are the best people to see about this in Perth?
    Cheers
    Michael

  18. James 28 December 2014 at 11:23 am - Reply

    Hi my name is James. I’ve had Keratoconus since I was in high school. My left eye is much worse than my right. I live on the gold coast in QLD. Is there someone I can see to talk about treatment options that is near me?

    Thank you

  19. Mel 7 January 2015 at 10:39 pm - Reply

    Hi doc, my partner was diagnosed with Keratoconus since June 2014.. That’s when it was just the one eye, now he’s right eyes is blurred up and he would have to squint he’s left eye to see even tho it’s not so clear . He’s is 24 years old, has a 2 year old baby and one on the way and we are suppose to get married next month. I’m afraid this will get worse for him, what do you recommend.. He also has surgery next month on the 16th for a transplant on his right, is this a good idea or should we try this ring treatment ? The reason why we are going through with surgery is because we were place on he waiting list and it will be for free for us as he is not working , all these other treatments have been quite expensive and we can barely afford any. Help us out doc pls

  20. Ned Morris 18 January 2015 at 11:58 pm - Reply

    Hello

    I have kertoconus, but have trouble conisistently wearing my contacts due to my vision not being sper bad.

    so i would like to explore my options of the implants. Who do you reccomend to speak to in Melbourne city?

    Ned

  21. Eve 8 February 2015 at 6:04 am - Reply

    Do you know if CXL combined with T PRK has proven to give successful results.

    Also, living in Canberra, do you recommend any particular eye specialist or contact lens fitter to treat keratoconus?

  22. chrid 9 February 2015 at 3:20 am - Reply

    is this treatment being done in usa and is do where i live in mich

  23. mehreen rehan 12 March 2015 at 9:45 am - Reply

    Hi dr Ji. I m 29 yr old..Have been diagnosed keratoconus in my right eye..have been told by an optometrists that no power of glasses will work in my right eye.I went for regular eye test due to headaches n reduced vision..have been using glasses with-3.5 in left eye and -6 in right eye..after the test she told be abt keratoconus in right eye and told no power will work now.she has given me new power for my both eyes I.e 4.75.. With left eye I.e -4.75 I m able to view things fine but I am very tensed about my right eye as the vision is extremely blur can’t read..who do u suggest to see in Melbourne.. Will be very thankful for ur advice. Regards

  24. Prachi 12 March 2015 at 3:53 pm - Reply

    I would like to know the cost of Intacs and C3R. I consulted a doctor in Chicago and he told me Intacs is $4000 per eye and C3R is $2500 per eye. When I researched on internet I found these figures are pretty high.

  25. Joann Swafford 13 May 2015 at 3:59 am - Reply

    Looking for Any referrals in United States. N preferably in Texas. My daughter has this horrible eye disease. ..

  26. manicse 25 May 2015 at 12:50 pm - Reply

    Hi Dr Jim,
    i live in melbourne! i am 35 and diagnosed with Keratoconus at 18. i am wearing RPG lenses since diagnosed and my vision is stable but recently having trouble with wearing leans on right eye feeling very uncomfortable! i guess something is wrong and would like to visit an expert in melbourne for checkup and advise ?

  27. Barbara Carbajal 27 May 2015 at 2:56 pm - Reply

    Hello,
    My son is getting ready to schedule a CXL procedure. Is this the same as CR-3? Is there a doctor in the United States that is performing the CR-3 procedure? And where?

  28. Damien 31 May 2015 at 6:19 am - Reply

    Hi jim I suffer from keratoconus in both eyes ive had a corneal graft unfortunately after 3 yrs it rejected im left with cloudy virtually no vision in the right eye I am on an operating waiting list are their any other options apatt from invasive surgery I am early 30s its always been a big problem with allergies and lenses are comfortable at the beginning but end up not fitting falling out and very costly please help

  29. Nathan 1 July 2015 at 7:39 pm - Reply

    Hi Dr Jim;

    My name is Nathan and I’m suffering from keratoconus, I live in Perth WA and was diagnosed at 25 and I’m now 27.

    I’ve tried rigid contact lenses but could not stand them. I now have gasses. With or without my glasses im effectively blind in my right eye, my vision is solely reliant on my left eye.

    What do you think is the best course of action? I have a great optometrist named Ernie and he said the next step is cross linking

    Any advise would’ve appreciated

  30. viral jagada 4 August 2015 at 5:58 am - Reply

    my name is viral.i am from india.my wife has carataconus sinc last 10 years.i want to kenw that does cr3 treatment possible in india and what is the cost.which doctor can i contact.i am from gujrat india.pls send me ans soon as possible.give me ans in my email address

  31. Hussain 16 August 2015 at 8:50 am - Reply

    and please tell me the cost in melbourne and after the surgery how long that I can get back to normal?

  32. danny 12 October 2015 at 6:01 am - Reply

    Hi,
    I have got Keratoconus and wearing scleral lens.have satisfactory vision but a kind of headaches and very problem in night driving with glare. Is there any way i can make my life easier, i did CXL as well. I am also pharmacist myseld but the hell KC took the life away. cant concentrate in anything and very difficult life..Suggestions please. appreciated.thankx.

  33. Yvonne 3 December 2015 at 2:48 am - Reply

    Hi Dr Jim,
    My husband is turning to 30 next year, he is diagnosed with Keratoconus with his right ey a month ago with last stage, cornea front shown its 6.62mm for Rs, K251.0D, Rf6.96mm K148.50D and Cornea Back Rf4.99mm K1 -8.0D, Rs4.54mm, K2 -8.8D.
    We have seen two specialist said Corneal transplant is the only way for my husband, the cross link with Vitamin B is not suitable for him as he is at a very late stage, do you have specialist located in Gold Coast or Brisbane that we can meet for advis?
    Thank you.
    Yvonne

  34. kirsty 14 January 2016 at 2:12 pm - Reply

    Hey. I was diagnosed with keratoconus around 6 years ago my eyes deteriorated to much for glasses early on and I currently wear rigid hard contacts and My eyes are slowly getting worse every year it seems. Was wondering if I could get the c3r treatment in Australia. I’m located in darwin. Thanks

  35. Chan 27 April 2016 at 7:32 am - Reply

    Hi,

    I am at age 34 years old and was just being told I am diagnosed with Keratoconus. The doctor has recommended me to perform CXL although she said it might not be so effective for me due to my age.

    I am not sure should I give a try given my age and I did read articles that usually after the age of 30, it may stop progress and also it is no recommended for CXL due to the responsiveness to the collagen applies.

    Kindly advise.

    Thanks

  36. Faisal 7 May 2016 at 4:10 am - Reply

    Hi D.Jim, who would you recommend to see in perth?
    Thanks,,

  37. Ashutosh 7 May 2016 at 8:00 pm - Reply

    Hi, I am Ashutosh Gupta from INDIA, I have Keratoconus in my left eye and was treated with C3R in both eyes as a precaution for right eye. Later on Intacs were planted in Dec2014 . Since then there is very little improvement in my left eye vision. Feeling blurry in my right eye now. Can you please share what are the new research like stem cell therapy or some other treatment going on or approved to operate on eyes with keratoconus

  38. asiri 25 May 2016 at 10:40 pm - Reply

    Dr.Jim .I was diagnosed with Keratoconus.Could you please recomend a specialist in canberra for treatment as i haven’t had any treatments yet.
    Thank you.

  39. Brendan 3 June 2016 at 4:15 pm - Reply

    Hi,

    I am 25 from Perth, WA. I recently visited an eye specialist and was diagnosed with keratoconus. The doctor highly recommended the collagen cross linking procedure. Just wondering who you would recommend in Perth to perform these procedures.

  40. manu 8 August 2016 at 3:56 am - Reply

    Hi,

    I am from Melbourne, suffer from keratoconus, have got the C3R bonding in both the eyes, but would like to know if there is any good surgeon in Melbourne who could help me further please. What sort of cost is involved, if I could get a rough estimate.
    Thanks

  41. Ebrahim 19 September 2016 at 5:59 am - Reply

    Dear Dr. Jim

    Please provide an email address so I can attached my Eye Test / Topography from 2004 up to now.

    I have been advised to perform different corneal surgery (i.e. Cross Linking+Lasek, Corneal Ring +Cross Linking even corneal Transplant) by various specialist which is quite confusing.

    I would appreciate your expert opinion considering I am 42 years old engineer doing office work, No retina issue, normal eye pressure.

  42. Nicole Fisher 23 October 2016 at 3:58 am - Reply

    Hi,
    I am trying to organise fundraising for a 22 year old man in Gambia with advanced keratoconus – he requires surgery overseas to fix it – I contacted HelpMeSee charity in New York to find a clinic near him. Through them I have been liasing with a man who oversees various clinics in the area including the one I sent this young man to. The ophtalmologist is preparing me a report so I can set up a GoFundMe page.

    Just wondering what we in Australia can do to help? He cant work he can barely read due to such terrible sight and his education has been limited due to this. I’d like to see him be able to see again and get a vocation (he’d like to be a plumber rather than a firewood collecter/cutter).

    Thanks,
    Nicole

  43. Nicole Fisher 7 November 2016 at 12:16 am - Reply

    Hi Jim I have supplied you with the necessary document regarding the Man in Gambia with Keratoconus and need advice on what can be done for him, where it might be done, what follow up care might be needed and costs involved so I know what to fundraise for.

  44. Ahmed Abdallah 18 January 2017 at 9:31 am - Reply

    Dear Dr Jim Kokkinakis, thank you for taking the time to read my email, i have kerodeconus in both eyes, i’m 38 years old and have had this problem since i was about 17 years old, i have tried glasses, soft lenses and hard contact lenses neither do the result, i currently wear glasses but have to take them off a short time later as my vision distorts and i have to squint to see, i have had a surgery in my right eye with a lens implanted behind the cornea about 10 years ago but it’s doing nothing for me, i have run out of options, my eyes are still getting worse and now i’m experiencing a burning sensation sometimes where i cant open my eyes anymore and they get very watery, my last option from my current specialist is a cornea transplant which i really don’t want to do, i’m hoping you can help me or point me to the right direction, i live in Melbourne 20 minutes from cbd, it would be much appreciated, thank you.

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