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Published on: October 21, 2022
Fluorescein pattern interpretation in keratoconus.
Barbara Fink1, Cynthia Heard, Jeff Schafer
1The Ohio State University College of Optometry, 320 West Tenth Avenue, Columbus, OH 43210-1240, USA. fink.4@osu.edu
Summary
Clinician accuracy in interpreting contact lens fluorescein patterns for keratoconus does not depend on disease severity. Many factors influence interpretation, not just the stage of keratoconus.
Area of Science:
- Ophthalmology
- Optometry
- Corneal Disease
Background:
- Contact lens fitting is crucial for managing keratoconus.
- Fluorescein pattern assessment is a common method for evaluating contact lens fit.
- The influence of keratoconus severity on the accuracy of this assessment is not well understood.
Purpose of the Study:
- To evaluate if keratoconus disease severity affects the accuracy of clinician interpretation of contact lens fluorescein patterns.
- To determine the relationship between keratoconus severity and the precision of ranking contact lens base curves using fluorescein patterns.
Main Methods:
- Two clinicians assessed fluorescein patterns on 111 eyes across mild, moderate, and severe keratoconus groups.
- Clinicians ranked six contact lenses based on fluorescein patterns, from flattest to steepest.
- Accuracy was measured by percentage of correctly ranked lenses and sum of squared differences from actual base curve values.
Main Results:
- No statistically significant relationship was found between keratoconus severity and the percentage of correctly ranked contact lenses (p > 0.15).
- Accuracy of contact lens base curve ranking, as assessed by the sum of squared differences, was not related to keratoconus severity (p > 0.15).
Conclusions:
- Keratoconus disease severity does not appear to impact the accuracy of contact lens fluorescein pattern interpretation by clinicians.
- Accurate interpretation relies on a complex interplay of factors including the fluorescein, tears, cornea, contact lens, external forces, and the clinician's technique.
