Mismatch of corneal specialists’ expectations and keratoconus knowledge in general ophthalmologists - a prospective observational study in Switzerland

Abstract

Background To assess whether Swiss general ophthalmologists have the minimal keratoconus knowledge that corneal specialists would expect them to have. Methods Corneal specialists defined “minimal keratoconus knowledge” (MKK) with respect to definition, risk factors, symptoms and possible treatment options of keratoconus. A telephone interview survey was conducted among one hundred ophthalmologists (mean age 51.9 years (SD 9.5), 60 % male) from the German-speaking part of Switzerland. For each participant, years of work experience, number of keratoconus patients seen per year and access to a topography device were obtained. We calculated the proportion of MKK and examined in multivariate analyses whether ophthalmologists with access to topography and with greater work experience performed better than other groups. Results No single ophthalmologist had MKK. The mean MKK was 52.0 %, and the range was 28.6–81.0 %. Per 10 years of working in private practice, the MKK decreased by 8.1 % points (95 % CI: -14.2, -2.00; p = 0.01). Only 24 % of participants correctly recalled the definition of keratoconus, 9 % all risk factors, 5 % all symptoms and 20 % all treatment modalities. The MKK values were not associated with the number of keratoconus patients seen per year and the availability of topography to diagnose keratoconus. Conclusions There is a substantial mismatch between corneal specialist’ expectations and general ophthalmologists’ knowledge about keratoconus. The low recall of symptoms and risk factors may explain why ophthalmologists diagnose relatively few cases of keratoconus, resulting in inefficient care delivery and delayed intervention.

Self-reported knowledge and skills related to diagnosis and management of keratoconus among public sector optometrists in the Limpopo province, South Africa

“…To the best of our knowledge, no similar study investigating the knowledge and skills of KC was conducted with optometrists, and only one such study was conducted with ophthalmologists at a tertiary referral centre in Lucerne, Switzerland. 20 The study found that none of the ophthalmologists had minimal keratoconus knowledge (MKK) concerning its definition, risk factors, symptoms and possible treatment options. However, they had a mean MKK of 52%, with a range between 28.6% and 81.0%.…”

“…Early detection and appropriate management of KC patients require optometrists to be knowledgeable and clinically competent and have appropriate infrastructure. A lack of these will potentially contribute to misdiagnoses and underdiagnoses, 19 , 20 , 21 , 22 with resultant poor prognoses and diminished quality of life of the affected patients. Considering the observed increase in KC cases in these facilities, this study was conducted to establish whether optometrists, as primary eye care practitioners, were sufficiently knowledgeable and skilled in the diagnosis and management of KC.…”

Impact of big data resources on clinicians’ activation of prior medical knowledge

“…Different levels of prior knowledge affect the cognitive load of medical students in the use of whole case and series clue case format, thus affecting students' knowledge acquisition or diagnostic accuracy ( Kiesewetter et al., 2020 ). Baenninger et al. (2021) showed that the low recall rate of symptoms and risk factors by Swiss general ophthalmologists leads to relatively few cases diagnosed with keratoconus, which makes patients unable to receive effective and timely care.…”

“…Whether the appropriate prior knowledge can be activated in time is an important premise to ensure the clinicians to give full play to their clinical and nursing ability. Baenninger et al. (2021) evaluated the possible impact of whether general ophthalmologists in Switzerland have the minimum keratoconus knowledge expected by corneal experts.…”

Automated Cornea Diagnosis using Deep Convolutional Neural Networks based on Cornea Topography Maps

“…However, especially in early stages, keratoconus and other cornea pathologies are hard to detect, making a diagnosis based on these scans extremely difficult. Additionally, according to a study done by the Department of Ophthalmology of the Cantonal Hospital of Lucerne, there is a substantial mismatch between corneal specialists' expectations and keratoconus knowledge in general ophthalmologists 5 . Such a method could help to close those gaps and to establish a baseline diagnosis for corneal diseases.…”