Keratoconic patient profile and management at public sector facilities in South Africa

Abstract

Background: Keratoconus (KC) is a condition marked by thinning and protrusion of the cornea resulting in high myopia and irregular astigmatism. Knowledge of KC patients’ profiles and management approaches used can help to predict the needs of public hospitals to improve patient care.Aim: This study aimed to describe the profiles and management of KC patients.Setting: Capricorn district, Limpopo Province, South Africa.Methods: Medical records of 188 KC patients attending public hospitals of Capricorn District from January 2017 to December 2020 were reviewed. Data on patient profile and their management were collected and analysed.Results: The mean age of KC patients was 20.64 ± 6.82 years and the majority (56.9%) were males. Clinical findings were mean unaided visual acuity (UVA) of 0.19 ± 0.18, best corrected VA of 0.53 ± 0.24, spherical equivalence of -4.89 ± 9.17 dioptre (D), mean K of 57.37 ± 17 D and corneal astigmatism of -6.24 ± 4.27 D. A total of 54.5% of patients had severe KC. Bilateral KC was found in almost all patients (97.3%) and a mean K difference of 7.59 ± 6.08 D (p 0.001) between the better and the worse eye. The study found no significant difference in KC severity by age (p = 0.451) and gender (p = 0.819). Patients fitted with scleral lenses had the highest VA improvement of 0.44 ± 0.17.Conclusion: Most patients presented with bilateral and severe KC. Scleral lenses provided higher VA improvement than other methods.Contribution: The study aimed to present the clinical profile and management of keratoconic patients attending public sector facilities. Knowledge of the patterns of KC presentation may assist in the development of intervention strategies and guidelines for best practice in the management of KC, especially in public sector facilities.