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Category Archives for Keratoconus

Treatment for Kearatoconus eye disease

Kertatoconus Expert Answers Your Questions

​Q1. Is Keratoconus eye disease hereditary?                                                                          A1. Genetics are supposed to play a part in transmission of this disease.

Q2. Neither my parents nor my grand parents had the disease. Why did I get it?           A2. Your grandparents may have had subtle disease. In those times diagnostic equipment to detect this sight threatening disease did not exist. There is also a possibility that your disease may be a new mutation. Finally there is a chance it may be not be hereditary.

Q3. Besides genes is there any cause for getting Keratoconus?                                         A3. Rubbing the eye is a major culprit. In fact there is a school of thought that this is the major common pathway for progression. So please do not tub your eyes.

Insurance and keratoconus treatment reimbursement.

​Q. Does vision insurance like VSP or Spectra cover surgical treatment of keratoocnus?                                                                                                                               A. VSP covers for contact lens like scleral contact lens​ for improving vision in keratoconus eyes. They do not reimburse for cornea cross linking or intacs.

Q. Which medical insurance covers cxl for keratoconus?                                                   A. Many medical insurances have started reimbursing for prevention of progression of keratoconus. An important caveat is that the surgeon has to be certified  to use FDA approved riboflavin. Currently Avedro Photrexa is the only FDA approved.

Q.If I have a high deductible, can I still have cxl?                                                                A. Yes you may even use affordable monthly payment plans.

Q. Can i use my flex or HSA plan towards my keratoconus eye procedure.                   A. Since this is a medically necessary procedure you can pay for it by HSA or FLEX funds.

Scleral Contact Lenses – a new hope


If you have actually been told in the past that you cannot wear contact lenses due to an irregular cornea or various other problems, you might wish to get a second opinion and also ask your ophthalmologist regarding scleral contact lenses.

Scleral contacts are large-diameter or larger in size than normal contact lenses or gas permeable contact lenses specially designed to vault over or cover the whole corneal surface area and also hinge on the "white" of the eye (sclera). In doing so, scleral lenses functionally replace the irregular cornea with a flawlessly or perfectly smooth optical surface area to correct vision problems caused by keratoconus and various other corneal irregularities.

Additionally, the space in between the cornea and the back surface area of a scleral lens acts as a fluid reservoir to provide convenience for individuals with extreme dry eyes that otherwise might not endure contact lens wear.

Types of Scleral Lenses

Scleral contacts are significantly bigger than conventional gas permeable General Practitioner contacts and have a diameter equivalent to or greater than that of soft contact lenses. The smallest sclerals are around 14.5 mm in diameter, and also the biggest can be approximately 24 mm.

How a scleral lens vaults over a misshapen cornea to assist somebody with keratoconus see far better.

Large-diameter scleral and semi-scleral General Practitioner lenses hinge on the sclera and vault over the irregular cornea of an individual with keratoconus, for better vision. Increase the size of generally lenses that are 18 mm or smaller are subcategorized as mini-sclerals.

The ordinary human cornea is around 11.8 millimeters in diameter, so also the smallest scleral contacts are developed to cover the entire} corneal surface area.

In contrast, the majority of traditiona General Practitioner contact lenses are 9.0 to 9.5 mm in size and cover only 75 to 80 percent of the cornea.

An additional category of gas permeable lenses bridges the size gap between traditional General Practitioner lenses and mini-sclerals. These lenses, called corneo-scleral lenses, normally are roughly 13 to 15 mm in diameter.

Corneo-scleral lenses often} are a great {option for people who require larger-than-normal General Practitioner lenses for betterconvenience}. They also are frequently used when contact lenses are required after LASIK or other corneal refractive surgical treatment to correct irregular astigmatism.

The dimension of lens used usually is identified by the level of complexity of the condition. Milder types of keratoconus and irregular astigmatism from corneal grafts as well as refractive surgical treatment frequently are conveniently managed with scleral lenses at the smaller sized end of the spectrum.

Smaller sized scleral and mini-scleral contacts can be much easier to apply, can be less expensive and need less} care products

Much more complicated problems, consisting of advanced keratoconus, pathologically dry eyes or serious eye surface condition that may call for a huge tear storage tank, commonly are fitted with bigger scleral lenses, as they have a lot more capability to hold liquid or bridge huge adjustments in corneal curvature.

Throughout your contact lens examination as well as fitting, your eye treatment expert will certainly establish the most effective scleral lens type and also size for your particular requirements.

Scleral Contact Lenses for Keratoconus

Several optometrists as well as ophthalmologists advise scleral contact lenses for a range of hard-to-fit eyes, consisting of eyes with keratoconus.

In instances of very early keratoconus, a common GP lens might be made use of.  Nevertheless, if the lens does not center correctly on the eye or moves excessively with blinks and also triggers discomfort, switching over to a large-diameter scleral contact lens might solve the problem.

Since scleral lenses are developed to rise the corneal surface and also hinge on the much less sensitive surface area of the sclera, these lenses usually are much more comfy for an individual with keratoconus.

Additionally, scleral lenses are developed to fit with little or no lens activity or movement during blinks as they are hinged on the sclera, making them much more stable on the eye, compared to conventional corneal gas permeable lenses.

Scleral Contact Lenses for Various Other Eye Troubles

Along with keratoconus, scleral contact lenses can be utilized for various other eye problems such as eyes that have actually undergone a corneal transplant, and also for individuals with serious completely dry eyes triggered by problems such as Sjogren's disorder, graft-versus-host disease (GVHD) and also Stevens-Johnson disorder.

Advancements in lens design technology are enabling makers to develop scleral lenses that can remedy a lot more problems than ever, consisting of bifocal sclerals for the correction of presbyopia.

Special-Effect Scleral Contacts

Often the term "scleral lenses" (or "sclera lenses") additionally is used to explain special-effect contact lenses that significantly change the look of the user's eyes.

Nevertheless, these costume contact lenses also called theatrical contact lenses, Halloween contacts or gothic lenses generally are soft lenses that bear little resemblance to scleral gas permeable contacts in -- apart from their big diameter size to completely mask the cornea. Likewise, soft theatrical contacts generally are made for aesthetic functions just and not for vision correction.


Scleral Contact Lenses Aid Celebrity Perform Crazy Movie Stunt

Star Tom Cruise is known for doing his very own adrenalin-pumping, in some cases crazy film stunts. In his 2015 movie Mission Impossible Nation, Cruise put on scleral lenses during one of his stunts.

Enjoy as Tom Cruise prepares for one of his most talked-about motion picture stunts. See if you can catch the clip where they insert his scleral contact lenses.

Cruise put on the scleral lenses to safeguard his eyes as well as enable him to open them while dealing with {high speed winds. Why did he require them? Due to the fact that the star did a scene hanging onto the wing of a turboprop armed forces transport airplane the Airplane that flew 5,000 feet in the air.

Scleral contact lenses are tailor-made for every user, so suitable scleral contacts needs better know-how as well as even more time than fitting conventional soft or GP contact lenses.

Typically, computerized maps of the curvature of the whole cornea are produced to assist in the lens installation, as well as a number of test lenses of various dimensions and also curvatures might be related to the eye during the fitting process.

Los Angeles Latest Treatments for Keratoconus

Many patients are unaware they might have keratoconus and they see their eye doctor because of increasing spectacle blur or progressive changes in their prescription. In many instances even a good refraction yields poor vision. Keratoconus should be diagnosed by a cornea specialist who may see typical findings when examining the patient at the slit-lamp.

In early forms of the disease there may be no obvious finding on slit-lamp evaluation and the diagnosis is made by computerized video keratography only. Keratoconus can start at puberty and progresses to the mid thirties at which time progression slows and often stops. Because it affects the young primarily, Keratoconus is a serious eye disease.

Keratoconus treatment here in Los Angeles depends on your symptoms. When your symptoms are mild, your vision can be corrected with eyeglasses. Later you may need to wear special hard contact lenses to help keep vision in proper focus. However, a permanent treatment to Keratoconus does exist.

New research suggests the weakening of the corneal tissue that leads to keratoconus may be due to an imbalance of enzymes within the cornea. This imbalance makes the cornea more susceptible to oxidative damage from compounds called free radicals, causing it to weaken and bulge forward.

A number of surgical options are available to the keratoconus patient. Since keratoconus can vary widely from patient to patient, the proper recommendation of any of these procedures depends on the individual nature of your problem.

Now, doctors can perform multiple types of corneal transplants, including deep anterior lamellar keratoplasty (DALK). DALK has emerged as the preferred transplant approach for keratoconus in most countries, although penetrating keratoplasty (PK) remains more popular in the United States.

One of the perceived advantages of DALK is that there is no risk of endothelial rejection, which should result in a higher likelihood of long-term allograft survival.

Dr. Khanna and the Keratoconus experts at Khanna Vision Institute are leading edge Los Angeles experts in the latest treatment options for Keratoconus. Dr. Khanna offers both DALK, Intacs for Keratoconus, and Cornea Cross Linking Riboflavin. Together, these leading treatments can help stop the progression of Keratoconus.  Contact Dr. Khanna to get the latest technologies available for Keratoconus.

Keratoconus Doctor

Meet Keratoconus Doctor Rajesh Khanna, MD

Keratoconus Doctor Khanna is here to help you attain better vision.You or your loved one plagued by keratoconus eye disease may be a teen, a young adult or more mature. If you are suffering from keratoconus eyes disease, you need somebody compassionate to help you. Glare, difficulty in driving may be preventing you from living your life to its full potential. Let us introduce you to  expert keratoconus surgeon Dr Rajesh Khanna.

He has been in the field of eye surgery for over twenty five years. He has been helping people see better for a long time. His passion to help people with Keratoconus eye disease led him to get specialized training in hard contact lens twenty years ago. He realized these lenses were very troublesome. They caused irritation, redness and even fell off the eye. Worse they caused scarring of the cornea by rubbing against the bulging cornea. Dr. Khanna decided to get further medical and surgical training in keratoconus at University of Cincinnati in mid nineties.

Keratoconus Surgeon of Los-Angeles


Dr.Khanna has been performing insertion of Intacs for over a decade. In fact he was amongst the first in Los Angeles to master the art and science of intacs technology. He was certified by the manufacturer  of intacs – Addition Technology. As his experience grew he imbibed new technology. Dr.Khanna now even implants newer thicker ring segments. He loves extreme precision in keratoconus eyes.  He has evolved  from the mechanical prolate system for intacs insertion to laser guided intacs placement. He acquired an ocular coherence tomography to map the thickness of the cornea suffering from Keratoconus. He calculates a predetermined depth to engage the laser for channel creation. Than he effortlessly slips the ring segments in.

Younger patients with Keratoconus require early intervention with Cornea cross linking with Riboflavin. Dr. Khanna performs Cxl  or epi on cross linking to halt the progression of keratoconus. His calm nature helps the teenagers and young adults to undergo this therapy

#1 Keratoconus App by Keratoconus Doctor of Los-Angeles

Keratoconus doctor los angeles

His vast expereince in treating keratoconus eye disease and improving lives has led him to create the most popular app on keratoconus treatment.

Can any eye doctor surgically treat Keratoconus eye disease?

Experts in Keratoconus are best suited to treat keratoconus eye disease. An eye doctor has to have attended medical school, an ophthalmology residency and fellowship training in cornea and keratoconus.

Can my optometrist perorm cornea cross linking?

No optometrists are not allowed to perform this procedure. Only skilled surgeons are permitted to do so.

Can any ophthalmologist do Intacs insertion?

EYE MD or an ophthalmologist has to be trained and certified in Laser Intacs insertion and cornea cross linking.

Crosslinking for Keratoconus is FDA approved

Crosslinking FDA approved. We are happy to announce that USA is now on par with the world. FDA after careful consideration has said cross linking is safe for treatment of Keratoconus.Avedro based in Massachusetts is the company, worked hard to get cross linking of cornea approved.

Cross Linking for treatment of Keratoconus has thus far been done only in FDA studies or off label in the US. Therefore it had been expensive. The protocols were often restrictive.Many doctors were hesitant to prescribe it for their patients.FDA approval will allow  many more patients to seek treatment for their bulging corneas. In many patients it may be curative.

Keratoconus is a disease where the front clear part termed cornea is weak. It bends under outward pressure from the fluids inside the eye. This disease is rampant in the teenage years. It is often missed. Optometrists do not perform this exam as part of annual exam. Advanced diagnostic technologies like OCT tachometry map and color cornea topography help to detect it. Intervention in teenage years can save sight. All school going children should have this simple test performed and analyzed by a Corneal Keratoconus specialist.

Cross linking works by increasing the strength of the cornea. A strong cornea is able to tolerate the forces from within the eye. This prevents the further bulging of the eye. When cross linking is performed in the teenage years it decreases the progression of the disease. The positive effect can last over a decade. By than the normal progression of the disease is naturally slowed down.

Lear more about Management of Keratoconus eye disease by downloading the Keratoconus app. This app has been developed for non medical people to figure out what is best for them. Please click on the icon below

Better Vision

Crosslinking FDA approval and Medical Insurance coverage

FDA approval will also allow insurances to cover the treatment. This will make the intervention by CXL affordable for people. A cat code code will soon be available. Financing options are also available.

For protocol  of Cross-linking as approved by FDA


Hypotonic Riboflavin Collagen Cross Linking for Thinner Corneas

Hypotonic Riboflavin Collagen Cross Linking for Thinner Corneas


By Rajesh Khanna, MD

Collagen cross linking has recently been invented in this century. A lot of people who would benefit greatly from this novel treatment have missed the recommended inclusion criteria. This has been because either their cornea has thinned out too much, developed scars or become very steep. keratoconus doctors strive to gel these patients living with keratoconus.

Researchers like Peter Hersh MD have led the way to help keratoconus sufferers. For thinner corneas a novel approach has been designed. Hyoptonic Riboflavin is with less salt and no dextran. This leads to swelling of the cornea. Normal concentration riboflavin on the other hands leads to corneal thinning. The thickness of the cornea is important to proven the uv radiation reaching the inner cells of the cornea.

Inclusion Criteria:

  • 18 years of age or older
  • A diagnosis of progressive keratoconus or a diagnosis of corneal bulging following Lasik eye surgery or PRK
  • Vision with contact lenses or glasses is worse than 20/20
  • Corneal thickness greater than 300 microns at the thinnest point

Exclusion Criteria:

  • Cornea pachymetry >400 microns
  • Corneal pachymetry ≤ 300 microns at the thinnest point .
  • Previous ocular condition (other than refractive error) in the eye(s) to be treated that may predispose the eye for future complications
  • Clinically significant corneal scarring in the CXL treatment zone
  • Pregnancy (including plan to become pregnant) or lactation during the course of the study
  • Patients with nystagmus or any other condition that would prevent a steady gaze during the CXL treatment or other diagnostic tests.
  • Patients with a current condition that, in the investigator’s opinion, would interfere with or prolong epithelial healing.

Depending on the situation patients younger than 18 can be treated. Utilizing general anesthesia even uncooperative kids, people with nystagmus can benefit from this sight saving cure.

Hope this information on Hypotonic Riboflavin Collagen Cross Linking for Thinner Corneas is helpful in the fight against Keratoconus.

Learn about Causes of Keratoconus

Corneal Cross Linking (CXL)

Corneal Cross Linking (CXL)

Cure for Keratocons – A new ray of Hope

Keratoconus is a disease of the cornea where there is structural abnormality. The fibers in this clear part of the eye are not able to withstand the pressure from inside the eye. The weakened cornea is pushed forward and than pulled downward by gravity. The center part from where we see is pushed out farthest giving it a conical shape. The covering of this thin part, the epithelium is also very thin. These anatomical eccentricities cause physiological and optical aberrations leading to poor sight.

If we could reestablish the structure of the cornea it would lead to restoring of the vision of the eye. This implies regenerating the corneal fibers using stem cells. Investigation is underway for this holy grail in the cure for keratoconus. Research is also being conducted to prevent onset of keratoconus. Scientists are identifying the genes responsible for the condition. They would than develop gene therapy to alter expression of the problematic genes.

These futuristic scenarios are good and rosy. This vision of keratoconus free world drives the inventors to work hard. Lets not lull you into inaction while waiting for these developments which may be decades or even centuries away. Currently the cure for keratoconus is corneal cross linking.

There are various names assigned to this treatment. Some call it CXl, others label it as cornea cross linkage, corneal cross linking, cornea cross connections, corneal collagen cross linkage – Riboflavin (C3R). More important than what it is called is how it works.

CXL stiffens the weak cornea and imparts strength to it. This fortified cornea is able to withstand the pressure of the eye and thus halts the progression of keratoconus. The treated stiffer cornea also flattens improving the vision.

Ventura LASIK

Ventura LASIK

Its funny that our LASIK Institute is on the border of ventura and LA county. So we are close to cities in ventura county like Camarillo, Ventura, Oxnard and Dos Vientos
Camarillo is down the hill. Our refractive surgery centry is one of the only few around. We do LASIK, PRK, Superlasik, Intacs, Visian ICL, Restor multifocal IOL.
Our goal is to do whats best for you. Ventura lasik vision correction is certainly an option for you.

So ventura residents what are you waiting for? Did you know Ventura county lasik surgeon- Dr. Khanna has been voted favorite by readers of ventura county star for many years in a row. He has helped many people including your friends neighbors. Trust the best. Come and get a free evaluation. See if you like him and can place your faith in one of the top experts in the field of lasik eye surgery. Ventura lasik eye surgery has never been so affordable.