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Review
. 2022 Dec 15;9(12):1973.
doi: 10.3390/children9121973.

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

Minji Song  1   2 , Tanya Chen  1   2 , Adam Moktar  1   2 , Elsie Chan  1   2   3 , Elaine W Chong  1   2   3 , Mark Daniell  1   2   3 , Srujana Sahebjada  1   2
Affiliations
Review

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

Minji Song et al. Children (Basel). .

Abstract

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.

Keywords: attitude; diagnosis; keratoconus; management; ophthalmologist; opinion; optometrist; practices; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA Diagram.
Figure 2
Figure 2
Bar chart characterizing the number of included paediatric (orange) and adult (blue) studies that explored diagnosis, non-surgical management, surgical management, and referral as their key outcomes.
Figure 3
Figure 3
Pie chart illustrating the number of included studies (further broken down into pediatric and adult studies) that focused on non-surgical management (orange), referral (yellow), and surgical management (green) as a management strategy for keratoconus.
See this image and copyright information in PMC

References

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