Clinical Scorecard: Contact Lenses: Comanaging Corneal Crosslinking
At a Glance
| Category | Detail |
|---|---|
| Condition | Keratoconus (KCN) |
| Key Mechanisms | Epi-off corneal crosslinking (CXL) halts KCN progression. |
| Target Population | Patients with keratoconus and progressive corneal ectasia. |
| Care Setting | Optometry practices with referral to corneal specialists. |
Key Highlights
- Early detection of KCN is critical for CXL success.
- Optometrists should use corneal topography and keratometry for timely referrals.
- Patient education enhances compliance with referrals.
- Establish relationships with multiple corneal specialists for optimal care.
- Regular follow-up is essential post-CXL for monitoring and CL fitting.
Guideline-Based Recommendations
Diagnosis
- Refer when asymmetric corneal topography, steep K readings, Vogt’s striae, or loss of best-corrected vision is noted.
Management
- Educate patients about KCN, CXL, and expected outcomes.
- Monitor postoperative medication use and initiate CL fitting as needed.
Monitoring & Follow-up
- Follow patients every 3 months for the first 6 months, then semi-annually.
Risks
- Potential for reduced best-corrected vision and need for corneal transplant, though unlikely.
Patient & Prescribing Data
Patients undergoing corneal crosslinking for keratoconus.
Timely referrals and comprehensive education improve patient outcomes.
Clinical Best Practices
- Use corneal topography for accurate diagnosis.
- Establish a comanagement relationship with corneal specialists.
- Communicate any unexpected events to the surgeon.
References
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