Diagnosis and Management of Keratoconus-A Narrative Review of Clinicians' Perspectives

This review discusses the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) in adults and children by optometrists and ophthalmologists in order to highlight the differences on a global scale. Two independent reviewers searched the electronic databases and grey literature for all potential articles published from 1 January 2000 to 1 June 2022 on management of KC. Keywords used in searches included keratoconus, diagnosis, management, treatment, attitude, practices, opinion, optometrist, ophthalmologist, consensus, and protocol. A total of 19 articles was included in this review-12 from the database search and seven from the grey literature. Although a common stepwise approach of non-surgical management was noted, there were differences in the rates of prescribing rigid gas permeable lenses. Furthermore, while clinicians agreed on the need for early diagnosis, the timeline and type of referral varied significantly. A similar discordance was found in the milestones for surgical intervention and preferred surgical techniques. Practice patterns in keratoconus diagnosis and management vary throughout the world. Multiple recommendations and suggestions to minimise the differences have been provided in the literature, with the main themes being improvement in education, interdisciplinary patient care, and further research to reach consensus.

Automated summary

This review examines the current practices, attitudes, and trends in diagnosing and managing keratoconus (KC) by optometrists and ophthalmologists worldwide. It highlights the differences in non-surgical management approaches, prescription rates of rigid gas permeable lenses, timelines and types of referrals for early diagnosis, and milestones for surgical intervention and preferred surgical techniques.