Current optometric practices and attitudes in keratoconus patient management

•Optometrists play a paramount role in the diagnosis and management of keratoconus.•There is no previous reports regarding the attitudes of optometrists in Europa.•Optometrists show similar attitudes about keratoconus management in the UK and Spain.•Keratoconus patient co-management may optimize the treatment and improve visual care.

PurposeTo compare the current optometric practices and attitudes in the management of keratoconus patients in the UK and Spain.MethodsAn online survey (adapted to optometric practices) was distributed via a newsletter emailed by various professional organizations in the UK and Spain.ResultsFour hundred and sixty-four practitioners (126 in the UK; 338 in Spain) who prescribed gas permeable GP contact lenses (CLs) more than once per month (54.8% of UK practitioners and 28.1% of practitioners in Spain; p < 0.01) responded to the questionnaire. A combination of multiple factors is considered necessary in the keratoconus detection (79.4% in the UK, 75% in Spain; p = 0.68), and the use of classification criteria is considered relevant (67.5% in the UK, 70.7% in Spain; p = 0.49). There is a high consensus on the consideration that GP CL fitting is more difficult in keratoconus (79.4% in the UK, 80.5% in Spain; p = 0.79) requiring more diagnostic lenses (3.2 ± 1.4 and 3.4 ± 1.2 in the UK and Spain, respectively; p = 0.72) than are necessary for healthy eyes. Using corneal topography is uncommon from both countries (38.1% in the UK, 59.8% in Spain; p < 0.01), with a similar ophthalmologist referral pattern (at initial diagnosis, 50% in both the UK and Spain; p = 1.00). Few cases of co-management with ophthalmologists were noted (no co-management reported by 60.3% in the UK and 72.8% in Spain, p = 0.01).ConclusionThis study provides initial observations and evidence regarding keratoconus management by optometrists in the UK and Spain and shows similarity in the professional practices and attitudes of practitioners in these two countries.