Background: Patients with keratoconus, which is a common corneal ectasia, often present to specialised clinics for management. Understanding the clinical characteristics of keratoconus patients can help improve knowledge of the presentation and management of this corneal ectasia and predict the needs of the clinic providing care for affected individuals.Aim: To describe the clinical characteristics of keratoconus patients attending the University of KwaZulu-Natal (UKZN) eye clinic.Setting: University of KwaZulu-Natal eye clinic.Methods: The study used a retrospective research design by reviewing the clinical record cards of patients attending the UKZN contact lens eye clinic over a 4-year period (January 2014 to December 2017). Data related to age, clinical characteristics and method of management of the keratoconus patients were extracted and analysed using descriptive statistics.Results: Just less than one-quarter of all patients (n = 1210) attending the UKZN contact lens eye clinic had keratoconus that was most often bilateral. The mean age at presentation was 25.2 ± 9.6 years with 74% of the sample being younger than 30 years. More than 90% (n = 419) of the sample reported refractive reasons as the primary reason for presenting to the clinic. The majority of the sample had severe keratoconus (n = 257) and rigid contact lenses were most commonly used for management of keratoconus patients.Conclusion: Keratoconus presents at an early age with a more severe grade and it is most commonly managed using rigid contact lenses. These findings should be considered for keratoconus screening, diagnosis and treatment programmes in KwaZulu-Natal.

Visual impairment (VI), a global concern that is likely to escalate with prolonged life expectancies, has gained increasing attention in the realm of eye care. The purpose of this article is to highlight the different aspects of VI, including its definition and characteristics, prevalence, causes and implications. The importance of rehabilitation in individuals with VI is also discussed.

Lenses used in vision correction have evolved from the initial glass reading stone of the 10th century to the currently anticipated planar metalens made from "nanopillars" of titanium dioxide. With ideas from early scientific minds being translated into reality, and military commissioned concepts adapted for civilian use, spectacle lens and contact lens materials have progressed significantly over the last century, with the expectation of further lens material innovations ahead. The purpose of this article is a review of literature on the historical developments and advances in spectacle lens and contact lens materials.

The purpose of this study was to compare the intraocular pressure (IOP) values measured with the Tono-Pachymeter NT530P (Tonopachy™) and the iCare® rebound tonometer (iCare®) with those obtained by the Goldmann applanation tonometer (GAT). The right eyes of 105 subjects aged 18 to 82 years (mean age = 29.27 ± 14.67 years) were assessed with the three tonometers. Central corneal thickness (CCT) was measured first using the Tonopachy™ and then IOP was measured by Tonopachy™, iCare® and GAT. The data was analyzed with descriptive statistics, paired  t-test, correlation and regression analysis. The Bland-Altman method of analysis was used to evaluate agreements between the sets of data from the three devices. The CCT values ranged from 440 µm to 606 µm (mean= 518.49 ± 33.01 µm). There was little or no correlation between CCT and IOP for any of the instruments used in this study (r = 0.29 for Tonopachy™, r = 0.22 for iCare®, r = 0.17 for GAT). The mean IOP measured with the Tonopachy™ was 14.31 ± 3.57 mmHg (range 8.7 mmHg to 31 mmHg) and 16.64 ± 4.38 mmHg (range 8 mmHg to 32 mmHg) using the iCare®. The mean IOP measured with the GAT was 14.79 ± 3.09 mmHg (range 8.7 mmHg to 29.7 mmHg). Using the Bland-Altman method, the upper and lower limits of agreement between the Tonopachy™ and GAT, iCare® and GAT, iCare® and Tonopachy™ were 5.1 mmHg and –4.2 mmHg, 8.6 mmHg and –4.9 mmHg, 7.5 mmHg and –2.8 mmHg respectively. In 79.1% of the eyes studied, the mean IOP difference between Tonopachy™ and GAT was less than 3 mmHg and in 20.9% of the eyes, the difference was greater than 3 mmHg. However, mean IOP differences of greater than 3 mmHg were obtained by iCare® in comparison with GAT (40%) and Tonopachy™ (34.3%) respectively. Findings of this study suggest that the Tonopachy™ yielded IOP readings that were consistent with those of GAT values while iCare® yielded higher IOP values compared to both GAT and Tonopachy™. (S Afr Optom 2011 70(3) 109-116)

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