Ep 4: Drops and Kones (Keratoconus)

Image: Chawan Rasheed O.D.

You’ll learn

• Review pathophysiology, risk factors, and treatment options of keratoconus

• Discussion on epithelial cell mapping, higher order aberrations, corneal biomechanical measurements in early detection of keratoconus

• Documentation examples of keratoconus findings

• Discuss patient resources/support groups

Click here to listen on Spotify

Resources (in order of discussion in podcast)

• Upneeq

  • Upneeq with RVL pharmacy's phone number

  • IVMED-80 eye drop by iVeena announcement

• Tepezza

• National Keratoconus Foundation website

• National Keratoconus Day Events

  • Webinars mentioned:

    • Nov. 10 for doctors

      • Virtual World KC Day lecture sponsored by OCULUS. Drs. Peter Hersh MD, John Gelles OD, and Steven Greenstein MD, of the Cornea and Laser Eye Institute in New Jersey present: “Modern Management of Keratoconus: From Diagnostics, Progression, to Treatment” offering a discussion of the most up-to-date treatment options for individuals with keratoconus.

        • To register, click here.

    • Nov. 17 for doctors

      • OCULUS education series will host Dr. William Trattler, MD of the Center for Excellence in Eye Care in Miami who will offer tips and insight into the care of seniors affected with multiple eye conditions in his talk, “Simple Solutions for Complex Cases: How to Manage Keratoconus Patients with Cataracts”.

        • To register for the webinar, click here.

    • Nov. 17 NKCF webinar with Tommy Pham

      • NKCF will be joined by San Diego Padre outfielder Tommy Pham and Dr. Edward Bennett, OD from the University of Missouri- St. Louis College of Optometry.

      • Dr. Bennett will be interviewing Tommy Pham about his personal experience with Keratoconus in honor of World KC Day.

        • To register for the webinar click Here.

    • Nov. 17 for Optometry Students

      • To celebrate World KC Day, the Southern California College of Optometry and NKCF have developed an educational series focused on students of optometry. Four virtual lectures, presented by the cornea and contact lens faculty at the Southern California College of Optometry, tie together the diagnosis, treatment options and lifetime management of patients with this condition.

• General and new information on Keratoconus from American Academy of Ophthalmology:

• Mnemonics discussed:

  • Diagnosis, it’s as easy as 1, 2, 3:

    • 1 line of reduction in BCVA

    • 2 lines on the cornea (Vogt Straie)

    • 3+ diopters of corneal astigmatism

  • EARLI diagnosis

    • Epithelial thickness mapping

    • Abberations (vertical coma)

    • Resistance Factor

    • L-evation of posterior surface

    • Inferior steepening

• Complied Patient Resources PDF with links

• Keratoconus documentation examples PDF

• Not discussed, but a helpful article with flowchart of whether to CXL or to fit with scleral lenses

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Sources:

• Bibliography (downloadable word doc with links)

  Epidemiology/risk factors

  • https://www.uptodate.com/contents/keratoconus#H7023424

  Biomechanical Index:

  • Discriminant value of custom ocular response analyzer waveform derivatives in keratoconus.

  • Tomographic and biomechanical Scheimpflug imaging for keratoconus characterization: a validation of current indices.

  • Detection of keratoconus with a new biomechanical index

  • Biomechanical characterization of subclinical keratoconus without topographic or tomographic abnormalities

  Crosslinking:

  • Global Consensus on Keratoconus and Ectatic Diseases

  • United States Multicenter Clinical Trial for Corneal Collagen Crosslinking for Keratoconus Treatment

  Epithelial Thickness Mapping:

  • ttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3514625/

  Specialty contact lenses after crosslinking

  • https://www.reviewofcontactlenses.com/article/contact-lens-use-after-corneal-crosslinking

  Wavefront technology

  • Applications of wavefront technology

  Stem cell research in ectatic diseases

  • Study shows stem cells constitute alternative approach for treating corneal scarring (Medical News announcement)

  • Sphere-forming corneal cells repopulate dystrophic keratoconic stroma: Implications for potential therapy

  Topography-guided PRK

  • Visual and keratometric outcomes of keratoconus patients after sequential corneal crosslinking and topography-guided surface ablation: Early United States experience.