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Keratoconus is a thinning disorder of the cornea, whereby the clear window at the front of the eye becomes irregular, and starts to protrude like a cone, affecting vision quality.

Keratoconus often starts to affect individuals between the ages of 15 to 30. Symptoms include a reduction in distance and near vision, frequent changes in 'spectacle' prescription, increasing astigmatism, sensitivity to light, image distortion, and halos around lights.

Vision can in the early stages be improved by glasses, but more advanced cases require rigid gas-permeable contact lenses. Neither glasses nor contact lenses stop the progression of corneal thinning and worsening of the keratoconus. Corneal rings such as Kerarings and Intacs may also be used to normalise the corneal shape and improve vision, but they too do not stop progression.
Normal cornea vs keratoconus

Normal cornea vs keratoconus

A corneal topography scan demonstrating keratoconus

A corneal topography scan demonstrating keratoconus

Collagen cross-linking (CXL) is the only available treatment that stops the progression of keratoconus. CXL is performed as a day-case procedure under local anaesthesia. Ultraviolet light and vitamin B2 (riboflavin) drops are applied to the surface of the eye, and together they cause fibres within the cornea to bond more tightly (create ‘cross-links’). Without CXL treatment, at least 20% of all patients with keratoconus will eventually require a corneal transplant.

In advanced cases, where vision is not adequately corrected by a contact lens, or the patient cannot tolerate these specialised lenses, a corneal transplant may be required. Currently, keratoconus is the most common diagnosis for which patients require a corneal transplant, although with the advent of collagen cross-linking, the need for these is likely to lessen in the future.

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Dr Dana Robaei - Sydney Ophthalmologist

Dr Dana Robaei

Ophthalmic Surgeon MBBS(Hons) BSc(med) MPH PhD FRANZCO

Dr Dana Robaei is a consultant ophthalmic surgeon, with fellowship training in Cataract Surgery and Corneal Transplantation from Moorfields Eye Hospital, and Medical Retina from Sydney Eye Hospital.

She has extensively published in the national and international ophthalmic literature, and presented at international ophthalmology conferences.

She specialises in Cataract Surgery, Pterygium Surgery, Macular Degeneration and all aspects of comprehensive ophthalmology.

Dr Robaei is committed to clinical and surgical excellence, with the aim of providing the highest possible standard of care based on the latest available evidence, in combination with effective communication to patients and their referrers.

Professional Qualifications

  • Graduated from UNSW with Honours, Bachelor of Medicine, Bachelor of Surgery
  • Master of Public Health, UNSW
  • PhD in medicine (Visual impairment in Australian School Children)
  • Advances specialty training in ophthalmology and ophthalmic surgery at Sydney Eye Hospital
  • Subspecialty fellowship training in cataract surgery and corneal transplantation at Moorfields Eye Hospital, London UK
  • Clinical Senior Lecturer in ophthalmology, University of Sydney
  • Consultant Ophthalmologist, Westmead Hospital
  • Director of Forest Eye Surgery, Frenchs Forest