Vision is still good, but a scan picked up keratoconus
Corneal cross-linking (CXL)
At this stage the aim is to stop the cornea from steepening any further. Cross-linking does not sharpen sight. It protects the sight you already have.
Combined ICRS + CXL in one session · AAO-published surgeon
Stop keratoconus from progressing. Restore the vision it took.
Keratoconus is a progressive disorder in which the cornea gradually thins and bulges into a cone shape, causing distorted, blurred vision. Early stages are stabilized with corneal cross-linking (CXL) and reshaped with intracorneal ring segments (ICRS); advanced cases with central scarring may need a DALK corneal transplant.
Keratoconus is treatable at every stage, from early progressive cases (cross-linking only) to advanced disease (DALK transplantation). We perform combined ICRS + corneal cross-linking in a single session, the protocol of choice for progressive keratoconus that hasn't yet required transplantation. Femtosecond-laser-assisted ring placement for sub-millimeter precision. Transparent USD pricing, corneal cross-linking from $400 and intracorneal rings from $600.
Why choose us
International standard. Regional access.
Combined ICRS + CXL in one session
We do both procedures in a single visit, saving travelers a second trip and giving the cornea one optimization window instead of two.
Femtosecond-laser ring placement
Tunnels are created by femtosecond laser, not blade. This means sub-millimeter ring depth control and lower complication rates.
Smart Splash DALK: AAO-published technique
When transplantation is needed, Dr. Shaarawy's Smart Splash technique safely decompresses the big bubble in DALK. The technique was published in the AAO 1-Minute Video series.
Lifetime progression monitoring
Keratoconus needs follow-up every 3 months in year 1, then twice yearly. We coordinate this for international patients via tele-topography.
Is this how you see the world?
Keratoconus symptoms as you actually see them
Drag the divider to compare healthy vision with what a keratoconus patient sees. If the image looks like what you experience, it's time for a specialist diagnostic exam.
Normal vision
With keratoconus
Driving at night
Starbursts and halos around oncoming headlights, the earliest and hardest KC symptom
Read this text clearly
A healthy cornea is the key to clear vision
Read this text clearly
A healthy cornea is the key to clear vision
Normal vision
With keratoconus
Reading
Ghosting and double letters, as if every word is printed on top of itself
Normal vision
With keratoconus
Eye chart
Wavy, distorted letters, won't sharpen with regular glasses alone
Book a keratoconus diagnostic exam
Early diagnosis lets cross-linking stop the cone before vision is lost for good
Keratoconus treatment map
How would you describe your vision right now?
Choose the description that fits you
Blurred or distorted vision, keratoconus not advanced
Corneal ring segments (ICRS), or rigid and scleral lenses
Ring segments flatten the steepest part of the cornea so the image lands more evenly. Scleral lenses reach a similar optical result without surgery, by vaulting over the irregular surface.
Advanced keratoconus, or a scar in the cornea
Deep anterior lamellar keratoplasty (DALK)
When the other options no longer hold, the damaged front layers are replaced and your own healthy inner layer stays in place.
This guide is for orientation only. Your corneal scan (Pentacam and topography) sets the treatment plan, not this page.
Book a corneal assessmentProcedures & pricing
Transparent USD pricing.
Final cost is set after clinical examination. Local-currency equivalents available on request. Insurance reports issued for international patients.
| Procedure | Best for | From (USD) |
|---|---|---|
| Corneal cross-linking (CXL) | Stops progression by stiffening the cornea. Indicated for documented progression in mild to moderate cases. | $400 - $800 |
| Intacs | Intracorneal ring segments. Suits mild to moderate keratoconus. | $600 - $1,200 |
| Keraring | Versatile ICRS for moderate to advanced keratoconus. | $800 - $1,500 |
| MyoRing | Full-ring implant for advanced keratoconus where segments aren't enough. | $1,000 - $1,800 |
| Combined ICRS + CXL (single session) | The gold standard for progressive keratoconus. One trip, two procedures. | $1,200 - $2,200 |
| DALK (Deep Anterior Lamellar Keratoplasty) | Partial-thickness transplant for advanced keratoconus with central scarring. AAO Editors' Choice surgical technique. | $2,500 - $3,000 |
تجربة مريض حقيقية
Watch a real patient's experience with Dr. Ahmed Shaarawy
A real patient tells the whole story, from keratoconus diagnosis to corneal stability and restored vision.
Common questions
Frequently asked.
Will rings cure my keratoconus permanently?
Rings reshape the cornea and improve vision, but they don't stop the underlying disease on their own. That's why we combine ICRS with corneal cross-linking (CXL) in the same session, CXL stops progression, ICRS restores shape.
Can the rings be removed later?
Yes. Unlike a corneal transplant, ICRS implants are fully reversible. They can also be exchanged if the disease evolves and a different ring power is needed.
Do I still need glasses or contact lenses after ICRS?
Most patients still need a small correction (glasses or rigid gas-permeable contact lenses) for sharp distance vision. The goal of ICRS is a wearable, comfortable correction and a stable cornea, not zero glasses.
When do I need a transplant (DALK or PKP) instead of rings?
When the cornea has central scarring, very advanced thinning, or contact lenses are no longer tolerated. DALK preserves your own endothelium (the back layer of the cornea), keeping rejection risk low. PKP is reserved for cases where DALK isn't possible.
How urgent is treatment if my keratoconus is progressing?
Cross-linking should be done at the first documented sign of progression, typically a Kmax change of ≥1 diopter in 12 months. Earlier CXL preserves more vision and reduces the chance of needing a transplant later.
Can my children inherit keratoconus?
There's a genetic component: a minority of keratoconus patients have a first-degree relative with the disease. We recommend topography screening for first-degree relatives starting at puberty.
Does thyroid disease cause keratoconus?
There is a real association. A 2024 PubMed-indexed multicenter study co-authored by Dr. Ahmed Shaarawy (Said OM, Iqbal M, El-Massry A, Elgharieb ME, Mady M, Sharawy AM [Dr. Ahmed Shaarawy], Abdelaziz K, *Med Hypothesis Discov Innov Ophthalmol*, October 2024, PMID 39507808 / PMCID PMC11537235) compared 200 eyes from patients with thyroid gland dysfunction (TGD) against 200 age- and sex-matched controls. Keratoconus prevalence was 7.5% in the TGD group vs 0.5% in controls (P<0.0001), a 15-fold increase. 93% of TGD-keratoconus cases were associated with hyperthyroidism. Clinical takeaway: if you have thyroid dysfunction (especially hyperthyroidism), get a baseline corneal topography and a yearly recheck, early-stage keratoconus is fully treatable with cross-linking.
Send your topography. We'll tell you the right next step.
Recent topography (Pentacam, OCT, or corneal map) plus your refraction is enough for an initial assessment. Reply within 24 hours with whether CXL, rings, combined CXL+ICRS, or transplantation is the right call, and the full price.
Medical references
- Said OM, Iqbal M, El-Massry A, Elgharieb ME, Mady M, Sharawy AM, Abdelaziz K. "Thyroid gland dysfunction and keratoconus." Med Hypothesis Discov Innov Ophthalmol. 2024;13(3):104-111. PMID: 39507808 · PMCID: PMC11537235, Keratoconus prevalence 7.5% in thyroid-dysfunction patients vs 0.5% in controls (P<0.0001).
- Wollensak G, Spoerl E, Seiler T. "Riboflavin/ultraviolet-A-induced collagen crosslinking for the treatment of keratoconus." Am J Ophthalmol. 2003;135(5):620-627.
- Raiskup F, Theuring A, Pillunat LE, Spoerl E. "Corneal collagen crosslinking with riboflavin and ultraviolet-A light in progressive keratoconus: ten-year results." J Cataract Refract Surg. 2015;41(1):41-46.
- Clinic data, Dr. Ahmed Shaarawy, 20+ years of corneal surgery experience.