CRU 2025: Prioritizing early diagnosis of keratoconus

Melissa Barnett, OD, FAAO, FSLS, FBCLA, director of optometry at University of California Davis, discusses keratoconus diagnosis, management, and key insights in a presentation given alongside John D. Gelles, OD, FIAO, FCLSA, FSLS, FBCLA, at CRU 2025. In an interview with Optometry Times, she emphasizes early detection as critical for effective treatment.

Diagnostic methods

• Can diagnose keratoconus without advanced equipment
• Use indicators like: - Retinoscopy - Vision changes - Increased astigmatism - Differences between auto refraction and refractive astigmatism
• Advanced techniques include corneal topography and tomography

Cross-linking

• Approved in 2016
• Crucial for halting keratoconus progression
• Strengthens cornea
• Prevents vision loss and potential corneal transplant
• Especially important before pregnancy, as cornea changes during this period

Rehabilitation options

• Scleral contact lenses
• Corneal gas permeable lenses
• Soft lenses for keratoconus
• Various surgical interventions

Pediatric keratoconus insights

• Prevalence: 1 in 334 patients
• Progresses more rapidly in younger populations
• Recommend screening as early as ages 7-8
• More aggressive progression compared to older patients

Patient resources

• National Keratoconus Foundation
• Clearly KC Podcast
• Provide educational materials for patients and parents

Key recommendations

• Early screening
• Comprehensive evaluation
• Patient and parent education
• Proactive management

Barnett stresses the importance of understanding keratoconus, detecting it early, and utilizing available treatments to preserve vision and prevent progression. The focus is on comprehensive care, patient education, and leveraging both diagnostic techniques and treatment options to manage this corneal condition effectively.