Laser Vision

Keratoconus: Your Questions Answered

In this new LaserVision series, your questions answered, we aim to cover a number of pertinent topics, explaining any misconceptions, answering common questions and hopefully allaying any fears. This first edition covers keratoconus (Greek keras = cornea; latin conus=cone), a potentially visually disabling condition that is easily stopped if diagnosed and treated early.

What is it?

Keratoconus is a condition that causes your cornea, the clear front window of your eye, to weaken and change shape. It is thought that a biochemical and structural weakening of the cornea leads to this bowing and conical change in shape. It is surprisingly common and may in fact be under-reported due to delays in diagnosis. Untreated it can cause significant visual disability so regular reviews with a corneal specialist are essential.

What causes it and who is likely to get it?

It usually starts during the teenage years and can occur through to the early forties when it stabilises due to naturally occurring stiffening of the cornea which happens as we get older. Keratoconus is thought to be genetic and run-in families but in addition there are several other causes and associations (environmental factors such as eye rubbing / atopy or allergy; systemic conditions such as Marfan’s syndrome / Down syndrome) which are not fully understood. It may also occur randomly or sporadically.

What does it do to my vision? Does it change or get worse?

As the cornea becomes more cone shaped and distorted it may cause a progressive deterioration in vision. This may result in blurring, glare, haloes, or increased sensitivity to light. Unless treated, it is usually progressive and affects both eyes but to varying degrees.

How is it diagnosed?

It is diagnosed in clinic by a corneal specialist ophthalmologist. High astigmatism or progressive astigmatism is highly suspicious for the condition. The abnormal corneal shape is confirmed, and diagnosis made using a combination of clinical examination, glasses prescription (or refraction) and corneal tomography (advanced 3D mapping of the corneal shape and thickness).

What treatment is available?

The primary aim is to diagnose and treat as early as possible: stabilisation of the cornea is achieved using corneal collagen cross-linking (CXL) to prevent any further progression and change to vision. Riboflavin (vitamin B2) and UV-A light are applied to the corneal surface resulting in the formation of bonds between the collagen layers and overall stiffening of the cornea. Once stabilised, the treatment aim is to restore vision which can be achieved by glasses, contact lenses, intracorneal ring segments. It is also possible to combine CXL and laser to stabilise the keratoconus and smooth the corneal shape to improve the vision (Athens protocol). Sometimes in advanced disease, a corneal graft (DALK or penetrating keratoplasty) may be necessary to restore vision.

If you are concerned you or someone you know might have keratoconus or you have recently been diagnosed, please get in touch for a comprehensive review, assessment, and discussion of treatment options.

MEDICAL DISCLAIMER: this article is written as general information and should not be considered medical advice. It is always recommended to see your GP, ophthalmologist or other healthcare provider if any medical concerns. 

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Colin D. profile picture
Colin D.
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I was initially going to write a brief review, but thought it might be beneficial to anyone considering using LaserVision Prema, if I gave a more detailed account of my personal experience? After 10 years of my eyesight gradually deteriorating due to age, wearing glasses became a necessity for all distances, which constantly frustrated me after having had perfect vision for most of my life. I'd heard of lens replacement surgery, so looked deeper into it and due to their positive reviews, settled on LaserVision Prema for an initial consultation to discuss options. From the outset, the experience has been amazing. The staff are friendly, making patients feel very welcome and at ease, there's no pressure to agree to have anything done and any concerns you have will be addressed, including any negative points you may need to consider? During the initial consultation, my eyes were thoroughly examined using a variety of methods and equipment, which gave me confidence the results would be accurate. Following this, I met with Rakesh, who performs the operations, to discuss the different options available based on the results. Fortunately, my eyes were suitable for any of the procedures. Rakesh took the time to make sure I knew exactly what the pros and cons of each lens type were, he also ensured I was aware that although my vision would likely be much better, nothing available at the present time will give me perfect sight back? In the end, I decided to opt for lenses which would improve vision at all distances. On the day of the operation, staff do everything to relax patients, and nothing feels rushed. The whole experience was easy and completely painless, taking approximately 15-20 minutes per eye. Throughout the procedure Rakesh will ensure you're fine. Although you can see enough to walk immediately afterwards, your vision is initially very much reduced, so you won't be able to drive. I'd booked a room in the Travelodge opposite in case I wasn't able to travel after the operation and walked to it without assistance. LaserVision Prema provide you with various eye drops, required to be used several times a day for a couple of months to ensure your eyes properly heal. I used these as prescribed and didn't experience any problems. As the day went on my vision started slowly improving, to the point where I could watch a film on my iPad, without it being too blurry. Later in the evening, I looked out the window and was immediately aware of a massive improvement to my distance vision, being able to see things clearly at distances I previously would have needed glasses for. The only discomfort in the entire process was in the evening after I'd had the operation, my eyes felt like they were gritty and began to water for two or three hours. Although it was quite annoying and noticeable, it was manageable. After a few hours my eyes stopped watering and the grittiness was at the point where I no longer thought about it. Rakesh called me late in the evening, in his own time, to ask how I was getting on and make sure I was ok? This is the level of care LaserVision provide. The morning after the operation, the improvement to my near, intermediate and far distance sight was incredible. This was done in December 2025 and since then, I haven't needed to ever wear glasses again for anything, at any distance - I don't even own a pair now! To give an idea, I can read unaided N4 size words on a reading chart. As Rakesh pointed out, it hasn't given me totally pin sharp eyesight back, but it really isn't far off and seven months later, I'm still amazed at what LaserVision Prema was able to achieve. The operation itself isn't the end of the process, you will also receive an aftercare service of follow up visits to check everything is as expected and to ensure you are happy with your progress. As mentioned, the results in how much your eyesight can be improved differs from person to person. This review is purely to highlight how impressed I am with LaserVision Prema, their professionalism and level of care provided to patients.
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Fab Smith profile picture
Fab Smith
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Tim Ford literally gave me my vision back — life-changing care! For years I’ve struggled with contact lenses, feeling frustrated and limited by my keratoconus. But from the moment I met Tim Ford, everything changed. He didn’t rush; he truly listened to my challenges, understood exactly what I’d been going through, and carefully created a personalised plan that finally works for me. His expertise, patience, and kindness are incredible — he didn’t just treat my eyes, he cared about restoring my quality of life. I can’t believe the difference; it feels like he has truly given me my vision back. If you’re looking for an optometrist who goes above and beyond, especially for complex eye health, Tim is absolutely amazing. Thank you so much for everything! 🙏✨
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Nigel Steward
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Excellent professional care.
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Darren Toomer
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I have been delighted with the level of care provided by Rakesh and his team during my eye lens replacement surgery. The results of the surgery have been nothing less than life-changing. I shall always remain extremely grateful to the gift of 20:20 sight given to me.
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Peter Dixon profile picture
Peter Dixon
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Excellent, could not have asked for more.
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ros summers profile picture
ros summers
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Excellent service, very friendly approachable staff. My eye condition was identified quickly & medication prescribed. So pleased I decided to book my initial appointment. Highly recommended
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Janey Power profile picture
Janey Power
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Absolutely incredible service so far. The most attentive staff that greet me by name and make me feel so valued. My Ophthalmic Surgeon, Mr Rakesh Jayaswal has made everything understandable and couldn’t be a nicer, more relatable gentleman than he is. The professionalism from all staff especially Vicky, Tracey, Jane and Rakesh, has made me feel so secure and I know I’m in safe hands. The lens replacement surgery was a bit strange but painless and over quickly. Now just looking forward to my recovery. My sincere thanks to all involved . It is now 5 months post surgery and I cannot believe the quality of the aftercare that I have received from Vicky and Rakesh. My biggest concern was that after paying for surgery, I would just be left then to get on with things but they have seen me regularly and given me the most incredible service. Nothing was too much trouble and they have checked and checked my vision every step of the way. I have been made to feel like an important guest and their warmth and concern has made me feel so special. For anyone considering Prema, please take my word for the most incredible experience and I can read, see and do jigsaws with NO GLASSES. Words are not enough to thank them for what they have given me. 5 stars are not enough!!!
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Alison Philp
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Caring, empathetic staff with a lovely atmosphere in the clinic. The time taken to make sure I was happy with the treatment was never rushed & the whole procedure was so much more relaxed than I would have thought possible. Amazing.
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Robert James profile picture
Robert James
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Very well looked after by Mr Tapper at his Nuffield Woking clinic today, following a capsulotomy by him 6 weeks ago. I now have greatly improved vision in the affected eye. The LaserVision support team are also excellent. I would not hesitate to recommend this clinic to others.
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Lynette Marshall profile picture
Lynette Marshall
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If you are nervous about eye surgery, I highly recommend LaserVision Prema in Portsmouth. They looked after me so well from start to finish. Mr. Rakesh Jayaswal is a true gentleman whose calm manner and precision made me feel completely comfortable. The team is professional, kind, and happy to answer any questions. A five-star experience!
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