Patricia I. Cobb,W. Walker Motley,
Surgical Management of Keratoconus in a Young Adult with Cognitive and Behavioral Disability
Surgical Case Reports
2020
2613-5965
http://dx.doi.org/10.31487/j.SCR.2020.04.12
https://www.sciencerepository.org/surgical-management-of-keratoconus-in-a-young-adult_SCR-2020-4-112 
Abstract: Case Presentation: A 25-year-old man with cognitive impairment (CI) and behavioral issues presented for
corneal collagen crosslinking (CXL) surgical management of progressive keratoconus.
Results: The conventional CXL technique was modified to avoid complications due to potential postoperative behavioral issues.
Conclusions: Significant post-operative pain and aggressive behaviour can occur following epi-on CXL.
Aggressive behaviour can result in significant complications in relatively low-risk eye surgery. Preoperatively, it is appropriate to devise a multifaceted surgical, medical and behavioural treatment plan
including psychotropic if needed in patients with history of cognitive impairment and aggressive behaviour.Keywords: Crosslinking, disability, keratoconus