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Keratoconus treatment: cross-linking, lenses, CAIRS and what laser can’t do

Written By
Published on October 11, 2026

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Corneal cross-linking stops keratoconus getting worse in most treated eyes, and the NHS funds it when scans show the cornea is changing. NHS hospitals report it stops progression in more than 7 in 10 people (Dudley) to about 94% (Moorfields' own results since 2013). Privately, one eye costs £1,700 to £3,000 at the providers below, and some of those fees leave out the hospital or scans. Cross-linking keeps the cornea's shape as it is, so most people still need glasses or contact lenses afterwards. Once the cornea is stable, ring segments, CAIRS or a lens implant (ICL) can reduce the prescription.

  • NHS cross-linking: when scans show progression
  • Private, one eye: £1,700 to £3,000
  • Private consultation: free to £600, scans often extra
  • Laser eye surgery alone: not suitable

Watch: How keratoconus changes the cornea, how cross-linking is done, and what it costs. 1 min 32 s.

Read the transcript

Keratoconus treatment, explained.

With keratoconus, the cornea slowly becomes cone-shaped, and vision turns blurred or distorted.

It’s usually diagnosed in the late teens or early twenties, and a corneal scan maps the cone.

Corneal cross-linking stops keratoconus getting worse in most treated eyes.

After numbing drops, the surface layer of the cornea is brushed off.

Riboflavin drops, which are vitamin B2, go in, then ultraviolet light shines on the eye. Together they stiffen the cornea.

It takes under 30 minutes. The eye is sore and blurred at first, so plan at least a week off work.

Cross-linking keeps the cornea’s shape as it is, so most people still need glasses or contact lenses afterwards.

Once the cornea is stable, ring segments, CAIRS or a lens implant called an ICL can reduce the prescription.

Laser eye surgery on its own isn’t suitable, because it removes corneal tissue and thins the cornea.

At a consultation, your cornea is mapped, and a specialist decides which options fit your eyes.

At the 8 clinics we checked, cross-linking one eye costs £1,700 to £3,000. Some fees leave out the hospital or scans.

The NHS funds cross-linking when scans show keratoconus is getting worse.

Compare quotes from clinics near you.

The treatment pathway, in order

  1. Diagnosis Usually in the late teens or early twenties

    Vision becomes blurred or distorted. An optometrist or eye doctor examines the eye with a slit lamp, and a corneal scan (topography) maps the cone. Moorfields says urgent referral is not needed, because keratoconus takes years to develop.

  2. Stop it getting worse Cross-linking, if scans show progression

    Riboflavin (vitamin B2) drops and ultraviolet light stiffen the cornea. The NHS funds it when repeat scans show change. Stop rubbing your eyes. In a 2023 meta-analysis, people who rubbed their eyes had about five times the odds of keratoconus.

  3. See well Glasses or soft lenses early, then rigid lenses

    Moorfields says contact lenses usually correct vision even in advanced keratoconus. Hospital contact lens services charge £61.77 a lens (April 2026), and under-16s pay nothing. Once the cornea is stable, ring segments, CAIRS or an ICL can reduce the prescription.

  4. Monitoring Scans repeated for up to five years

    Moorfields' early keratoconus clinic rechecks vision, glasses prescription and corneal scans for up to five years from the first visit. Keratoconus usually stops getting worse by the mid-30s, as the cornea stiffens naturally with age.

  5. If lenses stop working A corneal graft

    Without cross-linking, about 1 in 5 people with keratoconus eventually need a corneal transplant, according to Moorfields and Dudley's NHS leaflets. Moorfields now describes grafts as rare. Grafts for keratoconus had 98% survival in the European registry's report on 12,913 transplants.

Cross-linking on the NHS: who qualifies, and the wait

Local NHS boards set the rules for cross-linking. Norfolk and Suffolk's policy, ratified on 1 April 2026, is quoted below because it is current and spells out its thresholds.

Topic What the NHS does Detail
Cross-linking Funded when keratoconus is progressing NICE says epithelium-off (epi-off) cross-linking can be used with normal arrangements for consent and audit (2013 guidance, now HTG319). Norfolk and Suffolk funds it on documented progression, for example a rise in the steepest corneal reading (Kmax) of 0.5 dioptres in 6 months or 1 dioptre in 12 months in early keratoconus, or 1 dioptre in 12 months above 55 dioptres. It also accepts people at high risk of progression, including everyone under 18. The cornea must be at least 325 microns thick.
Epi-on and combined treatments Not routine NICE found too little evidence on epithelium-on cross-linking and on cross-linking combined with other procedures. It says they should only be used with special arrangements for consent and audit, or in research. Healthcare Improvement Scotland endorses the NICE guidance.
Referral Optometrist or GP to the hospital eye service Royal Wolverhampton's leaflet: "If there is evidence of the Keratoconus getting worse, your Ophthalmologist will refer you to your nearest hospital that offers this treatment." Moorfields says it can normally list a patient for treatment within a few weeks of finding progression.
Waits Ophthalmology in England, August 2026 Of 622,784 open ophthalmology waits, 72.2% were under 18 weeks. The median was between 10 and 11 weeks, and 4,975 were over 52 weeks. Four trusts sent no data. No wait is published for cross-linking itself.
Contact lenses Hospital contact lens service £61.77 a lens, or a six-month supply of disposables, per eye (April 2026). Free under 16, from 16 to 18 in full-time education, or on qualifying benefits.
Grafts At NHS corneal units For very advanced keratoconus where contact lenses no longer give useful vision (Moorfields).

Local NHS boards set the rules. Norfolk and Suffolk's April 2026 policy is quoted below.

  • Cross-linking What the NHS does: Funded when keratoconus is progressing Detail: NICE says epithelium-off (epi-off) cross-linking can be used with normal arrangements for consent and audit (2013 guidance, now HTG319). Norfolk and Suffolk funds it on documented progression, for example a rise in the steepest corneal reading (Kmax) of 0.5 dioptres in 6 months or 1 dioptre in 12 months in early keratoconus, or 1 dioptre in 12 months above 55 dioptres. It also accepts people at high risk of progression, including everyone under 18. The cornea must be at least 325 microns thick.
  • Epi-on and combined treatments What the NHS does: Not routine Detail: NICE found too little evidence on epithelium-on cross-linking and on cross-linking combined with other procedures. It says they should only be used with special arrangements for consent and audit, or in research. Healthcare Improvement Scotland endorses the NICE guidance.
  • Referral What the NHS does: Optometrist or GP to the hospital eye service Detail: Royal Wolverhampton's leaflet: "If there is evidence of the Keratoconus getting worse, your Ophthalmologist will refer you to your nearest hospital that offers this treatment." Moorfields says it can normally list a patient for treatment within a few weeks of finding progression.
  • Waits What the NHS does: Ophthalmology in England, August 2026 Detail: Of 622,784 open ophthalmology waits, 72.2% were under 18 weeks. The median was between 10 and 11 weeks, and 4,975 were over 52 weeks. Four trusts sent no data. No wait is published for cross-linking itself.
  • Contact lenses What the NHS does: Hospital contact lens service Detail: £61.77 a lens, or a six-month supply of disposables, per eye (April 2026). Free under 16, from 16 to 18 in full-time education, or on qualifying benefits.
  • Grafts What the NHS does: At NHS corneal units Detail: For very advanced keratoconus where contact lenses no longer give useful vision (Moorfields).

Norfolk and Suffolk ICB policy ratified 1 April 2026; NHS England referral to treatment data for August 2026, published 8 October 2026; Plymouth Hospitals contact lens charges, April 2026.

Private prices at eight providers, and who publishes none

Published prices, read from each provider's own website on 11 October 2026. They cover different things, so the table says what each includes. Prices are per eye unless stated.

Provider Price Consultation Paying monthly
Optical Express Offers cross-linking; no price published Not published for keratoconus Not published for cross-linking
Optegra Offers cross-linking; no price published Not published for keratoconus Not stated
Optimal Vision (London) Cross-linking from £1,500 an eye when both eyes are treated; £1,700 for one eye £30 booking fee, refundable Finance available over 6, 10 or 12 months, 10% deposit
OCL Vision (London) Cross-linking from £1,720
CAIRS from £5,360
DALK graft from £12,795		 From £360, plus £55 a scan (up to three) Finance available for up to 24 months, 10% deposit (Novuna Consumer Finance)
Precision Vision London Manual cross-linking £1,750
Laser-assisted cross-linking £2,000
Corneal implants £2,575		 £250 keratoconus assessment, non-refundable once attended Finance available over 12 months, £250 deposit an eye (through Ideal4Finance, a credit broker)
My-iClinic (North London) Cross-linking £1,800
CAIRS from £3,200
Corneal graft £9,000		 £300, scans extra Finance available, subject to status
Newmedica Cross-linking £1,995 one eye; £2,495 both eyes From £195 Finance available over 10 months on treatments over £1,000, 10% deposit
K Vision Centre (Harley Street, Spire St Anthony's, Spire Gatwick) Surgeon's fee £2,399 one eye; £3,999 both eyes. Scans and facility fees extra Not stated Not stated
Harley Street Eye Centre Topography-guided laser for keratoconus from £2,500, which can be combined with cross-linking Free assessment Not stated
Eye Correction Centre (North West, North Wales, Yorkshire, Lincolnshire) Clinician fee £3,000 for cross-linking or a Keraring implant; hospital charges extra £200 to £300; scans from £100 Finance available for qualifying patients
Moorfields Private (London) Priced after consultation Consultant £250 to £600, plus hospital tests £53 to £460 Not stated
Spire, Centre for Sight Offer cross-linking; no price published Varies Not stated

Read from each provider's website on 11 October 2026. Per eye unless stated.

  • Optical Express Offers cross-linking; no price published Consultation: Not published for keratoconus Paying monthly: Not published for cross-linking
  • Optegra Offers cross-linking; no price published Consultation: Not published for keratoconus Paying monthly: Not stated
  • Optimal Vision (London) Cross-linking from £1,500 an eye when both eyes are treated; £1,700 for one eye Consultation: £30 booking fee, refundable Paying monthly: Finance available over 6, 10 or 12 months, 10% deposit
  • OCL Vision (London) Cross-linking from £1,720
    CAIRS from £5,360
    DALK graft from £12,795     Consultation: From £360, plus £55 a scan (up to three) Paying monthly: Finance available for up to 24 months, 10% deposit (Novuna Consumer Finance)
  • Precision Vision London Manual cross-linking £1,750
    Laser-assisted cross-linking £2,000
    Corneal implants £2,575     Consultation: £250 keratoconus assessment, non-refundable once attended Paying monthly: Finance available over 12 months, £250 deposit an eye (through Ideal4Finance, a credit broker)
  • My-iClinic (North London) Cross-linking £1,800
    CAIRS from £3,200
    Corneal graft £9,000     Consultation: £300, scans extra Paying monthly: Finance available, subject to status
  • Newmedica Cross-linking £1,995 one eye; £2,495 both eyes Consultation: From £195 Paying monthly: Finance available over 10 months on treatments over £1,000, 10% deposit
  • K Vision Centre (Harley Street, Spire St Anthony's, Spire Gatwick) Surgeon's fee £2,399 one eye; £3,999 both eyes. Scans and facility fees extra Consultation: Not stated Paying monthly: Not stated
  • Harley Street Eye Centre Topography-guided laser for keratoconus from £2,500, which can be combined with cross-linking Consultation: Free assessment Paying monthly: Not stated
  • Eye Correction Centre (North West, North Wales, Yorkshire, Lincolnshire) Clinician fee £3,000 for cross-linking or a Keraring implant; hospital charges extra Consultation: £200 to £300; scans from £100 Paying monthly: Finance available for qualifying patients
  • Moorfields Private (London) Priced after consultation Consultation: Consultant £250 to £600, plus hospital tests £53 to £460 Paying monthly: Not stated
  • Spire, Centre for Sight Offer cross-linking; no price published Consultation: Varies Paying monthly: Not stated

Prices change, so confirm before you book.

Read from each provider's website on 11 October 2026. Epithelium-off (epi-off) cross-linking is the version NICE says can be used with normal arrangements for consent and audit. Moorfields uses a faster (accelerated) epi-off version and says its long-term results are not yet available. Prices change, so confirm with the provider before you book.

What cross-linking involves

  1. Scans Rigid lenses out for two weeks, soft lenses for one

    Corneal maps and thickness measurements, repeated to show change. If you can't manage without lenses, Moorfields may still offer treatment based on your age and how thin the cornea is.

  2. Treatment day Under 30 minutes; allow half a day

    Numbing drops and a clip to hold the lids open. The surface layer is brushed off (epi-off), riboflavin drops go in for at least 10 minutes, then ultraviolet light shines for 8 minutes in Moorfields' accelerated version or 30 minutes in the standard one. A bandage contact lens goes on. Moorfields can treat both eyes the same day; Dudley treats one eye and waits a month or more before the second.

  3. The first week Sore and blurred; at least a week off work

    Moorfields says the eye is gritty, red and sensitive to light for several days, and advises a week off work, or two if your job is mostly screen work and the treated eye is your better one. The bandage lens comes out at the one-week check. Dudley says no driving for at least a week. Drops continue for about four weeks.

  4. Weeks to months The prescription settles over 6 to 12 months

    Moorfields says most glasses prescriptions are stable by six months and some take a year. In a German series of 163 eyes, 8.6% had noticeable haze in the cornea at one year.

  5. Monitoring A scan at six months, then checks for up to five years

    Moorfields repeats vision tests and scans six months after treatment and monitors for five years. Under 1% of its patients since 2013 have needed a second treatment.

The evidence, with the study behind each figure

The authors of KERALINK, the UK trial in children, say cross-linking should be considered first-line treatment for progressive keratoconus.

  • Progression stopped About 94% Moorfields' own results since 2013. Moorfields cites over 90% in three randomised trials at one year; Dudley tells patients more than 7 in 10.
  • Steepest reading after 3 years 1.03 D flatter, against 1.75 D steeper untreated Randomised trial, 94 eyes analysed, Melbourne, Ophthalmology 2014
  • Children 10 to 16 still progressing at 18 months 7% against 43% KERALINK, UK randomised trial of 60 patients, Ophthalmology 2021
  • Ten years on Steepest reading 3.6 D flatter 34 eyes followed for about 11 years, Dresden, JCRS 2015
  • Vision worse after treatment Under 3% Moorfields. Infection under 1% (Moorfields). Sterile inflammation in 7.6% of 117 eyes in a Zurich series, JCRS 2009
  • CAIRS: sharpest corrected vision About 3.7 lines better Meta-analysis of 442 eyes in 14 studies, Am J Ophthalmol 2025; one severe event (0.2%)

D means dioptres. A lower steepest reading (Kmax) means a flatter, less cone-shaped cornea.

Worth knowing

  • Most people still need glasses or contact lenses after cross-linking, say Moorfields and Dudley
  • Epi-on cross-linking, which leaves the surface on, had fewer complications but 4.49 times the risk of progression at a year in a meta-analysis of 12 trials and 966 eyes
  • In a Zurich series of 117 eyes, keratoconus kept progressing in 7.6%; a high steepest reading raised the failure rate (the authors suggest a cut-off of 58 dioptres), and age over 35 raised the complication rate
  • Moorfields' faster accelerated version has no long-term results yet, by Moorfields' own account

Can I have laser eye surgery with keratoconus?

LASIK, LASEK or SMILE on their own. No. OCL Vision’s corneal surgeon writes that “laser eye surgery by itself is not possible in people with keratoconus because laser surgery removes corneal tissue and thins the cornea”. Clinics map the cornea before any laser treatment to screen for it.

Topography-guided laser with cross-linking. A few clinics smooth the cornea with a small surface laser treatment and cross-link it. Harley Street Eye Centre charges from £2,500 an eye. NICE groups cross-linking combined with other procedures as “CXL-plus”, found the evidence inadequate, and says it should only be done with special arrangements for consent and audit, or in research.

A toric ICL. Once scans show the cornea is stable, a lens implant placed inside the eye can correct short sight and astigmatism without removing corneal tissue. A 2024 review of 13 case series, with no randomised trials, called it “a valid refractive therapeutic approach” for stable keratoconus with a moderate to high prescription. Optical Express ICLs start at £3,595 an eye and My-iClinic’s at £3,500. Precision Vision London lists a specialist keratoconus lens at £4,300 an eye. The Royal College of Ophthalmologists says surgery should not happen on the day it is recommended and recommends a week to decide. Our ICL guide

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Questions people ask about keratoconus

Yes, when scans show your keratoconus is getting worse and you meet your local NHS board’s criteria. Norfolk and Suffolk’s April 2026 policy also accepts people at high risk of progression, including everyone under 18. Your optometrist or GP refers you to the hospital eye service.

One eye costs £1,700 to £3,000 at the providers on this page, and Optimal Vision charges from £1,500 an eye when both are treated. Newmedica charges £2,495 for both eyes. Consultations cost £195 to £600, scans are often extra, and K Vision and Eye Correction Centre quote a surgeon’s or clinician’s fee with the hospital charged on top, so ask for the total.

Its job is to stop the cornea changing. Moorfields expects most patients’ vision to recover to where it was before treatment, and some improve. In the Melbourne randomised trial, unaided vision improved by 0.15 logMAR at three years. Most people still need glasses or contact lenses afterwards.

Moorfields says the eye is gritty, red and sensitive to light for several days and vision is blurred for the first few weeks. It advises at least a week off work and no long-haul flights in the first week. Dudley’s NHS leaflet says no driving for at least a week, and only once your vision meets the driving standard. The glasses prescription can take up to a year to settle.

Moorfields says keratoconus does not cause blindness, and that even in advanced keratoconus contact lenses can usually correct vision. Scarring in advanced cases can reduce vision, and a corneal graft is the next step where lenses no longer work.

Another name for corneal cross-linking with riboflavin. Moorfields uses CXL and C3R for the same treatment.

Corneal allogenic intrastromal ring segments are strips of donor cornea placed inside your cornea to flatten the cone. A 2025 meta-analysis of 442 eyes found sharpest corrected vision improved by about 3.7 lines on a letter chart. It costs from £3,200 an eye at My-iClinic and from £5,360 at OCL Vision. We found no NHS policy that funds it.

About 1 in 725 people, in a 2020 meta-analysis of 7.2 million people in 15 countries. A Dutch insurance study put it at 1 in 375. In a Midlands hospital study of 1989 to 1998, keratoconus was four times as common in Asian patients as in white patients, and Asian patients were diagnosed younger, at an average age of 22.3 against 26.5.

We have not checked insurers’ policy wording on cross-linking. Moorfields says you can use private medical insurance for its private keratoconus treatment, and Newmedica says it is recognised by the major medical insurers. Ask your insurer in writing before you book, including whether keratoconus diagnosed before your policy started is excluded. Laser eye surgery and insurance

Related guides

Sources and how we checked the prices

Every price on this page was read from the provider's own website on 11 October 2026. Clinical figures come from the sources below. Prices change, so confirm with the provider before you book.

  1. NICE HTG319 (formerly IPG466), photochemical corneal collagen cross-linkage using riboflavin and ultraviolet A for keratoconus and keratectasia (opens in a new tab), Published 25 September 2013; fetched 11 October 2026
  2. NHS Norfolk and Suffolk ICB, corneal collagen cross-linking for keratoconus policy (opens in a new tab), Ratified 1 April 2026
  3. Moorfields Eye Hospital, corneal cross-linking (opens in a new tab), Fetched 11 October 2026
  4. Moorfields Eye Hospital, keratoconus diagnosis and treatment, and stable keratoconus clinic (opens in a new tab), Fetched 11 October 2026
  5. Moorfields Eye Hospital, adult cross-linking aftercare (opens in a new tab), Fetched 11 October 2026
Show all 38 sources Show fewer sources
  1. Dudley Group NHS, corneal cross-linking leaflet, version 5 (opens in a new tab), June 2026
  2. Royal Wolverhampton NHS Trust, keratoconus leaflet (opens in a new tab), Produced 2017; review date 7 December 2025
  3. NHS England, referral to treatment waiting times, August 2026 incomplete pathways by provider and statistical press notice (opens in a new tab), Published 8 October 2026
  4. Plymouth Hospitals NHS Trust, hospital contact lens service (opens in a new tab), Issued June 2025; charge for April 2026
  5. Royal College of Ophthalmologists, Professional Standards for Refractive Surgery, standard 5.11 (opens in a new tab), Reviewed 1 December 2024
  6. Wittig-Silva et al., randomised trial of cross-linking in progressive keratoconus, three-year results, Ophthalmology 121(4) (opens in a new tab), 2014
  7. Raiskup et al., cross-linking in progressive keratoconus, ten-year results, J Cataract Refract Surg 41(1) (opens in a new tab), 2015
  8. Larkin et al., KERALINK randomised trial in 10 to 16-year-olds, Ophthalmology 128(11) (opens in a new tab), 2021
  9. Nath et al., transepithelial versus epithelium-off cross-linking, meta-analysis, Ophthalmology 128(8) (opens in a new tab), 2021
  10. Koller et al., complication and failure rates after corneal crosslinking, J Cataract Refract Surg 35(8) (opens in a new tab), 2009
  11. Raiskup et al., corneal haze after cross-linking in keratoconus, J Refract Surg 25(9) (opens in a new tab), 2009
  12. Friedrich et al., CAIRS for keratoconus, meta-analysis, Am J Ophthalmol 276 (opens in a new tab), 2025
  13. Nowrouzi et al., phakic intraocular lens implantation in keratoconus, Eur J Ophthalmol 34(5) (opens in a new tab), 2024
  14. Dunker et al., outcomes of corneal transplantation in Europe, European Cornea and Cell Transplantation Registry, J Cataract Refract Surg 47(6) (opens in a new tab), 2021
  15. Hashemi et al., prevalence and risk factors for keratoconus, meta-analysis, Cornea 39(2) (opens in a new tab), 2020
  16. Godefrooij et al., age-specific incidence and prevalence of keratoconus in the Netherlands, Am J Ophthalmol 175 (opens in a new tab), 2017
  17. Pearson et al., ethnic origin and keratoconus in a Midlands hospital, Eye 14 (opens in a new tab), 2000
  18. Seth et al., keratoconus, eye rubbing and allergic eye disease, meta-analysis, Clin Exp Ophthalmol 51(4) (opens in a new tab), 2023
  19. Optical Express, keratoconus (opens in a new tab), 11 October 2026
  20. Optical Express, lens surgery pricing (ICL) (opens in a new tab), 11 October 2026
  21. Optimal Vision, corneal collagen cross-linking (opens in a new tab), 11 October 2026
  22. OCL Vision, corneal collagen cross-linking, CAIRS, DALK and payment plans (opens in a new tab), 11 October 2026
  23. OCL Vision, laser eye surgery and keratoconus, Mr Allon Barsam (opens in a new tab), 15 November 2015
  24. Precision Vision London, pricing (opens in a new tab), 11 October 2026
  25. My-iClinic, prices and cross-linking (opens in a new tab), 11 October 2026
  26. Newmedica, private eye treatment prices (opens in a new tab), 11 October 2026
  27. K Vision Centre, cross-linking costs (opens in a new tab), 11 October 2026
  28. Harley Street Eye Centre, topography-guided laser for keratoconus (opens in a new tab), 11 October 2026
  29. Eye Correction Centre, pricing (opens in a new tab), 11 October 2026
  30. Moorfields Private, keratoconus diagnosis and treatment (opens in a new tab), 11 October 2026
  31. Spire Leeds Hospital, corneal cross-linking for keratoconus (opens in a new tab), 11 October 2026
  32. Optegra, keratoconus (opens in a new tab), 11 October 2026
  33. Centre for Sight, keratoconus and pricing (opens in a new tab), 11 October 2026

Written By

William Amps is the lead writer at Lasik Eyes, where he covers laser eye surgery, lens replacement, cataract treatment and the UK clinics that provide them. He has spent years researching the private eye surgery market, comparing clinic prices, interpreting published outcome data and translating the jargon of refractive surgery into plain English for people weighing up whether it’s right for them.

His work on Lasik Eyes focuses on the questions patients actually ask: what the procedure really costs, how clinics differ, what the risks are and what the research says about long-term results. Every price, procedure and clinic review he writes is checked against the provider’s own published information and updated as the market changes.

His articles are intended to help you ask better questions at your consultation, not to replace the advice of a registered optometrist or ophthalmic surgeon.

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