Management Approaches for Keratoconus: Insights from a National Survey of Corneal Specialists in Saudi Arabia
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By
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Saud AlJohani
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Ahmed Y. Al Othman
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Abdulmajeed Al Khathami
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Abdulaziz Alshehri
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November 28, 2025
Clinical Scorecard: Management Approaches for Keratoconus: Insights from a National Survey of Corneal Specialists in Saudi Arabia
At a Glance
| Category | Detail |
|---|
| Condition | Keratoconus |
| Key Mechanisms | Progressive ectatic corneal disorder leading to thinning, protrusion, irregular astigmatism, and visual distortion. |
| Target Population | Individuals with keratoconus, primarily adolescents and young adults. |
| Care Setting | Ophthalmology clinics and tertiary care centers. |
Key Highlights
- Keratoconus is characterized by corneal thinning and irregular astigmatism.
- Corneal cross-linking (CXL) has transformed management by halting disease progression.
- Access to advanced diagnostic tools is variable across Saudi Arabia.
- A significant burden of keratoconus exists, particularly in southern regions.
- Deep anterior lamellar keratoplasty (DALK) is preferred over penetrating keratoplasty (PK).
Guideline-Based Recommendations
Diagnosis
- Utilize advanced diagnostic technologies such as Scheimpflug imaging and AS-OCT.
Management
- Consider corneal cross-linking for stabilization of keratoconus.
Monitoring & Follow-up
- Regular follow-up to assess disease progression and treatment efficacy.
Risks
- Potential for advanced disease leading to corneal transplantation.
Patient & Prescribing Data
Patients with varying stages of keratoconus, including early and moderate cases.
Newer contact lens designs and surgical options are available for advanced cases.
Clinical Best Practices
- Implement standardized diagnostic criteria for keratoconus.
- Promote co-management between optometrists and ophthalmologists.
- Encourage access to modern diagnostic and therapeutic tools.
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