Vision Scotland : Everything you need to know


If you have keratoconus, your cornea (the clear window at the front of the eye) becomes thinner and more curved than it should be. As a result, your vision may be blurred and distorted during your teenage years, but then stabilize later into adult life.

Everything you need to know


Choosing the correct lenses for your eyes is the most important decisions you will make. It is really important to ensure you understand the options available to you and how they will affect your vision after surgery.
Mr Jonathan Ross looking down a microscope during cataract surgery


To make a diagnosis of keratoconus, your Vision Scotland consultant will measure the curvature of your cornea. The test used to study the eyes surface is called topography. Topography measures the curvature of the surface of the eye and creates a coloured map of the cornea. The consultant and optometrist will carry out a number of further diagnostic tests to understand your eyes.

Cat, Optometrist at Vision Scotland

What is keratoconus?

Keratoconus is the thinning of your cornea (the clear window at the front of your eye) that can cause short-sightedness and astigmatism. It’s quite a common condition that usually only affects teenagers, and stabilises during adulthood.

In the early stages, you might find all you need is glasses, then as time goes by contacts might be more effective. If your condition worsens, you may need surgery.

The good news is that Keratoconus rarely leads to blindness, however you may find it difficult to lead a normal life without relying on glasses or contact lenses, or opting for corrective surgery.

Treatment for keratoconus

Treatments for keratoconus include collagen cross linking (a new kind of laser eye surgery) and corneal graft surgery. But often glasses or contacts are enough to allow patients to lead a normal life without further treatment. Your individualised treatment plan will depend on the condition of your eyes.

Your initial consultation with Vision Scotland will help us decide the best option for you, your condition and your lifestyle. You will also have the chance to learn more about your options and ask any questions you may have. If you decide to go ahead with treatment, we will tell you everything you need to know about the procedure, what you can do to prepare and book you in. Or you can go away and think about your options, and call us when you are ready.

Close up of a human eye
Mr Sanjay Mantry, Consultant Ophthalmic surgeon in scrubs

Collagen cross linking

Collagen cross linking is a relatively new kind of laser eye surgery, which slows down or completely stops keratoconus from getting any worse and in some cases has even partially reversed the symptoms.

The procedure itself is totally painless and usually takes around 30 minutes to complete. Anaesthetic drops will completely numb your eye, shortly after a special dye called riboflavin drops is applied for a few minutes. You will need to look at a blue light for about 20 minutes while it reacts with the riboflavin to stiffen the cornea – this process links together protein molecules.

You should be able to go straight home afterwards wearing special contact lenses. It is normal to experience sore and watery eyes for a few days but if you have any problems or concerns during this time you can contact your Vision Scotland surgeon directly for advice.

Corneal graft surgery

Corneal graft surgery is a more complex type of eye surgery.  It is only carried out by a small number of eye specialists in the UK, Vision Scotland being one of these.

Corneal graft surgery takes much longer than many other eye surgeries, lasting between one and two hours, usually under general anaesthetic.

It involves removing your own cornea and replacing it with a healthy donor cornea – sourced from a specialist ‘eye bank’ who have rigorously tested and stored the cornea prior to your transplant surgery. Long-term success rates are around 90% for this transplant procedure – but you will need to apply daily eye drops for up to several years afterwards.

Catriona with a patient carrying out diagnostic tests for lens replacement surgery

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