Keratoconus Co-Management

How the roles divide

Your optometrist may be the first to suspect keratoconus from a changing prescription or topography, and refers for confirmation. Our cornea specialist confirms the diagnosis with tomography, stages the disease, decides whether it is progressing, performs cross-linking if it is, and manages any corneal complication. Lens fitting can be with your optometrist if they fit specialty lenses, or with our specialty contact lens service, and routine monitoring can be shared, with tomography at the intervals the specialist sets and vision and lens checks with your optometrist in between.

What is shared

• Tomography scans and their comparison over time, so both practices see the trend
• The cross-linking record and the post-treatment stability scans
• Lens parameters and the state of the fit, so a refit follows a corneal change
• Any findings of concern: progression, scarring, hydrops, or lens-related corneal problems

When to refer back

Any increase in the steepest curvature or decrease in thickness on tomography, a drop in best lens-corrected vision, new scarring, sudden pain and blur suggesting hydrops, or a lens that can no longer be fitted comfortably. Young patients (under 25) are referred for tomography every three to six months because they progress fastest.

For optometrists

We welcome referrals for confirmation and cross-linking and return patients to you for lens care with a full report and the scans. If you do not fit specialty lenses, our service can fit them and you continue routine care. We are glad to discuss any patient before referral.