£2.4m funding to develop non-invasive treatment for keratoconus

University of Liverpool researchers receive £2.4 million to advance a minimally invasive treatment for keratoconus, aiming to improve patient access and reduce NHS costs

Researchers at the University of Liverpool have secured over £2.4 million in funding to develop a novel, non-invasive treatment for keratoconus, a progressive eye condition that causes the cornea to become misshapen, leading to significant vision impairment or blindness. This innovative approach uses a new cross-linking agent applied painlessly under local anaesthetic, without the need to remove the corneal epithelium, offering a safer and more accessible alternative to current invasive treatments.

The project, led by Professor Rachel Williams, aims to make this treatment available in community optometry practices, reducing the need for specialist hospital settings and potentially lowering the financial burden on the NHS, a promising development for the future of healthcare.

Keratoconus costs over £400m in the UK

Keratoconus affects one in 2,000 individuals in the UK, with prevalence rising to 1 in 200 among South Asian populations. The condition typically develops between the ages of 12 and 40, impacting education, employment, and quality of life. Figures from 2022 indicated that keratoconus cost the NHS over £400 million.

Current treatments prevent the disease progression; however, they are invasive and carry risks, including infections and long-term tissue damage.

Rachel Williams, Professor of Ophthalmic Bioengineering at the University of Liverpool, led the Liverpool research team, including Drs Lucy BosworthHelen CauldbeckAngela Stainthorpe, and Tansi Khodai, who will use Medical Research Council (MRC) funding to develop and clinically translate a new, minimally invasive treatment that offers a safer, more accessible alternative, a collaborative effort that includes the audience in the process.

Professor Williams said: “Our approach uses a novel cross-linking agent that can be administered painlessly under local anaesthetic, without removing the corneal epithelium – a key source of discomfort and complications in current treatments. This innovation has the potential to change the patient care pathway radically, making treatment available in community optometry practices rather than requiring specialist hospital settings.”

Over £2m funding for new treatment

Preclinical studies have already demonstrated the safety and efficacy of the novel cross-linking agent treatment in vivo, showing no histological changes in the cornea or surrounding tissues, providing reassurance about its potential benefits.

The new formulation is applied using a suction ring and does not require the removal of protective surface tissue, making the procedure more straightforward and more comfortable. As a result, the treatment could significantly reduce the financial burden on the NHS, potentially saving millions of pounds annually.

The team have been awarded £2,498,485 by the MRC Developmental Pathway, building on proof-of-concept work made possible through Harmonised IAA funding from the University’s Research, Partnerships and Innovation (RPI) directorate. Professor Williams has also benefited from ongoing support from the University’s Enterprise team, which has played a crucial role in facilitating collaborations and securing additional funding for the project.

Professor Williams concluded: “This award enables us to take the crucial next steps toward commercialising the treatment. We aim to partner with industry to bring this innovation into clinical use, working closely with our collaborator, Dr Vito Romano from the University of Brescia, reducing the need for invasive surgeries and dramatically improving access to care for patients with keratoconus.”

Read original article here.

NIHR grant awarded to UCL scientist Dr. Shafi Balal for community sourced AI-powered keratoconus research

The National Institute for Health and Care Research (NIHR) have awarded Dr. Shafi Balal a prestigious Doctoral Fellowship at University College London (UCL).

The NIHR Doctoral Fellowship is a full-time award that supports individuals to undertake a PhD in an area of research within the NIHR’s remit.

The funding will support Dr. Balal in groundbreaking research on using artificial intelligence (AI) to develop a foundation model (KERAFound) to enhance the early diagnosis of keratoconus, a corneal condition affecting vision. Keratoconus, impacts around 1 in 375 people and causes the cornea to become irregular and cone like, leading to visual impairment. Early diagnosis and timely treatment are crucial to prevent progression and avoid the need for corneal transplant surgery.

Dr. Balal expressed his gratitude for the support, stating:

This grant will enable us to advance our research and bring innovative solutions to the forefront of eye care. We are excited to explore the potential of AI in improving patient outcomes and reducing healthcare costs. We are seeking large anterior segment datasets and welcome national and international collaboration.

Harnessing the power of a foundation model, KERAFound will be tested on a broad range of conditions beyond keratoconus, including infections, inherited disorders, and glaucoma. In addition, exploratory work will focus on systemic conditions—an emerging field known as “oculomics.”

Dr. Balal’s research will be conducted in collaboration with Moorfields Eye Hospital, where the largest number of keratoconus patients in Europe are treated in its Keratoconus Clinic.

The team will use data from INSIGHT, an NHS-led data initiative hosted by Moorfields, to create a cloud-based database of high-quality scans to train the AI algorithms, ensuring accurate and reliable results. The project will use deep learning techniques to develop AI tools capable of diagnosing early keratoconus and monitoring its progression. This initiative aims to significantly reduce waiting times for specialist appointments, which can currently be as long as 44 weeks. Overall, this should provide substantial benefits to patients and the NHS.

Anterior segment scan

The study will be the first to use AI and INSIGHT data to look at anterior scans of the front of the eye to show how the cornea is changing shape over time. Previous successful work with INSIGHT data has looked at retinal scans of the back of the eye and led to the release of the RETFound AI foundation model.

Original article by NIHR here: https://moorfieldsbrc.nihr.ac.uk/nihr-grant-awarded-to-ucl-scientist-for-community-sourced-ai-powered-keratoconus-research/

Rethinking Workplace Adjustments: Gatekeepers, Power Trips, and the Subjectivity of ‘Reasonable’

By Daniel Morgan-Williams, Founding Director of Visualise Training and Consultancy

Working in the workplace adjustment space, we see this quite often. An employee requests an adjustment to remove a barrier, and instead of a constructive conversation, the request is blocked. The justification usually sounds familiar: “It’s not reasonable,” or “If we do it for you, we’ll have to do it for everyone.” But too often, what’s really happening isn’t about reasonableness at all — it’s about control. Line managers, HR teams, and senior leaders act as gatekeepers, making subjective calls on what counts as ‘reasonable.’ And yet, under the Equality Act, it isn’t ultimately their decision to define what’s reasonable — it’s the courts’.

This article explores two essential but often overlooked aspects of workplace adjustments: the gatekeeping behaviours that can turn adjustments into a power struggle, and the subjectivity trap of defining what “reasonable” really means. Along the way, we will consider examples from sensory loss — particularly visual impairment, tinnitus and hearing loss — to highlight how seemingly simple requests are frequently blocked, and why workplace assessments are a practical, objective way to resolve disputes and remove barriers.

The gatekeeper problem

Many disabled employees describe the process of requesting adjustments as daunting and exhausting. Rather than feeling supported, they feel they must convince a panel of sceptics. In too many cases, the people deciding — often line managers or HR staff — are not experts in disability or workplace barriers. Instead, they rely on personal judgement, assumptions, or organisational culture.

The result is gatekeeping. Adjustments are seen not as legal rights but as optional benefits that must be justified, rationed, or resisted. Phrases like “if we let you, everyone will want it” or “we’ve never done that before” become shields against change. While often presented as protecting fairness, the reality is these decisions can be about maintaining control, avoiding change, or simply not wanting to engage with the complexity of disability.

When control outweighs inclusion

In practice, this gatekeeping can feel like a power trip. An employee discloses their condition, explains the barrier they face, and requests a change, and instead of collaboration, they are met with suspicion or resistance. For example:

  • A member of staff with tinnitus asks to work from home two days a week to avoid a noisy open-plan office. The request is refused because “it wouldn’t be fair to the rest of the team.”
  • An employee with visual impairment asks for screen magnification software. The manager says, “It’s too expensive,” without checking the actual cost (often less than £100).
  • A worker with hearing loss requests captioning software for online meetings, but HR claims “we don’t support that platform.”
    In each case, the employee is left feeling dismissed, while the manager maintains their authority. The adjustment itself may have been low-cost, simple, and entirely reasonable. But the refusal becomes a statement of power: “I decide what you get.”

What the law says

The Equality Act 2010 is clear: employers have a duty to make reasonable adjustments where a disabled worker would otherwise be placed at a substantial disadvantage compared to non-disabled colleagues. These adjustments are not perks or privileges; they are legal entitlements.

The Act deliberately uses the term “reasonable” to allow flexibility across different organisations and circumstances. What is reasonable for a small employer may differ from what is reasonable for a multinational corporation. Factors include cost, practicality, and the effectiveness of the adjustment in removing disadvantage.

However, the law also makes it clear that it is not the line manager’s subjective opinion that decides reasonableness. If challenged, it is ultimately for an Employment Tribunal or court to determine whether an employer has complied with their duty. Too often, employers act as though they alone define what is reasonable, forgetting that their decisions can and will be scrutinised externally.

The subjectivity trap

The word “reasonable” is deceptively simple. In reality, it is one of the most contested aspects of workplace adjustments. Employers often hide behind this term, claiming that a request is “not reasonable” without providing evidence or exploring alternatives.

For example, some organisations still argue that home working is not reasonable, even when the pandemic proved otherwise. Others dismiss requests for specialist software or equipment as too costly without researching prices or considering funding support. Subjectivity leads to inconsistency: one employee might receive adjustments easily, while another in the same organisation is denied.

Tribunals repeatedly show how subjective employer decisions can be overturned. Recent cases have found that denying home working for employees with health conditions amounted to a failure to make reasonable adjustments. These rulings highlight the risk of leaving such decisions solely in the hands of internal gatekeepers.

Why blocking adjustments backfires

Blocking reasonable adjustments has significant consequences:

  • Legal risk: Employees can and do challenge refusals at tribunal, with employers facing damages, costs, and reputational harm.
  • Business impact: Skilled employees leave organisations that do not support them, leading to recruitment costs and loss of talent.
  • Workplace culture: Staff lose trust in leaders who dismiss or belittle adjustments, creating a culture of fear and disengagement.
    Perhaps most importantly, blocking adjustments undermines inclusion. It tells disabled staff that their needs are secondary, their barriers unimportant, and their contributions undervalued.
    Examples from sensory loss

Sensory loss provides clear illustrations of how adjustments can be misjudged:

  • Tinnitus: Dismissed as “just ringing in the ears,” yet it can severely affect concentration, sleep, and mental health. Reasonable adjustments may include quiet workspaces, home working, or sound-masking devices.
  • Hearing loss: In noisy offices, communication becomes exhausting. Adjustments such as captioning software, hearing loops, or quiet rooms can transform accessibility.
  • Visual impairment: Lighting, screen glare, and inaccessible technology create daily barriers. Adjustments include magnification software, screen readers, lighting control, and accessible documents.
    In all these cases, adjustments are often low-cost and practical. The real barrier is not financial but attitudinal — the reluctance of gatekeepers to act.

The role of workplace assessments

One of the most effective ways to avoid disputes and ensure compliance is through workplace assessments. These assessments provide an independent, expert view of what adjustments are appropriate. Rather than relying on subjective judgement, employers receive a clear report outlining barriers, solutions, and costs.

At Visualise Training and Consultancy, we carry out workplace assessments for people with visual impairment, hearing loss, and tinnitus every week. What we see, time and again, is that minor, simple adjustments make a huge difference — and prevent disputes before they arise. Assessments bring objectivity to a process that is too often clouded by subjectivity and power dynamics.

From gatekeepers to enablers

The fundamental shift required is cultural. Employers must move away from seeing adjustments as optional benefits controlled by gatekeepers, and towards recognising them as rights that enable inclusion. HR professionals and line managers should position themselves as enablers, working collaboratively with employees to remove barriers to success.

This means listening without judgement, seeking expert advice, and being open to change. It also means recognising that adjustments are not about giving someone an advantage, but about levelling the playing field. Fairness is not sameness — it is equity.

Conclusion

Reasonable adjustments are too often blocked by gatekeepers who see themselves as the final arbiters of what is reasonable. In reality, this power trip undermines inclusion, creates legal risk, and drives talent away. The subjectivity of “reasonable” makes it all the more important to approach adjustments with openness, evidence, and expert guidance.

Employers do not have the last word on what is reasonable — the law does. By embracing workplace assessments, listening to employees, and shifting from gatekeepers to enablers, organisations can create environments where disabled staff are supported, barriers are removed, and talent can thrive.

The question is not whether adjustments are reasonable, but whether employers are willing to step beyond subjectivity and power dynamics to build truly inclusive workplaces.

To find out more about making your organisation more accessible and inclusive for colleagues with hearing or sight loss, visit https://visualisetrainingandconsultancy.com/workplace-assessments/

Strategies for Coping with KC

Keratoconus (KC) doesn’t just affect your vision – it can also impact your daily life and emotional well-being. Distorted eyesight from KC can interfere with tasks like reading, driving, or recognizing faces, often leading to frustration or anxiety. That’s why coping with keratoconus is about more than just treating the eyes; it’s about preserving your quality of life. The good news is that with the right strategies and support, many people with keratoconus continue to live full, meaningful lives. Below are five key coping strategies, each aimed at helping you protect your vision and your day-to-day quality of life. 

Read the full article on the NKCF Website

Research update 3 shows promising results

If you have been following our previous posts; Engineers to develop spectacle lenses for keratoconus patients, Research update and Spectacles for KC Research update 2, you will be aware of Dr Ahmed’s work to address the problem of non-orthogonal astigmatism.

At our AGM and Speaker meeting both Dr Abass and optometrist Lynn White, carefully explained the progress of their work to find a solution for those of us who have to cope with not wearing contact lenses for a period of time; yet still need better vision for dealing with basic tasks. Both Ahmed and Lynn are convinced that with the advance of technology, spectacles can be manufactured to take account of a non-orthogonal angle of astigmatism. Indeed, some who have worn the spectacles in laboratory conditions, do not want to give them back.

In this clip, Dr Abass explained how he was able to interpret the high-resolution results without relying on the software provided by modern topography machines. He noticed that astigmatism is not always orthogonal, which led to his research project to find a better solution for keratoconus.

Here Lynn White explains the wider implications of Dr Abass’ research beyond keratoconus.

More details will follow in the next newsletter. To see a fuller summary of the talk click here 

There is still a long way to go but results to date are promising.

Here is the press release from Liverpool University.

In a recent KC patient group meeting, Dr Ahmed Abass from the University of Liverpool unveiled exciting research into a new type of spectacle lens designed to help those living with keratoconus; a progressive eye condition that causes thinning and irregular shaping of the cornea.

Traditional glasses often fall short in correcting vision for keratoconus patients due to a phenomenon called non-orthogonal astigmatism. However, Dr Abass and his team, supported by Fight for Sight and the UK Keratoconus Self-Help and Support Association, have been exploring an innovative lens design that targets this issue directly.

The results are encouraging. In this pilot study, many participants experienced clearer vision, reduced ghosting, and sharper letter recognition with these specially designed lenses.

“This is the first study of its kind,” Dr Abass said. “We’ve shown that the idea works. Now we need to focus on scaling it up, finding ways to mass produce these lenses and test them on a larger group.”

As the project looks towards the next stage, development and commercialisation, there may be exciting opportunities for those in the optical or medical device industries to get involved. Anyone interested in collaborating with the University of Liverpool or learning more is welcome to contact Dr Abass at a.abass@liverpool.ac.uk. or connect via linkedin

It is a small but meaningful step forward, offering new possibilities for those seeking alternatives to contact lenses or invasive procedures.

https://www.liverpool.ac.uk/people/ahmed-abass

New Research Study

Investigator Initiated, Prospective Study of Xenia Corneal Lenticule

This information is provided directly by researchers and we recognise that it isn’t always easy to understand. We are working with researchers to improve the accessibility of this information.

Cornea ectatic conditions such as keratoconus and post-LASIK (Laser In situ Keratomileusis) ectasia are disorders of the eye that are notorious for its uncontrolled progression over time, leading to loss of vision. There are valuable treatment options for controlling disease progression in mild to moderate stages of such disease. However in advanced cases and / or when contact lenses cannot be worn, surgery remains the only treatment option to rehabilitate vision. Most treatment options are highly invasive and represent significant risks. This study evaluates a novel corneal implant, Gebauer™ Lenticule to treat severe keratoconus or post-LASIK ectasia. This implant is derived from porcine collagen and intended for intra-stromal insertion. The Gebauer™ Lenticule is expected to improve the stability of the cornea while not impairing the vision. The procedure is an additive procedure after other treatment options have been exhausted. The procedure is reversible with removal of the implant (in the unexpected case of an adverse reaction), and vision may be restored to baseline.

The purpose of this study is to evaluate how well the implant is tolerated, it’s safety profile, and how effective this new treatment option is in the treatment of keratoconus or post-LASIK ectasia.

Visit the website for more details – here


Keratoconus in my teens/twenties


Around the age of 15/16 I was diagnosed with keratoconus. I was a glasses wearer, but I was really struggling to see anything in much detail. Trying to see the board at school was tough, even close up reading became a challenge. I spent most of my GCSE years squinting, much to my embarrassment. None of my friends had the same difficulties that I had. My Mom requested large print for my exams, and although at the time I felt pretty mortified by it, in hindsight the larger font and extra time was a big help – thank you Mom…..

That Summer, I was given rigid gas permeable lenses to try. I’ve always been very sensitive about anyone going near my eyes (even now at the age of 30, during a regular check up at the eye hospital it can be a challenge!), so someone putting these uncomfortable, foreign objects in my eyes was quite the ordeal. Especially considering the way I was taught to remove them was with a mini plunger – terrifying! Regardless, due to the steep improvement in vision with these RGP lenses, I persevered, and eventually got used to them. I even got used to wearing the single lens if one of my eyes was giving me some grief. My vision had improved and my confidence was up.

However, it wasn’t all good times in the coming years. I learnt the hard way that rubbing your eyes can make your vision worse (I haven’t done that now for 13 years and counting…..), I was given new RGP lenses which would prioritise comfort rather than sight, even having to change to piggyback lenses in one of my eyes as it couldn’t cope with just the RGP anymore, and I was told on a few occasions that my condition was worsening of its own accord.  The lenses themselves could be quite uncomfortable at times, and the slightest speck of dust could often send me into full on tears! And all this time being a young adult trying to navigate A-Levels and then university, I didn’t really listen to any advice I was being given, and I just got frustrated and angry at my hospital appointments. I wonder if the feeling may have been mutual from the hospital however, as I was constantly asking for replacement contact lenses due to them flicking out. Unfortunately when you’re experiencing the uni lifestyle of bars and nightclubs, the dehydration from a night out means that all I needed is a stray hand in and around my eye to make my contact lens flick out. There goes another payment (sorry Mom!) and many weeks waiting for the new lens to arrive…..

Fast forward to adult life in a full time employment at the age of 25 ,and I passed my driving test. I was always nervous about driving – I didn’t always have confidence in my sight (regardless of whether I could read the required line on the eye chart or not) and thought that it might affect my driving ability. After a few years of having lessons on and off, I finally booked a test. Weirdly the thing I was most nervous about on the day wasn’t actually the driving, but reading the reg plate in the car park! 

I feel that this is the point where my outlook changed. I could drive, and once I got my first car, I suddenly had way more opportunities in my life that were not there previously, in particular for work and travel. Now that I had this freedom, I really did not want to lose it. I started to take more care in my day-to-day life – less wear time with the contact lenses where possible, more time and care with cleaning and storing the lenses, I even started to wear Edgar Davids-esque protective goggles for sport. I didn’t care if I got the odd comment – I needed good eye health now more than ever. 

During a regular eye check-up at the hospital, I was told once again that my condition had deteriorated, and that once again, I should undergo cross linking to stop the condition from getting any worse. This operation is something that I had been told about on a few occasions previously. However, with my lack of affection of anyone or anything going near my eyes, as well as turning a bit of a blind eye to my condition in years gone by, I had always ignored the suggestion. This time though, I felt like I had something that I wanted to preserve – my eyesight for driving. I reluctantly agreed to be put forward for cross linking (under the condition of being under general anaesthetic, you can touch my eyes but I don’t want to be awake to see it!), and to my surprise within two months I was in hospital having the operation. I have written a piece previously about this operation, link as follows:

Before my operation, I was very nervous and I felt like I needed reassurance from somewhere. For many years, my Mom had been in contact with the West Midlands Keratoconus Group, even going to a few of the meet ups in Birmingham. Although her previous suggestions for me to join had fallen on deaf ears, this time I decided to join the latest Zoom call. It was an extremely eye-opening experience. Not only was I not alone with some of my experiences, they were in fact commonplace. Finally I had met some other people who were also fed up of the question ‘why can’t you wear glasses?’  Some of the members really had some extraordinary stories to tell which dated back decades, and it quickly became clear to me that some of my own annoyances in the past needed to be put into perspective a little more. On the call there were others who had gone through the cross linking experiences, and they proved incredibly helpful to get in contact with both before and after my procedure. 

Over 4 years on and I continue to join the Zoom calls and go to the in-person meets when I can. Because of the group, I have learnt about many other types of procedures/contact lenses/eyes drops/helpful practices etc which I never knew existed. Thanks to the group, I learnt about mini scleral lenses. At one of my contact lens appointments, I pushed for me to try these out. I have now been wearing mini scleral lenses for over a year, and the vision and comfort that they have given me so far has been fantastic.

At these meetings/on these Zoom calls, I hear of worried parents whose children are struggling and they don’t want to know about their condition. I find it quite humorous as the stories often parallel my own experiences, but I also will these young adults to step forward, talk about their condition and learn from others. Perhaps they also need their own eureka moment like I did when it came to protecting my vision for driving, or perhaps they can read something like my story and see that there is help out there if you ask for it.  

Spectacles for KC Research update 2

If you have been following this topic, you would have seen our earlier posts here and here

We are pleased to report that Dr Ahmed Abass has published his paper which we are proud to have co-sponsored with Fight for Sight.

Dr Abass has kindly provided the following simplified abstract. The full paper can be read here. You can also view his other papers on his University Page here

Purpose

The study aimed to investigate whether non-orthogonal correction in spectacles would improve the visual acuity of people with keratoconus. Non-orthogonal correction is where the angle between the cylinder powers of a spectacle lens for astigmatism is less than or greater than 90 degrees. Typically, keratoconus patients have this type of astigmatism, which is why standard glasses do not work well.

Methods

The study involved 18 patients with keratoconus from an eye clinic in Liverpool. After evaluating their eye condition, 23 eyes were selected for testing, while others were excluded due to the eye having little or no keratoconus or severe dryness. Each eye was tested first with standard lenses, and then with non-orthogonal lenses. The lenses were tested with different angles until the best one was found for each person. Participants were asked to rate their vision, specifically how clear letters appeared and how much “ghosting” (double vision) they experienced with each lens type.

Results

Of the eyes tested, 61% showed improved vision with non-orthogonal lenses, 30% saw no change, and 9% saw a slight decrease in vision. Regardless of vision improvement, 87% of participants noticed clearer letters, and 79% reported less ghosting. Most of the preferred angles for the non-orthogonal lenses were between 80° and 85°. The study also showed that for many people, the non-orthogonal lenses could provide a more accurate prescription compared to regular lenses. Nearly all participants said they would be interested in trying non-orthogonal glasses.

Conclusions

The study suggests that non-orthogonal lenses could improve vision and reduce issues like ghosting for people with keratoconus. While this is a promising step toward developing better glasses for these patients, more work is needed before these lenses can be made for everyday use. 

We are hoping to arrange for Dr Abass to speak at one of our future events.

Dale’s Story

Hi I’m Dale, I have Down syndrome, I’m autistic, I can be extremely challenging because the world doesn’t suit me very well… and I have KC. I will be 40 this year. My abilities are at about a two-year level. I love planes trains rugby and You’ve Been Framed.
When I was 5 my birth Mum had the folds by my eyes resected as she didn’t want me to look Downs. What hospital would do that? Later I was adopted into my always and forever family.

When I was 8 I had a squint corrected and instead of the promised left eye and despite a big marker pen arrow on my face, the guy did both eyes “for good measure”.  Ruined my good eye. The medical services have always been careless with me! They told Mum to drive me home straight away. I was cold and grey but they said they needed the bed. In the car I stopped breathing I was so congested.
When I was 11 a doctor in Spain thought I had leukemia and offered to open me up to see,  he said it didn’t matter if I didn’t survive as I was defective anyway….we came home fast. I was fine.
When I was 14 I was diagnosed with keratoconus, “severe and progressive.” Our local Hospital had no experience and bandaged my hydrops eye which went septic and stinky. Luckily Mum didn’t stick to their advice and we didn’t go back.
She took me to another hospital for assessment in 2000. We had hope and excitement! The Consultant Ophthalmic Surgeon said, ” Visual Acuity is 6/60 with correction (spectacles). This is probably adequate for his needs. Contact Lens fitting is not a sensible option in someone with an intellectual deficit.”
Adequate !! Er Nope. Luckily Mum likes a challenge.  And the word “lenses ” had been mentioned and being told ‘No’, made her cross! Mum found the kc group and via them, the magical Ken Pullum. Ken saw me for hours and hours and prescribed scleral contacts – I have help managing them and have vision as good as anyone since then 🙂  14/20 distance and symbols smaller than 2mm up close.
I was well supervised by Cheltenham General Hospital until staff changes meant they no longer had the expertise. In two weeks, I’m making a return visit to Ken after 25 years. I wonder if Ken will remember us. We remember him; he is my KC superhero.

Without and With Lenses