preview

There are many clinical signs that can be used to diagnose early keratoconus. The patient presents

Decent Essays

There are many clinical signs that can be used to diagnose early keratoconus. The patient presents with a primary complaint of a gradual reduction in vision over the past few years. As a starting point, it may be beneficial to phone Miss Stuarts previous optometrist to get a copy of her most up to date prescription along with her best corrected visual acuities. If the optometrist is willing to give the prescription over the phone, it would be a good indicator as to how much Miss Stuart’s prescription has changed within the past three to four years. If this is not feasible, a good starting point would be retinoscopy. An early sign of keratoconus can be seen on retinoscopy by the presence of a slight scissor reflex. Patients with normal …show more content…

The map then shows a further steeping of the cornea from the apex by the progressive change in colour from hot to cold colours.
Contact lenses can definitely be of benefit to Miss Stuart. The Contact Lens Manual states that the preferred method of correcting keratoconus is the use of rigid gas permeable lenses (RGP). The RGP lens “provides a new refracting surface for an irregular cornea” which gives the patient better vision compared to correction with spectacles. However, Miss Stuart has never worn contact lenses before. If she was fitted with RGP lenses, she may find them initially very uncomfortable and have difficulty adapting to them. Another option of contact lens correction is soft contact lenses. The benefit of these would be the great initial comfort and the ease of adaptation. The material usually chosen is silicone hydrogel because it is a high modulus material that can mask the irregular cornea. The centre thickness of the lens must be increased to a minimum of 0.35mm in order to increase the ability of the lens to mask the astigmatism. Soft contact lenses may be chosen as an initial treatment to allow Miss Stuart to get used to wearing contact lenses.
Keratoconus is a progressive disease and the cornea will continue to thin and distort over time, therefore, it is important that Miss Stuart attends regular aftercares so that the progression can be monitored. Eventually, soft contact lenses will no longer be adequate and Miss Stuart may

Get Access