Patients in Somerset with keratoconus, an eye condition that causes blurred vision and sensitivity to light, can now access treatment that prevents progression of the condition.
It’s all thanks to a cross-linking procedure that has been introduced at Musgrove Park Hospital to treat patients with corneal ectasia – where the round clear window of a patient’s eye becomes progressively thin, causing it to become cone-shaped and irregular.
Cross-linking is the only recognised treatment available that stops keratoconus from getting worse, and has a 95% success rate, with only 5% of patients going on to need further treatment.
Another benefit of the procedure is that patients with keratoconus will no longer need a lifetime supply of contact lenses, which tend to cost the NHS £600 per patient, per year, over their lifetime.
Keratoconus normally develops during a person’s teenage years or when they are in their 20s, and tends to gradually worsen over time.
The speed and severity of change is most common in people with connective tissue diseases, allergic eye disease, conditions such as Down’s Syndrome, and children with learning difficulties or autism.
Mr Indy Sian, a consultant ophthalmologist at Somerset NHS Foundation Trust, said: “We are extremely proud to introduce this new procedure in Somerset and are confident that it will help improve long-term vision for a significant number of patients every year.
“Many of the patients we treat would otherwise find it difficult to travel to other centres. Historically, our patients have needed to be seen at a specialist clinic in London to have this treatment, which was understandably very difficult for young families, or those individuals with additional needs.
“Patients with a learning disability or Down’s Syndrome may struggle to understand the whole process, so being able to have their treatment in a more familiar setting will be to their advantage. It will also make subsequent follow-up care much easier.
“We know that keratoconus has such a debilitating effect on people’s vision to the extent that they struggle to focus properly, which causes difficulty with depth perception and their ability to read.
“It can affect how they progress at school and can even lead to more injuries through falls and other balance-related activities with time. If not treated in a timely manner it may lead to the need for a cornea transplant.
“Being able to offer this cross-linking procedure here in Somerset means we have an effective way of stabilising a patient’s sight, so it does not get any worse over the years, and it can even improve the sight in some cases.
“It is not just an improvement in their vision, as it also means that they don’t need to frequently visit our team for further follow-ups. Instead, after three years of review via a virtual clinic, we can discharge them into the care of their local optician.
“The feedback we’ve had from our patients and their families has been positive, and they’ve told us that they’re very happy that we can offer this treatment locally.
“We are the only trust in the south west peninsula to offer this procedure, and this has meant that medical registrars have asked to come to work here so they can get exposure to crosslinking and gain experience – a great accolade for us and it promotes us as a unit of excellence. Our next step is to extend this further across the county. We were also very fortunate to secure charitable funds to help purchase the equipment.”
Once a patient has had the procedure, their follow-up care is handed over to an optometrist and corneal nurse specialist, who run the hospital’s monitoring clinics.
Rachel Adams, ophthalmology outpatients senior sister at Musgrove Park Hospital, explains: “When Sue and Camilla are satisfied that the patient’s condition is stable, they will let our consultant know so he can review the scans, before we discharge them into the care of their optician.
“At the moment we do the procedure in our ophthalmic theatre suite, and then we give the patient a telephone consultation two days later, before they come back in a week later for an in-person review.
“We are so pleased to be able to offer this treatment in Somerset and hope it will benefit patients for many years to come.”
Helen Evans, operational manager for ophthalmology at Somerset NHS Foundation Trust, added: “We have an incredible corneal service, and we will continue to develop our amazing service.”
Katharine Dunn, a patient who recently had the cross-linking procedure on both her eyes, said: “I was diagnosed with keratoconus 18 months ago so I recently underwent the cross-linking procedure under the care of the team at Musgrove Park Hospital.
“It was a straightforward procedure, and I have been pleased with the recovery time. The theatre team and Mr Sian were very caring and it was excellent to have the service so locally.”