Keratoconus Screening in Primary Eye Care – A General Overview

Keratoconus early detection (screening) and diagnosis requires an in-deep corneal analysis with different techniques; slip lamp assessment, corneal topography and corneal tomography are the most commonly accepted to detect clinical signs and assess anterior and posterior corneal surface and global corneal pachymetry. However, keratoconus early detection and definitive diagnosis are two different clinical procedures that require a different approach and goals. The aim of this review is to provide some general information about different corneal assessment technology, useful in keratoconus patient assessment; highlighting the differences in the adequate investigation techniques to its detection in primary eye care clinic and to conduct the definitive diagnosis (usually in a cornea specialist clinic). Information of most extensively available commercial devices and the advantages and disadvantages of their use in keratoconus early detection and diagnosis are described. In conclusion, corneal topography (Placido-based keratographers) plays a significant role in keratoconus detection, especially in primary eye care clinics. However, corneal tomography (with different slit scanning and/or rotational imaging devices) including posterior corneal surface assessment and global corneal pachymetry investigation, is critical in definitive keratoconus diagnosis.