Cross-linking questions, answered

Yes. Cross-linking is offered as Epioxa, insurance approval only. Epi-off cross-linking (Photrexa) is not a standard option; it may be considered only as a conditional exception if Glaukos approves it in select cases.

Epioxa is an epithelium-on (epi-on) cross-linking treatment for keratoconus. It is our first-choice path: we submit your case for insurance approval of Epioxa before considering epi-off options.

If insurance denies Epioxa, alternatives are decided case by case. Epi-off cross-linking may be considered only as a conditional exception if Glaukos approves it in select cases, for example humanitarian cases. Ask the office.

Cross-linking uses riboflavin drops activated by UV-A light to strengthen the collagen in the cornea and slow keratoconus progression. It does not reverse changes that have already happened.

Epi-off cross-linking removes the cornea’s surface layer (the epithelium) before treatment. Epi-on treatment leaves that layer in place. Keeping the surface intact is designed to make recovery more comfortable, and candidacy is decided by a full corneal exam.

Epioxa requires insurance approval. Bring your medical insurance card so we can start the approval process after your exam.

Keratoconus care starts with the $395 VIP lifestyle exam (self-pay) or an annual eye exam through insurance that includes detailed corneal imaging.

Cross-linking is mainly about stabilizing the cornea. If your goal is to improve the corneal shape, ask about CTAK.

Call us with any questions about past treatment, and we will send the recovery guide that applies to you.