Understanding Keratoconus

North Bay Eye Associates now offers a procedure called iLink corneal cross linking. This minimally invasive outpatient procedure is the only FDA approved cross linking treatment for progressive keratoconus and corneal ectasia following refractive surgery.

Keratoconus typically appears in individuals who are in their late teens or early 20s. The condition causes the cornea to weaken and thin over time, resulting in the formation of a cone-like bulge. As a result, patients can experience significant visual loss and may require a corneal transplant.

Diagnosing Glaucoma in the Sonoma Valley
Keratoconus and Crosslinking in the Sonoma Valley

The iLink procedure combines the use of specially formulated prescription eye drops called Photrexa® (riboflavin 5’ phosphate ophthalmic solution) and Photrexa® Viscous (riboflavin 5’ phosphate in 20% dextran ophthalmic solution), with ultraviolet light from the KXL System to help stiffen and strengthen the cornea that has been weakened by disease.


Keratoconus, often referred to as KC, is a non-inflammatory eye condition in which the typically round, dome-shaped cornea (the clear part of your eye) progressively thins and weakens, causing a cone-like bulge and optical irregularity of the cornea. Keratoconus can result in significant visual loss and may lead to corneal transplant if left untreated.

iLink™ is the only FDA-approved corneal cross-linking procedure for the treatment of progressive keratoconus, which means it has been proven safe and effective in rigorous clinical studies . This minimally invasive outpatient procedure uses specially formulated prescription eye drops called Photrexa (riboflavin 5-phosphate ophthalmic solution) and Photrexa Viscous (riboflavin 5-phosphate in 20% dextran ophthalmic solution), combine d with ultraviolet (UV) light from the KXL System, to slow or halt the progression of disease.

Under the conditions used for iLink™ corneal cross-linking, specially formulated pharmaceutical-strength riboflavin eye drops called Photrexa and Photrexa Viscous enable the cross-linking reaction to help slow or stop keratoconus from progressing.

iLink™ corneal cross-linking applies an artificial source of UV light from a machine called the KXL System once the cornea has been soaked in the Photrexa and Photrexa Viscous eye drops. This process works to stiffen the cornea by increasing the number of molecular bonds, or cross-links, in the collagen.

Yes, your doctor will apply topical anesthesia to numb the eye prior to the removal of the epithelium. This process helps prepare your eye so that the drug can penetrate the tissue of the cornea to have an effective iLink™ procedure. Today, this is the only cross-linking procedure deemed safe and effective by the United States FDA.

Yes, typically you will be awake during the treatment. You may be given relaxing medication and numbing anesthetic drops.

The actual procedure takes about an hour, but you will be at the office for approximately 2 hours to allow sufficient time for preparation and recovery before you return to the comfort of your own home.

  • After numbing drops are applied, the epithelium (the thin layer on the surface of the cornea) is gently removed
  • Photrexa Viscous eye drops will be applied to the cornea for at least 30 minutes
  • Depending on the thickness of your cornea, Photrexa drops may also be required
  • The cornea is then exposed to UV light for 30 minutes while additional Photrexa Viscous drops are applied
  • You should not rub your eyes for the first 5 days after the procedure
  • You may notice a sensitivity to light and an uncomfortable sensation in the treated eye. Sunglasses may help with light sensitivity
  • If you experience severe pain in the eye or any sudden decrease in vision, you should contact your physician immediately
  • If your bandage contact lens from the day of treatment falls out or becomes dislodged, you should not replace it. Contact your physician immediately
  • There is some discomfort during immediate recovery but usually not during the treatment. 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 is some discomfort, often described as a gritty, burning sensation managed with acetaminophen and artificial tears. If pain is severe, oral narcotic medications may be prescribed.

    No. There is no change in the appearance of your eyes following an iLink™ procedure.

    Patients who have been diagnosed with progressive keratoconus should ask their doctor whether they may be an appropriate candidate for iLink™ corneal cross-linking.

    Yes. Typically, doctors ask their patients to stop wearing contact lenses prior to surgery for several weeks. Once treated, patients may not be allowed back into contact lenses for up to 1 month.

    The iLink™ 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.

    If you have symptoms of Keratoconus, visit one of our optometrists for an eye exam right away

    Our team at North Bay Eye Associates are experts in this field. Make an appointment at one of our conveniently located offices in Healdsburg, Petaluma, Sonoma, Santa Rosa. Call our team today at one of our offices or reach us through our website by using our online contact form.