June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Current Trends in the Holistic, Long-Term Management of Keratoconus
Author Affiliations & Notes
  • Amy Catherine Nau
    Korb & Associates, Boston, Massachusetts, United States
    New England College of Optometry, Boston, Massachusetts, United States
  • Cherie B Nau
    Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Muriel Schornack
    Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Jennifer S Harthan
    Illinois College of Optometry, Chicago, Illinois, United States
  • Jennifer Swingle Fogt
    The Ohio State University Wexner Medical Center, Columbus, Ohio, United States
  • Ellen Shorter
    University of Illinois at Chicago College of Medicine, Chicago, Illinois, United States
  • Footnotes
    Commercial Relationships   Amy Nau, None; Cherie Nau, None; Muriel Schornack, None; Jennifer Harthan, Allergan (R), Bausch & Lomb (R), Contamac (R), Essilor (C), Essilor (R), Euclid (R), International Keratoconus Academy (C), Kala Pharmaceuticals (F), Metro Optics (F), Metro Optics (C), Ocular Therapeutics (F), Tangible Sciences (F); Jennifer Fogt, Alcon (F), Contamac (C), EyeLab (C), EyeNova (F), Innovega (F), Innovega (C), Nevakar (F), Ocugen (F); Ellen Shorter, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 776. doi:
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    • Get Citation

      Amy Catherine Nau, Cherie B Nau, Muriel Schornack, Jennifer S Harthan, Jennifer Swingle Fogt, Ellen Shorter; Current Trends in the Holistic, Long-Term Management of Keratoconus. Invest. Ophthalmol. Vis. Sci. 2021;62(8):776.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose : Studies which examine the degree to which holistic issues related to keratoconus (KC) management are non-existent, but could be an important component to increasing patient satisfaction.

Methods : An internet-based, 22 question, IRB approved RED-Cap survey of providers who managed at least one KC patient per week. Descriptive analyses are presented. Respondents were not required to answer every question, and some questions allowed more than one response.

Results : Of the 296 respondents, 245 providers with an average of 23.1 +12 years in practice met entry criteria. Respondents (n=220) averaged caring for 27.2 +35 KC patients each month. Only 19% of respondents (n=220) administer symptom questionnaires. Of responsdents that do (n=42), 28 use them only at the initial visit, 18 use them at every follow up, and 15 do so annually (more than one answer allowed). The majority (98%, n=220) ask about contact lens comfort at every visit. 51% (n=220) of respondents perform dry eye testing as part of follow up examinations. Point of care tests include ((n=299); multiple responses allowed): MMP-9 (n=17), osmolarity (n=23), lipid layer thickness (n= 33), meibography (n=38), KB light test( n=4), break up time (n=108), vital dye staining (n= 78), Schirmer test (n=32), Dry Eye Test 9 (n=19), other (n=19). It is uncommon for patients to be asked about depression related to their condition. Only 4% of providers always ask, 13% most of the time, 45% sometimes, 27% rarely ask and 11% never broach this topic (n=222). Providers rarely refer to support groups or mental health professionals. Only 2% do so all of the time, 6% most of the time, 26% offer sometimes, 43% do so rarely and 23% never refer for such services (n=222). 92.7% of respondents felt that patients were honest about problems related to their disease.

Conclusions : This is the first survey among eye care providers to examine holistic aspects of long-term keratoconus management. Results demonstrate that symptom questionnaires, inquiries about quality-of-life /depression and referrals to mental health professionals are seldom addressed. Dry eye is emerging as a problem for KC patients yet only half of respondents routinely test for this comorbid condition, which can negatively impact contact lens tolerance and overall quality of life. Results of this study identify several high impact, low-cost improvements to current practice patterns.

This is a 2021 ARVO Annual Meeting abstract.


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