Report from Optrafair...

[Lynn White]

Hi folks...

I spent three days at Optrafair.. the optical trade fair.. and picked up a lot of interesting information..

Corneal Topographers were well up on the equipment stands. For those of you who don't know what these are....they are machines that project concentric rings of light onto the cornea and from this, colour coded "maps" of the cornea can be made - rather like contour maps of the ground.

These show up KC very well and all of these instruments had KC detection software included. Not only that, you can then assess a virtual contact lens fit - even including simulated movement - using the software. Parameters of various companies lenses can be programmed in so you can simulate how they would all fit, without ever placing a lens on the cornea.

On some instruments, you can also record the behaviour of the pupil so that you can superimpose this on the scan - thus you can see whether the person is "seeing " through the distortion or if it is being masked by the iris.

I really do feel this technology is going to revolutionise KC contact lens fitting.

You can, of course, also design lenses suited to the exact parameters of the individual eye.

Lynn

[Sajeev]

Well I think thats just brilliant...Anything to reduce turn around times for patients is just great for the patients/KC specialists/the NHS...it would be a a win all round....there is certainly a "Need" for them...and I keep hearing that the NHS is based on "Need"...and that the patient is the most important person in the NHS!

[GarethB]

The Cov and Warwick eye unit used a topographical map to confirm my KC had developed to pull the graft out of place. Do not know if it had KC software on, but the optomatrist said as soon as the map was done that I had KC. The contact lens specialist took one look at the information and suggested two sizes of Rose K lens and the second was the best.

This was done really quickly so I do not know how much was down to experience or the instrument used.

Designing a lens to exact perameters would be even better if a virtual model could be sent.

Thanks for the news Lynn.

[Lynn White]

Gareth..

If you know what you are looking for, KC is fairly easy to diagnose from a corneal topographic map. Once you have experience, then deciding on the fit of a lens is again a doddle.

However, what we are faced with is many professionals who do not have extensive experience of KC merely because it is rare. So I was excited by this software because it means that professionals can learn from it and also that less experienced staff can fit lenses faster...

This will all mean a quicker more efficient service.

Since you can play around with the software to design your own parameters... it will also mean that new lens designs can developed on an individual basis.

Many times, fitting KC is guesswork and you have to go back and forth with the lab to get it right.... a lengthy procedure. With this, you can play around with a virtual fit - and the patient does not have to be even there...

With computer technology - you could take a corneal map in Scotland and email it to someone in Italy for an opinion or to Germany to get a lens made.

This technology has been around for a long time.. the application of it is slow in arriving!

Lynn

[Sajeev]

Hi Lynn...That sounds really interesting and thanks for telling us about it...

I wanted to ask you something about mis-diagnoses and wrong-diagnoses of KC (which I have read about, that mis/wrong-diagnoses happen at a high rate for KC...particularly for sub-clinical KC)...what I wanted to ask is, do you think this machine with the KC software make diagnoses easier?...I think it will..!

I have heard from various sources that say KC is more common then people think due to it not being detected correctly!!

[Lynn White]

Well Sajeev...

The topcon software actually comes up with a probability factor of KC on every scan... others tend to do the same thing as well... so perhaps this will improve detection rate...

The interesting thing was that an optom had asked to be scanned herself...as she suspected she was KC.. and the guy showed me that although she had a really FLAT cornea, the scan was classic KC. This would not normally be considered KC as it was non progressive and a flat cornea with normal thickness.

To me this is a KC cornea... but on the other end of the spectrum to most people here.. ie sub-clinical. If these sort of corneas can be detected more readily then we can get a wider picture of KC research wise...

Lynn

[Sajeev]

Thanks again for sharing your experiance with us Lynn...hopfully detecting KC earlier will one day get a treatment like X-Linking to halt KC from developing any further!

What a great day that would be!

[jayuk]

Lynn

Im glad you saw the development of the CT machines.....I couldnt stress enough how important these are

When I got diagnosed 9 years back I had to go into Central London to get mine done at £60 an eye......that was then...since then Ive had one every 9 months....for my own mind sake and plus to monitor the progression of my KC.......id rather see and know whats going on myself and than I am able to make informed decisions on what/where to go next..........

Now, a number have these machines...my local Opticians bought one with the software not so long agoso I suspect they have come down in price....as 9 years back they were £90,000 a machine lol...

But I think anyone who has KC needs/should have a topography done......for there own information but also for lens fitting......particilarly if you have reverse geometry lenses....as the Topography readings can help immensly

[Lynn White]

Couldn't agree more Jayuk..

Prices have come down a great deal...they are around £8,000 now... depending on the software. I am looking to get one myself ..

However, even at that relatively low price - its a hard call to justify for the average practice. I was trying my hardest to get one in Trinidad, as the only one on the island was in a laser refraction clinic and local optical politics meant I couldn't send patients there for a scan...don't ask lol... but it is hard to justify in a commercial practice as accounting wise it would attract a net loss each year unless the practice did a lot of KC work or refractive surgery work.

The costs are getting down there though...

Tell me.. are you still paying the same sort of fee for topography nowadays??

Lynn

[jayuk]

Lynn

Now I pay £25 for both eyes at a Opticians in East Londong, and its £70 if you go into Central London for both eyes......well it was £70 at two places that I checked