Evaluation of ophthalmic healthcare professional-led keratoconus management service in the United Kingdom: the Birmingham and Midland Eye Centre (BMEC) study

Keratoconus is the most common corneal ectatic disorder, affecting 1:375 to 1:2000 people globally [1]. Timely diagnosis and early intervention such as corneal cross-linking (CXL) is essential to stabilise progressive keratoconus, preserve vision and reduce the need for corneal transplantation [2]. In view of improved community screening [3], ophthalmic units across the UK are seeing a significant increase in community-to-hospital referrals for keratoconus management. To cope with the increased workload, several innovative pathways/services have been established, including the setup of virtual keratoconus clinics and CXL services led by nurses and optometrists [collectively known as ophthalmic healthcare professionals (OHPs)] [4, 5]. This cross-sectional study aimed to examine the effectiveness and safety of OHP-led keratoconus service in Birmingham and Midland Eye Centre (BMEC), one of the largest ophthalmic tertiary referral centres in the UK.