Difficulties In Diagnosing Keratoconus Patients: A Survey Study

To identify difficulties encountered in diagnosing keratoconus using ophthalmological findings and a questionnaire applied to the patients.

This study was conducted in the cornea and ocular surface department of a tertiary hospital. 

The medical records of 100 keratoconus patients were retrospectively reviewed. Age, best-corrected visual acuity (BCVA), keratoconus probability index (KPI) measured by cornea topography at diagnosis were recorded. Patients were surveyed to determine their age at diagnosis, duration of keratoconus, number of examinations prior to diagnosis, order of examination at which diagnosis was made and corneal topography was performed, number of spectacle changes prior to diagnosis, hospital type where diagnosis was made.

The mean age at diagnosis was 22.04±8.24  years.The disease duration, number of examinations prior to diagnosis, order of examination at which diagnosis was made and corneal topography was performed, number of spectacle changes prior to diagnosis were 5.46 years, 3.39±3.15, 4.28±3.18, 4.25±3.15, and 1.35±1.73, respectively. Of patients, 19% were diagnosed at the first visit. Keratoconus was diagnosed in 54%, 24%, and 22% of patients in tertiary, government hospitals, and special eye clinics, respectively. There were no correlations between BCVAs, KPIs of patients and number of examinations, order of examination at which diagnosis was made and corneal topography was performed.

The diagnosis of keratoconus could not be made in the first examination in 81% of the patients. Many of them were prescribed spectacles more than once prior to keratoconus diagnosis. It was observed that these delayed diagnoses were not related to the severity of the disease.