
Advances in eye care are constantly opening up new possibilities for people with progressive corneal disease. One such development is Epioxa®, an FDA approved treatment for keratoconus, which represents a new approach to corneal collagen cross-linking.
At South Shore Eye Care, knowing what the treatment options are can go a long way towards helping you make a decision about your vision and your long term eye health. The more you understand about keratoconus and the various treatments available, the better equipped you are to make a decision about your own eyes.
What Is Keratoconus?
Keratoconus is a progressive condition in which the cornea (the clear front surface of the eye) thins and bulges into an irregular, cone-shaped structure. As the cornea changes shape, light is not focused correctly onto the retina and vision becomes blurred and distorted.
Common symptoms are increased light sensitivity, glare and difficulty seeing in the dark with frequent changes in glasses or contact lens prescription. Keratoconus typically evolves in adolescence or early adulthood and can progress over time.
Early diagnosis and ongoing monitoring are key. While spectacles and special contact lenses can be used to manage the visual changes, corneal collagen cross-linking is a treatment which aims to strengthen the cornea and thus slow the progression of the disease.
What Is Epioxa®?
Epioxa is an FDA approved treatment for keratoconus in adults and children 13 and over. It was approved in October 2025 and is a major breakthrough in corneal collagen cross-linking.
Traditional cross-linking involves stripping away the epithelium (the outermost layer of the cornea) to allow the treatment solution to get through to the tissue. Epioxa takes a completely different approach (an epithelium-on approach) and treats the cornea with the epithelium left in place.
The procedure uses specialized riboflavin eye drops in conjunction with UV-A light and an oxygen enriched delivery system to help strengthen the bonds between the collagen fibers in the cornea. The effect is to improve corneal stability and to help slow the progression of keratoconus.
Possible Benefits of Epioxa Treatment
One of the most striking features of Epioxa is its 'epithelium-on' technique. As the outer corneal layer doesn't need to be stripped away, it provides an alternative to the conventional 'epithelium-off' cross-linking.
Possible advantages would be to avoid the intentional removal of the corneal epithelium and to provide some degree of corneal stabilization via collagen cross-linking. Of course the individual outcome will vary from person to person and the treatment will not in all cases lead to better vision or the elimination of the need for glasses/contacts.
As with any medical procedure there are potential side effects (eye pain, light sensitivity, redness, corneal haze, and short-term changes in visual sharpness, to name a few). An eye care professional can go through the risks and decide whether or not treatment is appropriate.
Who May Benefit From Epioxa?
Epioxa is indicated for patients 13 years and over with keratoconus. An eye examination and corneal evaluation will help establish whether a patient may benefit from treatment.
Your eye doctor will take into account a range of factors including corneal thickness, the shape of the cornea, your vision and your general eye health. A individualized assessment is important as not every patient with keratoconus will be an appropriate candidate.
Explore Advanced Keratoconus Care at South Shore Eye Care
Living with keratoconus can be a bit of a challenge in terms of everyday life (reading, working, driving at night, etc). There are now new options available in the form of Epioxa which can help to manage the condition and protect your cornea over the long term.
If you've been diagnosed with keratoconus or you've noticed some differences in your vision, get in touch with South Shore Eye Care to discuss your treatment options. A full eye exam will help you understand your condition and what the following steps are in terms of managing your vision.










