The global discussion on keratoconus is evolving rapidly, as highlighted in The Ophthalmologist’s recent expert panel, “Keratoconus Conversations.” This virtual event brought together top specialists, including ELZA’s Medical Director, Prof. Farhad Hafezi, MD, PhD, FARVO, to discuss the latest prevalence data, diagnostic strategies, and treatment innovations.
A New Perspective on Prevalence
Traditionally viewed as a rare condition, keratoconus has been redefined by advanced diagnostic tools. Prof. Hafezi shared findings from a Saudi Arabian study showing a pediatric prevalence of 4.7%, which is a stark contrast to the older estimate of 1 in 2,000. Such data underscores the urgent need for early detection and global screening programs.
Innovations in Diagnosis and Management
Panelists discussed advancements in imaging, particularly the role of corneal tomography and biomechanics, to differentiate subclinical keratoconus from ectasia risk. Genetic testing and biomarkers were also highlighted as potential future tools to predict disease progression. Prof. Hafezi emphasized the importance of patient education, including strategies like discouraging eye rubbing, which exacerbates the condition.
Cross-Linking: Current and Future Directions
Corneal cross-linking (CXL) remains the cornerstone for halting keratoconus progression. The panel discussed next-generation protocols, including epithelium-on (epi-on) cross-linking, which offers a less invasive alternative while maintaining efficacy. Prof. Hafezi outlined how combining advanced delivery methods and precise UV-light protocols is revolutionizing epi-on techniques, making them globally accessible and potentially enabling office-based treatments.
Addressing Inequities
A recurring theme was accessibility. Prof. Hafezi’s dream was of slip-lamp-based CXL, which could bring effective keratoconus treatment to underserved populations, especially in low-to-middle-income countries. This approach aims to remove cost and infrastructure barriers, ensuring equitable care worldwide.
The panel concluded with a call for enhanced public awareness and standardized diagnostic frameworks to prevent unnecessary vision loss. As keratoconus research progresses, such collaborative conversations pave the way for a better understanding and management of this complex condition.
Read the full discussion here.