La prise en charge du kératocone par l'optométriste

Abstract

Keratoconus refers to a corneal dystrophy appearing as a non-inflammatory protrusion of the cornea in its axial area; such protrusion occurs generally during adolescence and it progresses slowly. As a result, visual acuteness decreases in relation with important irregular astigmatism and frequent corneal opacities. The histological lesion is predominant on the Bowman’s membrane and on the corneal stoma; the exact pathogenesis remains unclear. Some types, weakly progressive, have been identified when corneotopographic investigation techniques were developed; they should be detected prior to any refractive surgery. First-line therapy consists of an optical treatment based on contactology, then surgery is considered. The aim of our study is to demonstrate the optometrist’s role in treating this disease based on the parameters extracted from the corneal topography (Kmax, Kmin, the minimum pachymetry, the appearance of various topographic maps it also allows the classification of the different stages of this disease. This is a clinical study of 20 patients with Keratoconus, ten patients fitted with rigid lenses and the others fitted with scleral lenses at the Ibn Al-Haythem center in Algiers. The consultation began with an interrogation of the patient, then the objective and subjective refraction, the visual acuity followed by a corneal topography in case of suspicion of KC. We observed a very good improvement in visual acuity and excellent comfort after wearing rigid lenses as well as for scleral lenses. The majority of cases almost positive. So treatment with these lenses is the most effective and best supported because of its advantages: tolerance, visual comfort and good safety conditions.