Opportunities for Improving the Long-term Management of Keratoconus Patients.

Background and Objective: This study determined whether practitioners specializing in keratoconus (KC) adhere to published guidelines for disease management and to what extent comorbid conditions of dry eye, contact lens tolerance, and psychological consequences of KC are formally assessed as part of long-term management. Materials and Methods: This cross-sectional study used an IRB-approved, Internet-based, REDCap platform. Descriptive statistics are presented. Results: A total of 222 participants qualified for participation. Most 134 (60%) followed young and unstable patients every 6 months and less frequent follow-up examinations for patients with stable findings, with 142 (64%) recommending annual examinations. Scleral lenses were the preferred optical correction method (36%), followed by corneal gas permeable lenses (21%). A total of 118 (55%, n=216) participants recommend crosslinking to any patient with documented disease progression regardless of age. Fewer than 25% of patients were referred for surgical correction of KC. Half of respondents, 114 (51%), reported testing for tear film dysfunction, while 108 (49%) never tested. No participants used a depression screening instrument. Conclusion: Practitioners managing patients with KC largely adhere to current consensus recommendations. This survey identified several potentially high-impact, low-cost improvements to current practice patterns, including screening for dry eye and depression.