Keratoconus Treatment Options
- Corneal Collagen Cross Linking (CXL)
- Topography-Guided Corneal Laser Reprofiling
- Cornea Trasplantation
- Tailor-Made Combined Treatment Plans
- Specialist Contact Lenses
Why choose AccuVision?
Patient satisfaction
Care promise
Refused treatment?
Advanced technology and clinical expertise enable us to safely treat and visually rehabilitate patients who may have been refused treatment elsewhere.
At AccuVision,
our focus is you.
Few things are more important than our eyesight and at AccuVision we are dedicated to giving you the best vision possible by using the safest and most effective treatments.
Keratoconus is a condition that we specialise in treating and we are very proud of the results that we have achieved with our patients. Every patient is offered a detailed consultation with an expert and using the very latest diagnostic technologies to determine the status of their eyes and where appropriate, the most effective long term treatment and aftercare plan.
What our Keratoconus patients say...
Have Any Questions?
We are NOT call centre based.
You can reach us directly at our clinic and speak to us about your individual treatment needs.
Treating Keratoconus
For over 15 years, AccuVision has been at the forefront of diagnosing, treating and rehabilitating patients with Keratoconus.
What is Keratoconus?
Keratoconus is an eye condition that affects the cornea (the clear dome-shaped window at the front of the eye). Progressive changes to the collagen fibre within the cornea can lead to thinning of this layer of the eye and thereby a weakening of its structural integrity. There is often a resulting ‘cone shaped’ bulge that distorts light as it passes through. Vision can vary a lot depending on how severe the condition is. The word Keratoconus comes from the Greek words for cornea (kerato) and cone shaped (conus).
What causes Keratoconus?
Diagnosis of Keratoconus
Keratoconus typically leads to myopia and astigmatism due to the irregular nature of the changes in the cornea. Eventually, the visual distortions become progressively more difficult to correct with traditional spectacles and ‘off the shelf’ contact lenses.
To diagnose Keratoconus at AccuVision, advanced Topography, Pentacam and Optical Coherence Tomography scanning is integral to every visual assessment for our Keratoconus patients. These advanced diagnostics allow us to detect Keratoconus at a subclinical level (very early on) before it begins to affect vision.
Many patients seen at AccuVision for other treatments have benefited from early detection of Keratoconus through these diagnostics so that their condition can be managed appropriately to preserve optimum vision.
What are the signs and symptoms of Keratoconus?
Due to the limitations of technology available on the ‘high street’, Keratoconus often goes undiagnosed until it is fairly advanced. In the early stages of Keratoconus, changes in vision can be corrected with reasonable success by changing your spectacle or contact lens prescription. As the condition worsens, these traditional visual aids can no longer correct the irregularity of the cornea. At this stage sufferers are usually referred on to ‘specialists’ in this field.
Sadly, the more the condition advances, the more limited the treatment options become.
The all too familiar story that far too many Keratoconus patients go through – “I kept going back to my optician as my vision was getting worse and each time I had to get stronger glasses and contact lenses. Eventually the glasses and contact lenses could not improve my eyesight to what it used to be. They started to get suspicious that I might have a problem and referred me to the eye hospital. That’s where I was told that I have Keratoconus.”
What is the cure for Keratoconus?
Currently there is no cure for Keratoconus. However there are safe and effective methods of halting the progression of Keratoconus and improving quality of vision dramatically. The best action is early detection and treatment.
If I Have Keratoconus, What are my options?
Your first step would be a detailed consultation with our experienced team of Optometrists and Ophthalmologists. No two eyes are the same and often the Keratoconus in one eye is more progressed than the other so careful analysis and treatment planning is vital.
Treatment plans for Keratoconus at AccuVision are specifically tailored for each patient, utilising our considerable experience to deliver the most effective outcomes.
Cornea Collagen Cross-Linking (CXL)
What is CXL?
Collagen Cross-Linking is a procedure that strengthens the cornea. The bulk of the cornea (stroma) is made up of collagen fibres which are held together by chemical links. When these links breakdown, weakening the integrity of the cornea, Keratoconus develops. CXL is a minimally invasive treatment during which Vitamin B2 (Riboflavin) drops are allowed to absorb into the stroma followed by photochemical activation with Ultraviolet (UV) light. This stimulates the formation of chemical ‘cross-links’ between the collagen fibres in the cornea, strengthening it, thereby increasing its overall stability.
How is CXL performed?
The procedure is performed under topical anaestheSia (eye drops) which numbs the surface of the eye and prevents any pain during the procedure. The outermost layer of the cornea, the epithelium, is removed and Vitmain B2 (Riboflavin) drops are applied to the exposed stroma for between 10 and 20 minutes. Once the Riboflavin has been abosorbed into the stroma the cornea is exposed to UV light at a wavelength of 365nm for 9 minutes. At the end of the treatment a soft bandage contact lens is applied and left in place for a few days to allow the epithelium to regenerate.
What happens after the treatment?
Immediately after the treatment somebody must accompany the patient home and the eyes must be rested as much as possible. The more the eyes are kept closed the quicker the epithelium regenerates. A combination of antibiotic and steroid drops are prescribed and must be used as instructed. The clinical team will monitor your progress periodically and adjust your aftercare as appropriate. A good pair of UV protective sunglasses must be used outdoors for the first year after treatment.
Once the cornea has is stabilised, we begin fitting contact lenses/spectacles to improve vision. Specialist, tailor-made and fitted contact lenses can provide more functional visual performance than glasses in most cases. Due to the resulting flattening of the abnormal part of the cornea, contact lenses are much more tolerable after CXL.
I've been told my corneas are too thin and my condition is too advanced. What now?
We have pioneered ways in which to safely and effectively perform CXL on patients with even very advanced Keratoconus. We routinely see patients who have been told ‘your cornea is too thin’ or ‘your cornea is too steep and irregular’ and ‘your Keratoconus is too advanced’.
Even today, many centres have the attitude of ‘monitoring’ – waiting and watching as the condition progresses and impacts the quality of vision and quality of life even further. This can risk passing sentence on the future vision and livelihood of the young people that suffer with Keratoconus that have the rest of their lives ahead of them.
Collagen Cross-Linking (CXL) with Topography-Guided Customised Ablation Treatment (T-CAT)
The irregularity of the corneal surface that develops with Keratoconus is what impacts quality of vision. In some cases we are able to use an excimer laser to reprofile the cornea prior to CXL. Advanced diagnostics allow us to very precisely map the topography of even very distorted corneas. This data is then transferred to the excimer laser and an ablation profile is created to normalise the asymmetry of the cornea.
In some cases the excimer laser can be further utilsed to correct refractive errors of the eye, thus leading to a significant improvement in the prescription.
Early diagnosis is the key here as unfortunately the longer the condition is left to worsen, the thinner one’s cornea becomes, the less scope there is for additional treatment options.
Corneal Ring Segments or INTACs
Corneal Ring Segment inserts or INTACs are another treatment option for patients suffering from Keratoconus. Very small curved clear plastic inserts are placed inside the cornea, helping to re-shape it. INTACs typically only partially correct the optical defect present so additional optical aids or surgery may be required to obtain a better correction.
The main disadvantage with Intacs are that they cannot prevent the cornea continuing to weaken and the patient may still require a corneal Graft in the future if the Keratoconus continues to progress.
Corneal Transplantation
Up until a few years ago, the only option for advanced cases of Keratoconus was corneal transplantation (Graft). During a transplant the disc of diseased corneal tissue is removed from the eye and it is replaced with a healthy donor cornea.
This operation could take one of two forms. A partial removal of the cornea called lamellar keratoplasty (DALK), or full removal called penetrating keratoplasty (PK).
Only the outer layer of the cornea is removed and replaced during lamellar keratoplasty. It has many advantages, including early suture removal and decreased risk of rejection. It is more time consuming and requires much greater technical ability from the treating surgeon.
The entire cornea is removed and then replaced during penetrating keratoplasty (PK). The new corneal tissue is attached to the unaffected part of the original cornea with very fine sutures. This surgery is usually performed under general anaesthesia. The whole procedure for one eye can take up to 90 minutes. Recovery from a corneal transplant can take up to a year or more. Rehabilitation usually involves spectacles and/or contact lenses, with on-going aftercare for many months following the operation.
Since the advent of Collagen Cross-Linking (CXL), the number of corneal transplantations performed due to Keratoconus has decreased significantly as so many more people are receiving Collagen Cross-Linking (CXL).
Have Any Questions?
We are NOT call centre based.
You can reach us directly at our clinic and speak to us about your individual treatment needs.
We won't divert enquiries to a remote call centre.
Choose to speak to AccuVision about the treatment you are interested in and you will be put through to a member of our highly experienced clinical team. You will be given qualified answers to the questions you need to ask to assist you in making your decision.
We won't try to baffle you with science or Marketing We will simply provide you with the facts.
We will communicate with you on the phone, by email and in person at your consultation in a way that helps you to clearly understand your vision and how it can be corrected.
We have in depth knowledge of the technical aspects of our treatment plans and the technology we use and will be pleased to share that with you too if you wish.
We won't make claims we can't substantiate.
You may hear claims such as ’20:20 or your money back’ but what they don’t tell you is you’ll have to wait a year, accept a re-treat and attend all your post op appointments – There are lots of t’s and c’s.
You will never be attended to by on inexperienced specialist.
Your first appointment will be with a highly experienced optometrist with 10 years experience or more. Whatever your prescription, they will give you impartial advice and base any recommendations on the specialist knowledge and expertise of the team at AccuVision. Our patient outcomes have been consistently outstanding since our inception. This can be seen through nearly two decades of patient testimonials.
We won't quote a low price just to attract your attention.
We won't give you a recommendation from patients you cannot contact yourself.
Our clinics
AccuVision Midlands
707 Warwick Road
Solihull
Birmingham B91 3DA
AccuVision Yorkshire
York Road
Wetherby
Leeds LS22 7SU
