Being told your keratoconus is changing can leave you wondering whether you need treatment now, and what it will mean for your vision. Corneal crosslinking, often called CXL, aims to slow or stop further progression. It uses riboflavin (vitamin B2) drops and controlled ultraviolet A light to strengthen the cornea, the clear front surface of your eye. 1
Crosslinking and contact lenses do different jobs. CXL treats the cornea’s tendency to weaken; glasses or specialised lenses help you see more clearly. Some people experience improved vision after CXL, but that is not its main purpose and cannot be promised. 2
An ophthalmologist performs the procedure, not your VCO optometrist. At Vision Camberwell Optometrists, we assess and monitor your keratoconus, arrange referrals when appropriate and coordinate your ongoing vision correction with your surgical team. We will help you understand where each part fits into your care.
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Who may need a crosslinking assessment?
Changes in your scans, prescription or vision
We compare corneal shape and thickness scans with your vision, prescription and previous results. A repeatable change matters more than an isolated scan number. Learn how we diagnose and monitor keratoconus. If progression is suspected, we can refer you for an ophthalmologist’s assessment rather than waiting for your sight to become noticeably worse. 1
Younger patients and higher risk eyes
Not everyone needs the same monitoring interval. A systematic review of 11,529 eyes found greater progression risk in younger patients and those with steeper corneas. It supports closer follow up and a lower threshold for considering CXL in higher risk patients. There is no universal rule that everyone must wait three to six months before referral. 3
Whether treatment is suitable for your cornea
Your ophthalmologist considers thickness, scarring, eye surface health and medical history alongside progression risk. A very thin cornea may need a modified technique or a different plan; one thickness cut off cannot determine everyone’s eligibility. Tell the team about previous eye infections, particularly herpes simplex, and ongoing allergies. 1
What does the evidence show?
In a Melbourne randomised controlled trial involving researchers from CERA and the University of Melbourne, eyes with progressive keratoconus were followed for three years. On average, untreated eyes became steeper, while treated eyes showed flattening and improved vision measurements. This supports CXL’s role in managing progression, but it is not a guarantee of an individual result. 2
Treatment success depends on the eye, technique and length of follow up. Your surgeon should explain the expected benefits and risks for you. Continued monitoring is still needed afterwards, including checking for renewed progression. 1
What happens during crosslinking?
Anaesthetic drops numb the eye. In an epithelium off procedure, the surgeon removes the thin surface layer before applying riboflavin and ultraviolet light. A temporary bandage contact lens is commonly used while the surface heals. This is a protective lens, not your usual vision correcting contact lens. 4
You may hear terms such as “accelerated” or “epithelium on”. These describe different treatment protocols, not interchangeable promises of the same outcome. Ask your surgeon which technique they recommend and why it suits your eye. 1
Recovery and contact lenses afterwards
The first days
Soreness, light sensitivity and blurred or fluctuating vision can occur after treatment. Follow your surgical team’s instructions for drops, pain relief, washing and activity. Plan time away from work or study, and arrange transport rather than assuming you can drive home. Recovery varies, so the surgeon’s advice takes priority over a general online timetable. 4,5
Increasing pain or redness, or a sudden deterioration in vision needs urgent advice from your surgical team. Do not assume every new symptom is part of normal healing. If you cannot reach the team, seek urgent eye care. 5
Returning to vision correcting lenses
Do not restart your own contact lens wear until your treating team says it is safe. Your previous lenses may need adjustment because the cornea can change after CXL. A new fitting also needs to account for healing and possible further prescription changes; there is no single restart date suitable for everyone. 4,6
At VCO, we assess whether your existing correction remains useful or whether glasses, a corneal RGP, hybrid or scleral lens would better meet your needs. We coordinate the timing with your ophthalmologist and explain if an interim correction or later refit may be needed. If you have had a corneal graft, see our page on contact lenses after a corneal graft.
Your crosslinking referral and follow up in Camberwell
Our role is to connect the assessment, referral and contact lens stages of your care. Referring practitioners can find details on our referral information page. Your ophthalmologist remains responsible for the procedure and surgical aftercare. We share relevant scans and findings and agree how ongoing optometric reviews fit around that plan.
Before your appointment:
- Bring previous corneal scans, prescriptions and any ophthalmologist’s letters.
- Bring your glasses, contact lens details and a list of current eye drops.
- Ask whether you should leave your contact lenses out before scanning; the advice depends on the lens and the tests planned.
- Note any recent changes in vision and questions about work, driving or lens wear.
Vision Camberwell Optometrists is at 784 Burke Road, Camberwell, in Melbourne’s inner east, serving patients from Hawthorn, Balwyn, Kew, Canterbury and beyond. Consultations with Jue Wang are available in English and Mandarin.
To arrange a keratoconus review, call 03 9882 5666 or contact our team. For the broader care pathway, see our keratoconus overview and our guide to keratoconus treatment options.
Questions about corneal crosslinking
Will crosslinking cure keratoconus or remove the need for lenses?
No. The goal is to limit further change, not return the eye to an unaffected state. Some people gain visual improvement, but glasses or contact lenses are commonly still needed. 2,4
Can I wait until my glasses stop working?
Do not use that as the trigger for seeking advice. High risk keratoconus can progress before the change feels dramatic. A review of your scans and risk factors is more useful than waiting for a particular symptom. 3
Is crosslinking risk-free?
No. Potential complications include infection, haze or scarring, delayed surface healing and reduced vision. Ask your ophthalmologist to explain these risks alongside the risks of leaving progressive keratoconus untreated. 1,4
Does VCO perform the surgery?
No. We provide optometric assessment, referral, monitoring and specialty contact lens care. The ophthalmologist assesses surgical suitability, performs CXL and directs surgical recovery.
References
- Deshmukh R, et al. Management of keratoconus: an updated review. Frontiers in Medicine. 2023;10:1212314. doi:10.3389/fmed.2023.1212314.
- Wittig-Silva C, et al. A randomized, controlled trial of corneal collagen cross-linking in progressive keratoconus: three-year results. Ophthalmology. 2014;121:812–821. doi:10.1016/j.ophtha.2013.10.028.
- Ferdi AC, et al. Keratoconus Natural Progression: A Systematic Review and Meta-analysis of 11,529 Eyes. Ophthalmology. 2019;126:935–945. doi:10.1016/j.ophtha.2019.02.029.
- Moorfields Eye Hospital NHS Foundation Trust. Corneal cross linking. Accessed 9 September 2026.
- Moorfields Eye Hospital NHS Foundation Trust. Adult collagen cross-linking aftercare. Accessed 9 September 2026.
- Lim L, Lim EWL. Current perspectives in the management of keratoconus with contact lenses. Eye. 2020;34:2175–2196. doi:10.1038/s41433-020-1065-z.
Reviewed by Dr Shonit Jagmohan, B.Optom (Hons), FIAOMC, IACMM, Ophthalmic Medicines Prescriber, Fellowship Chair for the International Academy of Orthokeratology and Myopia Control (Oceania). Last reviewed October 2026.
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T. (03) 9882 5666
E. vision@visioncamberwell.com.au
Find Us at:
784 Burke Rd, Camberwell
Victoria 3124, Australia
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Monday, Tuesday and Friday. 9am – 6pm
Wednesday. 9am – 5pm
Thursday. 10.30am – 7.30pm
Saturday. CLOSED
Book your appointment with one of our friendly team members today
T: (03) 9882 5666
Serving Camberwell and the Surrounding South Eastern Suburbs
An independent practice in Camberwell since 1951, we are experts in keratoconus and specialty contact lenses. We welcome keratoconus patients from Hawthorn, Deepdene, Surrey Hills, Balwyn, Kew, Canterbury, Box Hill, Glen Iris, and across greater Melbourne.
