Woman rubbing eyes from blurred vision

Corneal Cross-Linking

Your vision may be severely blurred and distorted due to a disease known as progressive keratoconus. 

Corneal cross-linking (CXL) is the only treatment that can stop this serious issue in its tracks. 

Find out why so many come to Cohen Eye Associates in St. Louis, MO, for vision-saving CXL. 

Why You Might Need Corneal Cross-Linking

Corneal cross-linking is a treatment for the eye disease known as keratoconus. Keratoconus causes your cornea, which is the front part of your eye, to degrade over time. This weakening leads to a bulging of the cornea, which can severely blur and distort your vision. 

Some studies suggest that keratoconus occurs in as many as 1 in 500 people. While symptoms may start in one eye and seem mild at first, this condition typically worsens for as long as two decades. If left untreated, the only solution may be a major and costly corneal transplant surgery.

Corneal cross-linking is the only procedure that can stop your progressive keratoconus from worsening now while preventing more vision-related problems in the future. 

Causes of


Keratoconus is a complex disease that is still not fully understood. Scientists theorize three main causes: family history, underlying medical disorders, and environmental risk factors. 

Despite an unclear understanding of the reason you might have keratoconus, one thing is clear: it must be treated. CXL is the best way to do so without the last resort of a corneal transplant. 

See Us in St. Louis Today Ophthalmology Experts You Can Trust

The time to act is now. Untreated keratoconus will only cause you more severe problems in the future. With a disease as serious as keratoconus, you need a doctor you can entrust your eyes to. 

Dr. Bruce H. Cohen is a laser vision correction specialist who can accurately diagnose you, and follow through with excellent treatment. His expertise led to him being named one of the top 100 laser vision surgeons in the country by TLC Laser Vision Centers, Inc.

The other members of his team include Dr. Kathryn L. Noonan, who has over two decades of experience at St. Louis' Cohen Eye Associates, and Dr. Nancy M. Buchser whose experience spans complex eye surgeries and minimally invasive procedures. Contact our practice today to learn about CXL.

(314) 361-5003

Our doctors
Dr. Bruce H. Cohen, Dr. Kathryn L. Noonan, and Dr. Nancy M. Buchser can help you experience healthy eyes and better vision.

Cornea Care With Doctors St. Louis Trusts


Lisa Pletz


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Love the caring, cheerful, & helpfulness of this staff ! Had all the answers I needed. Even though my appointment was on a holiday they didn’t seem to mind at all

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Barbara Nelson


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Doctor Buchser is the finest doctor I have encountered in years! She took the bull by the horns and called my primary physicians office and had them do what they should have been doing for two years !! When I called her office on a Monday morning and told them about my sudden loss of vision, they had me come in immediately ! She spent two hours running tests and totally explaining everything to me. All the office people were extremely kind.

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The Cross-Linking Procedure Timeline

Typical corneal cross-linking treatment lasts 30 to 60 minutes.

Cross-Linking's Simple Steps

Typical corneal cross-linking treatment lasts 30 to 60 minutes.

Anxiety Relief

The CXL procedure begins with the placement of numbing eye drops. If you desire, our doctors can also administer sedation. The priority at this stage is to ensure your cross-linking is pain and anxiety-free.

Epithelium Removal

There are two kinds of CXL: epi-on and epi-off, referring to the epithelium. The epithelium is the outside of the cornea. Removing the epithelium allows your medication to reach deep into the cornea, achieving the maximum healing effect. The epithelium will heal during your recovery process.

Riboflavin Placement

Riboflavin is an essential vitamin (B2). Your doctor will apply specially created riboflavin drops to your cornea. Coating the eye with riboflavin improves your cornea's ability to absorb light. It takes roughly half an hour for the riboflavin to soak into your cornea. 

Light Treatment

At this point in cross-linking, you rest in your chair and painlessly look at a beam of UV light. This light activates the riboflavin and leads to the growth of collagen in your cornea. The combination of riboflavin and ultraviolet light strengthens the weak portions of your cornea. 

Bandage Placement

The simple CXL procedure is ended with the placement of a bandaged contact lens. Dr. Cohen will then explain how long you should keep your contact lens in place to maximize the results of your cross-linking. 

Cross-Linking Aftercare

Following your CXL procedure, Dr. Cohen and his ophthalmology team will provide simple corneal care instructions to follow:


If you experience corneal discomfort, follow the medication regimen laid out by Dr. Cohen. 

Contact Lens

Dr. Cohen and his team will place a contact lens on your eye to encourage healing. If it falls out, call us instead of trying to replace the contact lens yourself. 

Light Sensitivity

Your recovering corneas may cause you to experience increased sensitivity to light. Sunglasses can help in this regard, as well as avoiding bright areas if possible.

No Rubbing

For a full five days after the procedure, you should not rub your eyes under any circumstance. This allows for better corneal healing.

In the rare instance you experience any complications, do not hesitate to call our St. Louis office. We offer emergency eye care if needed and are confident our decades of ophthalmology experience will allow us to address your issue. 

The Cost of Cross-Linking

The typical cost of cross-linking ranges from $2,500-$4,000 per eye. This CXL cost is significantly less than that of a corneal transplant, which you will need if your keratoconus goes untreated. Additionally, many insurance companies have started covering CXL since it is a medical necessity.

How We Help Patients Pay 

Our team knows that corneal health is of the utmost importance. We pride ourselves on helping patients fit much-needed cross-linking into their budget. To this end, we accept a variety of HMO and PPO insurance plans and will file insurance forms on your behalf.

Another way we help make CXL affordable is by accepting CareCredit®. CareCredit allows you to pay for your cross-linking in low-interest and interest-free monthly installment payments.

St. Louis Loves Our Work 


Ruth Ann Henke


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Great office and great doctors. I have seen both Dr. Cohen and Dr. Noonan. I am very impressed with them, as well as all the staff. I feel confident in their expertise.

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Donna Burds


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Everyone with whom I interacted at Cohen Eye Associates was friendly and professional. Each person took whatever time was needed to assess my vision and answer my questions.

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The doctors at Cohen Eye Associates, Limited

Cohen Eye Associates, Limited

At Cohen Eye Associates in St. Louis, MO, our team offers a full-service optical shop to address all of your vision needs. We can provide you and your family a range of eye care services, from LASIK and cataract surgery to glaucoma treatment. Our doctors are members of national professional organizations including:

  • American Academy of Ophthalmology
  • American Medical Association
  • American Society of Cataract and Refractive Surgery
  • American Glaucoma Society
  • American Optometric Association

To schedule an appointment with our eye care specialists, contact us online or call us at (314) 361-5003.

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