Sequence of events leading to diagnosis of keratoconus and its impact on quality of life

Abstract

Purpose: Early diagnosis of keratoconus (KCN) and corneal collagen cross-linking can ensure that best-corrected visual acuity is preserved. We report the sequence of events leading to the diagnosis of KCN, as well as its impact on quality of life. Methods: This survey-based study included patients diagnosed with KCN for the first time at our center. Their corneal tomography was analyzed, and they were provided with a proforma and the NEI-VFQ-25 questionnaire and were asked to answer the given set of questions. Results: The study included 328 eyes of 164 patients. At the time of diagnosis, 112 (68.3%) patients were not aware of a disease called “keratoconus.” VKC was present in 56 patients, and 92 patients were not aware of the need to avoid eye rubbing. In total, 101 patients gave a history of sleeping more often on the side with worse KCN. The preferred primary point of contact was an optometrist for 45.1% of patients; 51.2% of patients reported never having visited an ophthalmologist. Sixty-four (39%) patients were advised a screening test to rule out KCN before presenting to our center; 42 (71.8%) of these patients did not get it done. Vision-targeted score showed a significant negative correlation with grade of KCN (r value: −0.471) and positive correlation (r value: 0.534) with LogMAR vision. Conclusion: KCN is a disease of the young and severely affects the quality of life. Improving awareness of the general public, ensuring timely referral by optometrists, and keeping a high index of suspicion is emphasized.

Vision-Related Quality of Life in Patients With Keratoconus: A Nationwide Study in Saudi Arabia

“…This progression, if not halted, usually leads to the development of myopization and irregular astigmatism, resulting in impairment of visual acuity and quality of vision [ 1 ]. Typically, it begins in late childhood, clinically manifests in adolescence age, and persists till the third to fourth decade of life [ 2 ]. The prevalence of KC ranges from 0.05% in the United States to 18.7% in Saudi Arabia [ 3 , 4 ].…”

Quality of life of a sample of people with keratoconus in KSA

“… 13 The age at diagnosis and the post-diagnosis duration were likely to be a function of access to care rather than the actual disease onset. 14 …”

Topographic Keratoconus Incidence in Greece Diagnosed in Routine Consecutive Cataract Procedures: A Consecutive Case Series of 1250 Cases over 5 Years

“…Keratoconus is considered an unpredictably progressive disease that biomechanically "softens" the cornea. Current scientific knowledge suggests that the human cornea is probably the only part of the human body that is fully developed at birth, making the human cornea a unique anatomical tissue in shape and structure [1][2][3][4].…”