Keratoconus is an eye disorder that results in thinning and bulging of the cornea, which is a type of corneal ectasia. The usual round shape of the front part of the eye changes into a cone shape in patients with keratoconus due to pressure from within the eye that pushes out through the thin area.
This disease affects both eyes in a progressive manner, but sometimes, it may be asymmetrical. Symptoms often begin to manifest in late adolescence or early adulthood, but they can go unnoticed or undiagnosed for an extended period.
The cornea is commonly known as the “eye’s window,” as its shape directs light into the eye. As keratoconus changes the cornea’s shape, affected individuals become increasingly nearsighted and may develop sensitivity to light. The cornea also becomes more irregular, leading to progressively deteriorating vision that may be challenging to correct using glasses or contacts. If left untreated, this condition can significantly impact vision. The corneal bulge may worsen, and in severe cases, a corneal transplant may be the only viable treatment option available.
It is important to note that the goal of treatment for corneal cross-linking patients is to slow or halt the progression of the disease. For these patients, continued progression often results in loss of visual acuity or decreased tolerance to contact lens wear, caused by the ongoing changes in the cornea. Therefore, the earlier progressive keratoconus is diagnosed, the sooner treatment can be provided that may slow the progression of the disease.
Early signs of keratoconus may include asymmetric refractive error, high or progressive astigmatism, or reduced best corrected visual acuity. The onset of keratoconus often occurs in teenage years or early twenties but can start at any time.
Patient symptoms may include:
Keratoconus, especially in the early stages, can be difficult to diagnose and
All of the above symptoms could be associated with other eye problems.
The Epioxa corneal cross-linking procedure is the only FDA-approved, non-invasive, epithelium-on corneal cross-linking treatment for keratoconus (KC). It was just released in 2026 and Heartland Eye Care is proud to be one of the first to provide it in the Midwest region, and the only place in Topeka (and only place in northeastern Kansas outside of Kansas City)!
It is a non-invasive outpatient treatment that employs a combination of ultraviolet light and specially-formulated eye drops to strengthen and stiffen corneas weakened by disease or refractive surgery. This innovative technique has been widely accepted as the global standard of care for progressive keratoconus and corneal ectasia following refractive surgery.
The Epioxa corneal cross-linking procedure requires no scraping of the cornea. It uses ultraviolet light to activate riboflavin eye drops that have been applied to the eye’s surface. This process results in the formation of chemical bonds between collagen fibers in the cornea, which strengthen and stiffen the tissue. The procedure is performed on an outpatient basis, and most patients can resume their normal activities the next day. Compared to the previous epi-off crosslinking, it only takes 21 minutes instead of 1 hour.
In conclusion, the Epioxa corneal cross-linking procedure is a minimally-invasive outpatient treatment that provides patients with an innovative solution for treating keratoconus. This procedure has been widely accepted as the global standard of care and has helped many patients regain their vision and quality of life. If you or a loved one is suffering from these conditions, it is worth exploring this innovative treatment option with your eye care professional.
Part 1
Light-enhancing Epioxa and Epioxa HD drops are activated by the UV-light to cause the chemical reaction that makes cross-linking take place.
Boost Goggles® provide an oxygen-rich environment which is required for the cross-linking effect.
A special lamp delivers UV light which works with Epioxa eyedrops and oxygen to strengthen the cornea and help halt KC.
1. Applying the eye drops
The doctor will apply the eye drops for a few minutes
2. Fitting the Boost Goggles® and ensuring oxygen is flowing
Next, the doctor puts the goggles on and turns on the oxygen to allow it to flow into the goggles
3. Corneal cross-linking with UV light.
The special light source delivers UV light that works in combination with the eye drops and oxygen to strengthen the cornea.
The total process takes 21 minutes.
No! Epithelium is no longer removed, resulting in much more comfort after the procedure.
Yes, typically you will be awake during the treatment. You will be given numbing anesthetic drops.
There is only minimal discomfort during immediate recovery since the epithelium is now preserved. Immediately following treatment, a bandage contact lens is placed on the surface of the eye to protect the newly treated area. After the numbing drops wear off, there may be mild discomfort, often described as a gritty, burning sensation managed with acetaminophen and artificial tears. Oral narcotic medication is rarely needed with epi-on crosslinking.
No. There is no change in the appearance of your eyes following the procedure.
Patients who have been diagnosed with progressive keratoconus should ask their doctor whether they may be an appropriate candidate for corneal cross-linking.
Yes. Patients need to be out of their contact lens in the treated eye on the day of the procedure. Once treated, patients may not be allowed back into contact lenses for up to 1 month.
The Epioxa procedure is widely covered by commercial insurance policies in the United States. Please contact your insurance carrier or your healthcare provider to understand any out-of-pocket costs you may be responsible for.
Please feel free to schedule an appointment with us to discuss your specific needs and to hear more about how this revolutionary technology can benefit you. We’d love to hear from you.
Heartland Eye Care & Washburn Surgery Center, Where Clear Vision Is Our Mission.
