What is Keratoconus?

Keratoconus is a progressive eye condition that causes the cornea, the clear, dome-shaped front surface of the eye, to thin and bulge outward into a cone shape. This distortion can lead to blurry vision, increased light sensitivity, and difficulty with night driving. If left untreated, keratoconus can worsen over time and may eventually require a corneal transplant. That’s why early diagnosis and prompt treatment with corneal cross-linking can be essential in protecting long-term vision.

What is Corneal Cross-Linking?

Corneal collagen cross-linking is a treatment for progressive keratoconus that stiffens corneas that have been weakened by the disease. It works by strengthening the natural collagen fibers in the cornea, helping the eye maintain its shape and resist further bulging. Using the only therapeutic products that have been FDA approved for this treatment, cross-linking is a minimally invasive outpatient procedure that combines the use of the riboflavin pharmaceutical drops and ultra-violet (UV) light. The procedure does not correct vision, but it helps preserve it by preventing keratoconus from getting worse.

This treatment has been clinically proven to limit the progression of this sight-threatening disease. In many cases, it can delay or eliminate the need for more invasive options, such as corneal transplant surgery.

View Video

What Can I Expect During the Cross-Linking Procedure?

  • You will remain awake during the procedure but may be given a mild medication to help you remain relaxed. The entire procedure takes around an hour, however you can plan to be with us between 2-3 hours.
  • Numbing drops are applied to ensure you will not feel anything during the treatment. The thin layer on the surface of the cornea (the epithelium) is gently removed so that the drugs can penetrate the tissue of the cornea.
  • Next the Riboflavin eye drops will be applied to the cornea for at least 30 min.
  • Lastly, a UV light is used to activate the riboflavin and strengthen the bond of the eye’s collagen fibers.

What can I expect following the procedure?

A contact lens bandage is used immediately following the treatment to protect the eye.

Patients can expect some discomfort and light sensitivity, eye drops, and mild pain medication is provided to help.

Benefits of Corneal Cross-Linking

Corneal cross-linking offers several important benefits for patients diagnosed with progressive keratoconus or corneal ectasia. This FDA-approved procedure is designed to strengthen the cornea and prevent further vision loss. While it does not reverse the condition, it plays a crucial role in halting its progression and preserving long-term visual function.

  • Helps stabilize the shape of the cornea by strengthening collagen fibers
  • May delay or eliminate the need for a corneal transplant in the future
  • Reduces the risk of severe corneal scarring as the condition worsens
  • Minimally invasive outpatient procedure with a relatively short recovery
  • Only treatment currently FDA-approved to slow or stop progressive keratoconus
  • Compatible with other therapies, including glasses and contact lenses
  • Helps preserve vision by maintaining a healthier, more stable cornea

Cross-linking plays an important role in preventing further damage and helping patients maintain a more stable, healthier cornea over time.

Who Is a Candidate for Corneal Cross-Linking?

Not every patient with keratoconus will require cross linking, but for those showing signs of progression, early treatment can be essential. Determining candidacy involves evaluating the condition of the cornea, the stage of the disease, and overall eye health.

  • Ideal for individuals with progressive keratoconus or progressive corneal ectasia
  • Most effective when performed in the early stages, before significant corneal distortion
  • Corneal thickness must meet safety thresholds to protect the inner layers of the eye
  • Patients must be free from active eye infections or severe corneal scarring
  • Those with realistic expectations, who understand that the goal is stabilization and not vision correction, are best suited
  • Compliance with post-procedure care, including eye drops and follow-up visits, is required

Cross linking may not be the right option for every patient, but for those who qualify, it can significantly reduce the risk of worsening disease and future complications.

Why Choose Us for Cross-Linking in Charleston

Patients throughout Charleston and the Lowcountry trust Dr. David O’Day for advanced corneal care, including corneal cross linking. As a fellowship-trained corneal specialist, Dr. O’Day is one of the few ophthalmologists in South Carolina who regularly perform this FDA-approved procedure. His experience managing complex corneal disease gives patients access to a high level of care without leaving the region.

Our physicians understand the complexity of corneal disease and provides individualized evaluations to determine the best course of treatment. From your first consultation to your final follow-up, we focus on patient comfort, safety, and education. We use FDA-approved techniques and follow the latest clinical standards to ensure your care is both effective and supported by current evidence.

Patients trust us because we combine expert-level care with a local commitment to the Charleston community. We take the time to answer your questions, explain your options, and support you throughout the treatment process. When you choose our practice, you are choosing a team that is dedicated to helping you preserve your vision and maintain a healthier cornea for the future.

Cost of Corneal Cross-linking in South Carolina

Many insurance companies now cover the treatment. CLICK HERE to discover if yours is included.

If you have been diagnosed with keratoconus and wondering if corneal cross-linking is right for you, we encourage you to schedule an appointment with Dr. O’Day. As one of the most experienced in cross-linking in the state, you can rest-assured you are in good hands.

Corneal Cross-Linking 2

Medically reviewed by:

Dr. David G. O’Day,
M.D.

Call Our Team

Whether you’re concerned about your eye health, are interested in vision correction or just need an annual exam, we’re here to help.
Call to talk to us today.

Request an Appointment

Ready to book a consultation or schedule an exam? Request an appointment now. We look forward to help you see more clearly.

Frequently Asked Questions

Also called collagen cross linking or CXL, it is a minimally invasive outpatient procedure combining riboflavin eye drops and UV light to strengthen collagen molecules in the corneal tissue and prevent progression of keratoconus.

No, cross linking is not a refractive surgery. Its purpose is to stabilize the cornea and help preserve vision; you may continue to need new glasses or contact lenses afterwards.

The procedure itself lasts about an hour, but you should plan for 2 to 3 hours total at the office. Afterward you’ll wear a protective contact lens and use eye drops; most discomfort lasts about a week.

Some patients may experience corneal haze, mild postoperative pain, or eye infection (rare). Strict follow-up and the use of steroid drops help mitigate risks.

Very thin corneas or severe corneal scarring may disqualify a patient. In such cases, other options such as deep anterior lamellar keratoplasty or corneal transplant (penetrating keratoplasty) may be considered.

Many insurance plans now cover corneal cross‑linking surgery, but coverage varies. Our team can assist in verifying your benefits.

Unlike purely symptomatic treatments like specialty lenses, cross linking addresses the root weakening of the cornea. By halting progression, it may delay or prevent the need for more invasive procedures such as corneal transplant.