ArticleBMC ophthalmology2023
Diagnosis and management of keratoconus by eye care practitioners in Kenya.
Article in BMC ophthalmology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Vernal Keratoconjunctivitis: A Systematic Review.Clinical reviews in allergy & immunology · 2023Pooled it
- The effect of eye health system strengthening on the productivity of services: a before-and-after evaluation conducted in seven counties in Kenya.Frontiers in health services · 2026Article
- Halo sign in keratoconus: a case report.BMC ophthalmology · 2025Article
- Capacity of health facilities to diagnose and manage keratoconus: a Kilimanjaro region case study.International ophthalmology · 2025Article
- Prevalence and demographic profile of keratoconus among high school students in Kenya.International ophthalmology · 2025Article
- Assessing Access to and Utilization of the Advanced Diagnostic and Management Equipment for Early Keratoconus in Public and Private Healthcare Facilities Across Nyanza and Western Kenya.Clinical optometry · 2025Article
- Retinoscopes: Past and present.World journal of methodology · 2024Article
- Barriers to the Diagnosis and Management of Keratoconus Among Optometrists in Kenya.Clinical optometry · 2024Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTo explore current eye care practice in keratoconus diagnosis and management in Kenya.
methodsAn online questionnaire was distributed to ophthalmic clinical officers (OCO) and optometrists.
resultsA total of 203 responses were received from 52 OCOs and 151 optometrists with a response rate of 24.4% and 53.5% respectively. The majority reported having access to retinoscopes (88.5%; p = 0.48) and slit lamps (76.7; p = 0.14). Few practitioners had access to a corneal topographer (13.5%; p = 0.08) and rigid contact lens (CL) fitting sets (OCOs 5.8%, optometrists 33.8%; p < 0.01). One-third did not feel that retinoscopy (38.7%; p = 0.21), slit lamp findings (30.3%; p = 0.10) and corneal topography (36.6%; p = 0.39) are important investigations in keratoconus diagnosis. Corneal topography was not recommended in two-thirds of patients (59.0%; p = 0.33) with vernal keratoconjunctivitis (VKC). The majority counselled against eye rubbing in mild (73.6%; p = 0.90) VKC, 52.9% in moderate (p = 0.40) and 43.6% in severe (p = 0.24) cases. The majority prescribed spectacles in mild (90.2%; p = 0.95), 29% (p = 0.97) in moderate and 1.9% (p = 0.05) in severe cases. When the binocular best corrected visual acuity (BCVA) with spectacles was ≤ 6/18, 76.9% of OCOs and 58.9% of optometrists referred for CLs (p = 0.02). When binocular BCVA with CLs dropped to ≤ 6/18, 83.7% (p = 0.18) referred to the ophthalmologist for surgical intervention. Few OCOs fitted rigid CLs (15.4% OCOs, 51.0% optometrists; p = 0.01), majority referred to optometrists (82.7% OCOs, 43.7% optometrists; p < 0.01). Progression was monitored in 70.1% (p = 0.11) of mild, 50.9% (p = 0.54) moderate and 25.3% (p = 0.31) advanced cases. Few OCOs (15.4%) performed corneal cross-linking (CXL). A few respondents (5.4%; p = 0.13) did not know when to refer keratoconus patients for CXL. Co-management with ophthalmologists was reported by 58.0% (p = 0.06) of respondents.
conclusionThe results of this study highlight the need to map services for keratoconus patients, review current curricula and continuous education priorities for mid-level ophthalmic workers, develop guidelines for the diagnosis and management of keratoconus and improve interdisciplinary collaboration.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.