Referral patterns, treatment management and visual outcome in keratoconus
| Autor: | Kathryn H. Weed, Charles N J McGhee |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male medicine.medical_specialty Keratoconus Time Factors Visual acuity Adolescent genetic structures Referral Contact Lenses Visual analogue scale Eye disease Visual Acuity Corneal graft Ophthalmology Hypersensitivity medicine Humans Child Referral and Consultation business.industry Middle Aged medicine.disease eye diseases Treatment management Contact lens Treatment Outcome Disease Progression Optometry Female Stress Mechanical medicine.symptom business Keratoplasty Penetrating |
| Zdroj: | Eye. 12:663-668 |
| ISSN: | 1476-5454 0950-222X |
| Popis: | PURPOSE/METHOD To determine the patterns of referral, the hospital-based management and the subjective degree of visual success achieved by keratoconics attending the Corneal Service at Sunderland Eye Infirmary, England, a specifically designed anonymous questionnaire was mailed to 160 keratoconus subjects. RESULTS The following responses were obtained from 97 (61%) respondents: mean age of first referral (22.88 +/- 8.36 years); gender (male:female ratio 3:1); source of initial referral (optometrists 90%); visual symptoms experienced before referral (46% complained of blurred/distorted vision); and the type of visual correction before referral (70% wore a refractive correction: 72% spectacles, 28% contact lenses). Initial post-referral treatment included bilateral contact lens fitting (65%), monocular contact lens correction (26%), penetrating keratoplasty (8%) and no intervention (1%). Two-thirds of subjects were presently wearing contact lenses (67%), with the mean period of successful lens wear being 8.26 +/- 7.92 years, and 31% had undergone penetrating keratoplasty (PK) since initial referral. A subjective evaluation of visual acuity with contact lenses was made by respondents using a visual analogue scale. The mean value was 86.86 +/- 15.25 (range 50-100 mm), with 50 mm representing moderate visual acuity. Of those who underwent PK the mean subjective evaluation of the change in post-operative vision compared with pre-operatively was 82.41 +/- 26.57 (range 1-100 mm), with 50 mm representing no visual change. The majority of subjects therefore noted a moderate to marked visual improvement following PK. CONCLUSION In this fairly young group of patients, predominantly male, the majority wore a refractive correction for approximately 10 years before referral to the Hospital Eye Service (HES). Most referrals were initiated by optometrists. On initial HES assessment the treatment for two-thirds was bilateral contact lens fitting; only a quarter were fitted monocularly. However, by the time of this study only a tenth retained monocular contact lens correction, with the mean length of time from diagnosis to bilateral contact lens wearing being approximately 5 1/2 years. The progressive nature of this disease is further evidenced by the large number of contact lens sets required by patients (approximately 5) and by the number of patients (n = 22) requiring PK, the mean length of time from diagnosis to corneal graft being approximately 8 1/2 years. |
| Databáze: | OpenAIRE |
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