Optometrist Attitudes towards Keratoconus Patients in the West Bank: A survey-based study. رسالة ماجستير

Abstract

Keratoconus is a progressive corneal ectatic disease which reduces the patient’s vision and quality of life. Keratoconus (KC) requires multi-disciplinary approach to diagnose and manage. Optometrists’ expertise in detecting and managing KC is crucial for improving patient’s outcome. The research aimed to explore the optometrists’ attitudes towards patients with keratoconus, in terms of diagnosis, management and referral approaches in the West-Bank. Furthermore, the current study sought to examine the influence of work settings, access to tools such as corneal topography, and years of experience on their practices. A survey-based, descriptive study was conducted. A validated self-administrated online questionnaire has been used to collect data from Palestinian optometrists about their diagnosis and management methods of keratoconus patients. A total of 160 Palestinian optometrists completed the survey, with 46.9% having 1-5 years of experience in optometry. Approximately 75.6% of optometrists detected 1-10 patients with KC per month. Approximately 33.8% of optometrists considered multiple factors for keratoconus diagnosis. About 38.1% of the optometrists had access to corneal topography. About 70.6% of the participants prescribed glasses for KC at mild stages, and 47.8% prescribed or referred for RGP lenses for moderate cases with keratoconus. About 47.2% of the participants fit or referred for specialized contact lenses for severe cases. Only 25% of the participants reported monitoring progression of keratoconus at all stages. The referral criteria varied among the participants, with signs of progression (71.3%) being the most common reported factor. Chi-square test showed no statistically significance association between the years of experience and RGP lens fitting χ² (3, N = 160) = 2.309, p = 0.511, and corneal topography performing and RGP lens fitting χ² (1, N = 160) = 0.880, p = 0.348. The most common reported barriers for keratoconus diagnosis and management were the cost of RGP lenses (74.4%), lack of patient educational material (67.5%), and the absence of national guidelines (55%). Findings showed variations regarding the diagnosis, management and referral approaches of keratoconus among Palestinian optometrists. This study highlights the need for standardized referral guidelines, enhanced interdisciplinary collaboration, and continuous education to improve the diagnosis and management of patients with keratoconus