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Keratoconus and crosslinking - Improving access to care and reducing inequity

18 months
Approved budget:
Dr Akilesh Gokul
Health issue:
Proposal type:
Health Delivery Research Development Award
Lay summary
Aotearoa has one of the highest rates of keratoconus, a potentially blinding eye disease, in the world. Corneal cross-linking (CXL) is an effective treatment for keratoconus. CXL strengthens the thinned and deformed corneas and stops the progression of keratoconus with a high degree of safety and efficacy but requires an average of 6 clinic follow-ups in the first year following treatment. We recently published that access to CXL in Aotearoa needs to be improved, with our data demonstrating that 40% of eyes show signs of keratoconus progression whilst waiting to undergo CXL with a mean waiting time of 5 months. We propose that an optometry led, community-based postoperative care programme, using equipment typically used in a hospital setting, appropriate training and accessing ophthalmologist input via telecommunication can reduce the burden of follow-up care on hospital clinics by more than 50% and allow for more timely access to CXL treatment.