The Healthy Cornea
Smooth and dome-shaped, with organized collagen fibers that precisely focus incoming light onto the retina.
Keratoconus Diagnosis & Treatment in Los Angeles
If you're experiencing progressive blurriness, extreme light sensitivity, or frustrating changes to your eyeglass prescription, you may be living with keratoconus. Specialized care — and a clear path forward — is here, with FDA-approved corneal cross-linking available across five Los Angeles-area locations.
Corneal topography. Individual presentation varies.
What Is Keratoconus?
The cornea is the clear, dome-shaped front window of your eye, made largely of a highly organized matrix of collagen fibers. Its main job is to bend, or refract, light so that it focuses precisely on the retina, giving you a sharp, clear image.
Keratoconus is a progressive, non-inflammatory disease in which those collagen fibers weaken. As the cornea loses structural integrity, it gradually thins and bulges outward into an irregular, cone-like shape. Because the cornea focuses light, this distorted shape scatters it as it enters the eye, causing significant visual impairment that standard eyeglasses cannot easily correct.
See Treatment OptionsHow Keratoconus Affects Your Eye
Keratoconus develops in stages as the cornea weakens and changes shape — understanding the progression explains why early detection matters so much.
Collagen Weakening
The collagen fibers lose their structural integrity, allowing the cornea to progressively thin over time.
The Cone Shape Forms
The weakened cornea bulges forward into an irregular cone, scattering light rather than focusing it.
Visual Impairment
Scattered light causes distorted, blurry vision that standard glasses cannot correct, requiring specialized intervention.
Identifying the Signs
Keratoconus often begins in the late teens or early twenties and can progress slowly over 10 to 20 years. Catching it early lets us halt the thinning before severe vision loss occurs.
Blurred or Distorted Vision
Progressively blurred or highly distorted vision, often described as “ghosting” or seeing multiple images.
Light Sensitivity & Glare
Increased sensitivity to light (photophobia) and debilitating glare in bright conditions.
Halos & Starbursts
Halos or starbursts around lights that make night driving incredibly difficult.
Changing Prescriptions
Frequent changes to glasses or contact lens prescriptions as astigmatism rapidly worsens.
Eye Strain & Fatigue
Eye strain, headaches, and general visual fatigue throughout the day.
Detected by Topography
Advanced corneal topography creates a detailed 3D map of your eye, detecting the earliest microscopic steepening long before significant vision loss.
If you've been told your prescription keeps changing, or you simply can't see clearly no matter how new your glasses are, keratoconus may be the reason — and an evaluation can give you answers.
What Causes Keratoconus?
The exact cause is still being researched, but studies point to a combination of genetic predisposition, cellular imbalances, and environmental factors.
01
Genetics & Heredity
Roughly 1 in 10 people with keratoconus have a parent or family member with the condition. If you have a family history of corneal disease, regular eye exams are vital.
02
Oxidative Stress
Some research suggests keratoconic corneas lack the antioxidants needed to protect against everyday damage, leading to the progressive weakening of collagen fibers over time.
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Chronic Eye Rubbing
A major, highly preventable risk factor. Repeated rubbing physically traumatizes and weakens the cornea. Because it's often linked to allergies, atopic dermatitis, and dry eye, treating those underlying conditions is a key part of managing keratoconus.
Treatment Options at Berg-Feinfield
Our goal is twofold: stop the disease from getting worse, and rehabilitate your vision. The right treatment depends on your severity, corneal thickness, age, and topography — every patient gets a personalized roadmap, not a generic protocol.
01
Riboflavin Drops Applied
Specially formulated Riboflavin (Vitamin B2) drops are applied to prepare the corneal tissue to respond to UV light treatment.
02
UV-A Light Activation
A precisely controlled therapeutic beam of UV-A light activates the Riboflavin and triggers the cross-linking reaction.
03
Cornea Strengthened
New molecular “cross-links” form between the weakened collagen fibers, stiffening and stabilizing the cornea to halt further progression.
Corneal Cross-Linking (CXL) is the gold standard for stopping keratoconus progression — a revolutionary outpatient procedure that strengthens the cornea and prevents further thinning or bulging, often avoiding the need for a corneal transplant.
Epi-On Corneal Cross-Linking with Epioxa
FDA-approved in October 2025 and now available in Los Angeles. Berg-Feinfield is the first practice in Los Angeles to offer Epioxa — a less invasive, transepithelial approach that delivers the biomechanical benefits of cross-linking without surgically removing the cornea's outer epithelial layer.
Significantly Less Discomfort
The sensitive surface layer of the eye remains completely untouched, meaning far less pain during recovery.
Faster Healing Times
Without an epithelial wound to heal, most patients return to normal activities within days rather than weeks.
Reduced Risk of Complications
Keeping the epithelium intact greatly reduces the risk of post-operative infection and corneal haze.
Custom Contact Lenses for Vision Correction
Cross-linking stabilizes the cornea and protects the vision you have, but it isn't designed to correct vision like LASIK. After the cornea is stabilized, specialty lenses restore the clearest possible sight. We partner with trusted specialty-lens practices to connect each patient with the right ongoing care.
Scleral Lenses
Large-diameter rigid gas-permeable lenses that vault completely over the irregular cornea and rest on the sclera. The space between fills with sterile saline, creating a smooth new optical surface — unparalleled comfort and sharp vision for moderate to advanced keratoconus.
Hybrid Lenses
A rigid gas-permeable center for high-definition vision surrounded by a soft, flexible skirt for all-day comfort. An excellent middle ground for patients transitioning from soft lenses who want improved clarity without fully committing to a hard lens.
Rigid Gas Permeable (RGP)
Traditional custom hard lenses that replace the irregular corneal shape with a smooth refractive surface — a proven option for mild to moderate keratoconus with well-established long-term results.
Los Angeles's Keratoconus & Cornea Specialists
Managing a complex condition like keratoconus takes expertise beyond a routine eye exam. Our team combines decades of surgical experience with fellowship-level corneal specialization.
Alan M. Berg, MD
Co-Founder, Berg-Feinfield Vision Correction
The practice's primary surgeon for corneal cross-linking, with 30+ years of keratoconus and corneal surgery expertise. Among the first in Southern California to offer Glaukos's iLink CXL platform, an FDA clinical study participant, and a surgical educator who has trained ophthalmologists nationally. Sees keratoconus patients at all five locations.
Full profile →
Bonnie Sklar, MD
Fellowship-Trained Cornea Specialist
Fellowship-trained at Duke University Eye Center in Cornea & External Disease, with residency at Wills Eye Hospital in Philadelphia. Her focus includes keratoconus evaluation and co-management, corneal transplantation (DMEK, DSEK, PKP), complex anterior segment surgery, ocular surface disease, and advanced cataract surgery. Sees keratoconus patients at all five locations.
Full profile →Why Patients Choose Berg-Feinfield
The combination of modern corneal cross-linking — particularly the new Epi-On Epioxa approach — with custom scleral lens fitting represents the current standard of care for keratoconus management.
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Stop Progression & Restore Vision
Our approach addresses both goals at once — halting the disease with cross-linking and restoring lost vision with specialty lenses.
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First in LA for Epioxa
Berg-Feinfield is the first practice in Los Angeles to offer FDA-approved epi-on cross-linking, indicated for patients aged 13 and older.
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Beyond Older Approaches
We've phased out Intacs in favor of safer, more predictable methods, avoiding risks like ring extrusion, infection, and corneal haze.
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A Roadmap Built With You
We explain your corneal topography in plain terms and build a treatment plan together — guiding you through every decision, every step.
Keratoconus — Your Questions Answered
Keratoconus does not typically cause complete blindness. Without treatment, however, it can lead to severe visual impairment that makes reading, driving, or recognizing faces difficult without highly specialized contact lenses or a corneal transplant. Early intervention is the key to preserving your functional vision for the long term.
Numbing drops are used during the procedure, so you won't feel pain. With the traditional epi-off method there's mild to moderate discomfort for a few days as the epithelium regrows. With our advanced Epi-On method (Epioxa), post-operative discomfort is significantly reduced and most patients return to their normal routine within days.
Keratoconus usually stabilizes naturally by a patient's 40s or 50s. If your cornea has already stabilized with age, you may not need cross-linking, and our focus shifts to maximizing your vision with custom scleral or hybrid lenses. Every eye is unique, though, so only a thorough exam can determine whether your condition is still progressing and whether intervention is warranted.
Monitoring mild keratoconus without treatment is sometimes appropriate, but deciding when to intervene is nuanced — it depends on how quickly your cornea is changing, your age, and your long-term visual risk. The clinical community is increasingly moving toward earlier intervention. If you have questions about timing, we recommend an in-person evaluation with one of our specialists, and we'll give you an honest answer — even if that answer is to keep monitoring.
Cross-linking — epi-on or epi-off — primarily stabilizes the cornea and halts progression; it does not reverse vision already lost. Some patients see a modest improvement in maximum corneal curvature (Kmax) afterward, which may translate to mild visual improvement. Specialty contact lenses remain the primary tool for restoring the clearest possible vision once the cornea is stabilized.
Yes. Keratoconus is most commonly diagnosed during the teenage years and often progresses most aggressively in young patients — the younger the diagnosis, the more vision is at stake over a lifetime. Epioxa, our FDA-approved epi-on CXL treatment, is indicated for patients aged 13 and older, making earlier intervention practical for students and athletes who can't afford weeks of recovery. If your child has been diagnosed or flagged as a keratoconus suspect, we strongly encourage a timely evaluation.
Don't Let Keratoconus Steal Your Vision or Your Independence
If you've been diagnosed with keratoconus, or you're experiencing the frustrating symptoms of progressive vision loss, proactive specialized treatment is the key to preserving your eyesight. With state-of-the-art facilities across five Los Angeles-area locations, Berg-Feinfield is your trusted partner for world-class corneal care.