Does progression in keratoconus have to be witnessed by the hospital eye service for it to have occurred? | Eye – Nature.com

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Eye (2021)
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We thank O’Brart et al. for their comments on our article regarding the costs, capacity, and clinical implications of waiting for documented progression in young keratoconic patients prior to collagen crosslinking. They argue our ‘conclusions are unsupported, raising good medical practice issues’ [1]. While we accept their concerns regarding a blanket policy of universal crosslinking, the hypothetical question we raised was based around avoidable costs and delays to these young patients. We clearly stated more research is required to identify parameters at presentation which better identify patients likely to experience progression and so require immediate crosslinking [2, 3].

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O’Brart D, Zarei-Ghanavati M, Vasquez-Perez A, Liu C. Comment on: “What are the costs, capacity, and clinical implications of “waiting for documented progression” in young West of Scotland patients prior to collagen cross linking?”. Eye. 2021. https://doi.org/10.1038/s41433-021-01704-w.
Simpson A, Brogan K, Ramaesh K, Lockington D. What are the costs, capacity, and clinical implications of ‘waiting for documented progression’ in young West of Scotland patients prior to collagen cross linking? Eye. 2021;35:1808–10. https://doi.org/10.1038/s41433-021-01444-x.
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Tennent Institute of Ophthalmology, Gartnavel General Hospital, 1053 Great Western Road, Glasgow, G12 0YN, UK
David Lockington, Alasdair Simpson, Kerr Brogan & Kanna Ramaesh
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All authors contributed equally to the article.
Correspondence to David Lockington.
The authors declare no competing interests.
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Lockington, D., Simpson, A., Brogan, K. et al. Does progression in keratoconus have to be witnessed by the hospital eye service for it to have occurred?. Eye (2021). https://doi.org/10.1038/s41433-021-01792-8
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DOI: https://doi.org/10.1038/s41433-021-01792-8
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Eye (Eye) ISSN 1476-5454 (online) ISSN 0950-222X (print)
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