Keratoconus

Keratoconus causes the cornea at the front of the eye to bulge forwards in an abnormal cone shape. This causes blurred vision and pain to develop around your eyes.

There are several effective treatments for keratoconus, with prices ranging from just £15 up to £6,500. The type of treatment you will need will depend on the severity of your keratoconus.

The NHS do fund keratoconus treatment, however the eligibility criteria is strict so you must check with your optician or GP if you qualify.

Keratoconus: What Is It?

Keratoconus is a progressive eye disease which affects your cornea, the clear window at the front of your eye. The role of the cornea is to direct light onto the retina at the back of your eye to allow you to see clearly.

In keratoconus the middle of your cornea becomes thinner and weaker, causing it to bulge outwards in an abnormal cone shape. This can happen quickly, or occur over several years. The irregular shape of the cornea consequently makes your vision blurred, since it becomes unable to properly focus light onto the retina.

Keratoconus often affects both eyes, although one eye is usually more cone-shaped than the other. The disease occurs in approximately 1 in every 2,000 individuals, but can be more common in some ethnic groups such as South Asian people. It typically develops in your teens or early twenties, and affects both men and women equally.

Watch Mr CT Pillai, Founder and Medical Director at Advanced Vision Care, explain what Keratoconus is and how it affects those who suffer with the condition:

 

Video Transcript

"Keratoconus, we would say is a non-inflammatory degenerative condition of the cornea. People are born with it or it will develop in the early childhood. The cornea gets weaker so it becomes thinner and thinner as the age progresses. Because it is getting thinner the patient will increasingly become more astigmatic or more shortsightedness. They need glasses that won’t help them; they need contact lenses to get a good vision."

Mr CT Pillai, Founder/Medical Director at Advanced Vision Care

END


Keratoconus Causes

The exact cause of keratoconus is unknown, although several risk factors have been implicated in the development of the disease. These include those who:

  • Have family members who have keratoconus
  • Suffer from allergies such as asthma, eczema and hayfever
  • Suffer from itchy eyes and excessively rub them
  • Have Down’s syndrome or a connective tissue disorder
  • Have worn poorly fitted contact lenses for an extended period of time

Keratoconus Signs

The signs of keratoconus normally present themselves in your teenage years or early twenties, with symptoms worsening over time. Signs to watch out for are:

  • Blurred vision
  • Frequent changes in your optical prescription
  • Vision problems that cannot be corrected with glasses
  • Dry eyes
  • Sensitivity to light
  • Difficulty driving at night
  • Halos forming around bright lights, such as vehicle headlamps
  • Pain around the eyes
  • Headaches
  • Irritation in the eyes

If you think you have keratoconus, you should make an appointment to see your optometrist (optician) who will carry out in-depth investigations of your eye to determine if you have the disease.


How Is It Diagnosed?

Diagnosing keratoconus can be difficult because many of its symptoms are shared with other eye conditions, including common refractive errors such as myopia (short-sightedness) and hyperopia (long-sightedness).

To diagnose the condition, your optometrist will analyse your medical and family history and carry out an eye exam. During the eye exam, your optometrist will perform a number of tests. These include:

  • Refraction test: this determines the amount and type of refractive error you have (i.e. to what extent you are able to focus clearly on objects in your visual field). You will be required to read off a chart located approximately six metres away, while the optometrist will place lenses of different strengths in front of your eye.

  • Slit-lamp exam: this identifies any abnormalities or diseases of the eye. The optometrist will shine a high-intensity beam of light onto your eye and use a low-powered microscope to look closely at it.

  • Keratometry: this measures the curvature of the cornea. The optometrist will shine a circle of light onto your cornea and analyse its reflection to determine its basic shape.

  • Corneal topography: this is a computerized technique used for creating a detailed, visual map of the shape and power of the cornea. You will be required to sit in front of a bowl containing an illuminated pattern which will be shone onto your cornea. A digital camera at the base of the bowl will capture the reflection of the pattern off your eye. This reflection will then be used to make an image of your cornea’s curvature using specialist computer software.

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Keratoconus Treatment Options

If you are diagnosed with keratoconus, your optometrist will talk you through the most appropriate treatment options available to you. The treatments your eye specialist will recommend will depend on how severe your keratoconus is. The current treatment options are:

  1. Prescription glasses: these correct problems with blurred vision caused by keratoconus by accurately directing light onto the retina at the back of the eye to allow you to see clearly.

  2. Soft contact lenses: like prescription glasses, these lenses overcome problems with blurred vision. Made from a flexible plastic, soft contact lenses gently sit on the surface of your eye without changing the shape of your cornea.

  3. Gas permeable contacts lenses: unlike soft contact lenses, these are made from a firm plastic which retains its shape when placed on the eye. Gas permeable contact lenses therefore change the irregular cone shape of the cornea to a smooth, rounded shape that enables the wearer to see clearly. Because of their rigidity, these lenses can be more uncomfortable to wear than soft contact lenses.

  4. Scleral contact lenses: these are a larger version of gas permeable contact lenses. Instead of covering only a small portion of the cornea, these lenses sit over the entire surface of the cornea including the white of the eye (the sclera). Scleral contact lenses apply pressure to the eye to change the curvature of the cornea, correcting its abnormal shape. Because of their size, they can be easier to use than gas permeable contact lenses and are less likely to become dislodged in your eye.

  5. Corneal implants: these small, clear plastic rings are surgically inserted just under the surface of the eye in the outer edges of the cornea. Corneal implants help to change the atypical shape of the cornea to a flatter curve to improve your vision.

  6. Corneal collagen cross-linking: this innovative treatment attempts to increase the strength of the cornea. Specialist riboflavin (vitamin B2) eye drops are applied while ultraviolet light is shone onto the eye to create new, stronger bonds in the collagen that makes up the cornea. This corrects keratoconus by stopping the cornea from bending out of shape.

  7. Corneal transplant: also known as keratoplasty or a corneal graft, during this surgical procedure all or part of the weak cornea is removed and replaced with strong donor corneal tissue to restore the cornea’s normal shape. Most patients still need to wear prescription glasses or soft contact lenses after this procedure in order to see clearly, however.

Keratoconus Treatment Cost

The following table shows the average starting price for the various keratoconus treatments at top eye surgery clinics across the UK:

Keratoconus Treatment Type Starting Price
Prescription Glasses £25
Rigid Gas Permeable Contact Lenses £21
Soft Contact Lenses £55
Scleral Contact Lenses £15
Corneal Implants* £1,500
Corneal Collagen Cross-Linking* £2,500
Corneal Transplant* £6,500

*Starting price per eye

Surgical treatments do cost significantly more than non-surgical treatments due to the specialist expertise needed to perform the operation, as well as the necessary pre-surgery checks and aftercare required to monitor your recovery. However, it is important to remember that unlike non-surgical treatments which need to be frequently re-purchased, surgical options are a one-off treatment for keratoconus and so will be cost-effective in the long-term.


Finance Options For Keratoconus Treatment

As surgical treatments for keratoconus can be costly, the majority of private clinics now offer finance packages to make the procedures more affordable.

These packages typically require you to pay an upfront deposit (often around 10% of the overall price) to book the day of your surgery, followed by monthly instalments at a fixed amount to pay off the remainder of the balance. The more months that you spread the cost of the surgery over, the more likely it is that you will be charged interest on your payments, therefore driving up the overall price of the surgery.

The finance packages offered for keratoconus treatments will vary between clinics, so it is vital that you carry out research to find a payment package that best suits your circumstances, since late or missed payments can affect your credit score making it harder for you to borrow money in the future. Make sure that you read through all the terms and conditions of your finance package carefully, and seek advice from your clinic should you have any questions.

To find out more about paying for surgery on finance, visit our eye surgery cost page.


Can Keratoconus Be Treated On The NHS?

The NHS will pay for keratoconus treatment, but only for those in the very advanced stages of the disease who are at a high risk of losing their eyesight if it is left untreated. Whether the surgery is available to you however, will depend entirely on your local NHS trust and whether they allocate resources towards the treatment of keratoconus.

If you think you might be eligible for keratoconus treatment on the NHS, you should speak to your optometrist who will be able to refer you to your local hospital eye clinic if you are deemed a suitable candidate.

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