Keratoconus Virtual Monitoring Clinic In A Tertiary University Hospital In The United Kingdom

To describe a new pathway for the virtual keratoconus monitoring in the corneal department of a tertiary centre in the United Kingdom. 

Corneal and Optometry departments, Leicester Royal Infirmary, Leicester, England, United Kingdom.

A virtual outpatient clinic was set up (KCPHOTO) to monitor keratoconus. The patients were identified form our keratoconus database. On the visit, a health care assistant (HCA) and a technician performed the visual acuity and the topography with Pentacam (Oculus, Wetzlar, Germany), respectively. Then, the results were truly assessed by an optometrist at a later date to decide stability or progression of keratoconus.

We present the results from July 2020 to May 2021 when 802 patients were sent appointments. 536 patients (66.8%) were seen and 266 (33.2%) did not attended due to concerns of risk of COVID-19. Regarding the topography outcome, 351 (65.5%) were stable, 121 (22.6%) showed no definitive evidence of progression, and 64 presented progression (11.9%). 41 (64%) of these were listed for collagen cross linking and the remaining 23 patients warranted to be deferred treatment after pandemics. By converting one face to face clinic to a virtual clinic we could increase capacity by nearly 500 appointments per year.

In pandemics times Ophthalmology departments have developed new ways to ensure patient care and follow up, to avoid loss of vision or potential blindness. KCPHOTO is a safe and effective method of monitoring keratoconus patients for evidence of progression. Virtual clinics manage to increase capacity at a time when face to face appointments were not possible. The waiting time for keratoconus monitoring appointments has been reduced, adding flexibility for booking short notice appointments.