Treating keratoconus in children and young people

15 September 15

written by:

Ade Deane-Pratt

(more articles)

NHS funding body the National Institute for Health Research has given a grant of almost £1 million to test a treatment for keratoconus in children and young people.

 A cartoon of a person's eye in profile sowing the cornea as cone-shaped instead of round.
The cornea becomes cone-shaped in keratoconus

This is the second clinical trial to tackle one of the questions set by patients, family, carers and eye health professionals in the Sight Loss and Vision Priority Setting Partnership led by Fight for Sight with guidance from the James Lind Alliance.

Keratoconus affects the clear front surface of the eye (the cornea). Over time the cornea gets thinner and changes shape, which makes vision warped and blurry. Symptoms usually start in the teenage years although it's not normally diagnosed until the 20s.

The grant goes to Dr Frank Larkin, a consultant at Moorfields Eye Hospital in London, and co-investigators including Anne Kelpacz – a trustee at the UK Keratoconus Self-Help and Support Association.

They will run a study called the Keralink trial, to test a treatment known as ‘collagen cross-linking’ to find out if it’s safe and whether it works in children and young people.

Collagen cross-linking is all about making the cornea stronger. It’s already used on some adults with keratoconus and can stop the condition from getting worse.

Starting spring 2016

The team will recruit under-17s with keratoconus in one or both eyes, to take part in the research happening in London, Sheffield or Liverpool. Recruitment starts next spring and participants will be followed-up over 18 months or more.

“We’re very pleased that NIHR is supporting research on long-term disorders in children, especially as this trial is specifically to find out about how effective cross-linking is as a treatment for keratoconus,” said Ade Deane-Pratt, Research Communications Officer at Fight for Sight. “We know this is a very high priority for people affected by the condition.”

Frank Larkin gesturing as he gives a talk to NIHR in 2014.
Dr Frank Larkin

“Clinical trials of ophthalmic treatment devices are difficult to design but generate the most reliable information on safety and effectiveness” says Dr Larkin. “In regard to keratoconus we are very pleased to have support to investigate corneal cross-linking in the younger age group. Patients that have disease onset in the childhood age group have the highest risk of progression to corneal transplantation. In the event that keratoconus is found to stabilise in participants randomised to cross-linking in the Keralink trial, progression to the requirement for corneal transplantation will have been prevented in these patients.”

For more details about the project contact Mays Jawad at Moorfields Eye Hospital (

Cataract clinical trial

The first National Institute for Health Research grant to address a Sight Loss and Vision Priority Setting Partnership question is looking at how outcomes from cataract surgery can be improved. Results from the clinical trial to test the safety and effectiveness of laser-assisted cataract surgery are due to be published in September 2018.