Keratoconus is an eye disease in which the cornea begins to get thin and bulge into somewhat conical shape. The conical shape of cornea deflects light as it enters the eye on its way to the light-sensitive retina. This deflection results in distorted vision. Keratoconus often begins during a person's teens or early 20s. It can occur in one or both eyes.

Keratoconus Symptoms And Signs

As the cornea becomes more irregular in shape, it causes gradual nearsightedness and irregular astigmatism to grow, leading to further problems with distorted and blurred vision and sensitivity towards light.

Usually, keratoconic patients have their eyeglass prescription changed on every visit to their consultant or ophthalmologist.


What Causes Keratoconus?

Research studies suggest the thinning of the corneal tissue that leads to keratoconus may be due to an irregularity of enzymes within the cornea. This disparity makes the cornea more vulnerable to oxidative loss from compounds called free radicals, causing it to weaken and bulge forward.

Keratoconus Treatment | INTACS

Intacs corneal inserts or implants are a slightly invasive surgical option used primarily for the treatment of keratoconus.

For treating nearsightedness, Intacs correct vision by flattening the cornea to refocus light rays and enhance vision. For keratoconus, Intacs flatten the bulging part of the cornea or cone to reduce vision distortions.

Intacs are made of the same biocompatible material from intraocular lenses used for cataract surgery, so there is no danger of side-effects.



During the procedure, your surgeon creates a tunnel between layers of the corneal stroma, outside of the central optical zone. The surgeon then chooses the appropriate ring thickness. A thicker ring in Intacs means more thinning of the cornea, which increases the level of vision correction attained. The procedure is over once the required crescent-shaped Intacs are inserted into the tunnel.

Keratoconus Treatment | Corneal Cross-linking (CXL)

Corneal cross-linking (CXL) is an eye procedure that strengthens the cornea if it's been debilitated by keratoconus. The slightly invasive CXL procedure involves applying liquid riboflavin (vitamin B2) to the surface of the eye, followed by treatment with a measured application of ultraviolet light, to remove corneal ectasia.

The two basic types of corneal cross-linking are:

Epithelium-off CXL.In this type, the thin outer layer (epithelium) of the cornea is removed to allow the liquid riboflavin to more easily penetrate the corneal tissue.

Epithelium-on CXL. The process is also called transepithelial CXL, in which the protective corneal epithelium is left intact, requiring a longer riboflavin "loading" time.

During initial examinations, your ophthalmologist will measure the thickness of your cornea and make sure you are a good candidate for the procedure. You also will need to have a regular eye exam to check your visual sharpness and eye health. And your ophthalmologist will perform mapping of your cornea (called corneal topography) to determine the health of your eye.

In most cases, the crosslinking procedure takes 60 to 90 minutes.


If you are receiving epithelial-off crosslinking, your surgeon will place you in a reclining position and remove the epithelial layer from your cornea. Riboflavin eye drops will then be placed.
If you are receiving epithelial-on crosslinking, you are placed in a reclining position, and riboflavin drops are started. After enough time has passed (depending on the technique), the surgeon will assess your eye to ensure that the cornea has sufficient riboflavin present.
The corneal thickness will be checked, and then the UV light will be applied for up to 30 minutes.

Why treatment of Keratoconus at HASHMANIS

1: Hashmanis Hospital is the leading eye care hospital in Karachi established in 1987.

2: Hashmanis Hospital is well equipped with state of the art equipment.

3: Hashmanis Hospital is the only hospital that offers Intacs in Pakistan under the supervision the most experienced eye care surgeons who have years of experience in eye care and surgeries