Keratoconus: Diagnosis and Management by Family Physicians

Keratoconus is a chronic progressive disease that affects the cornea. Given the nonspecificity of the initial symptoms, it is often confused with common refractive errors (myopia and irregular astigmatism). This is a case of a 29-year-old male patient with a progressive decrease in visual acuity in his right eye, associated with ocular pruritus and frequent eye rubbing. Clinical examination revealed signs suggestive of keratoconus, leading to a timely referral to ophthalmology. Even so, the patient had to undergo a corneal transplant. Despite rapid recognition and referral by a family physician (FP), the impact on quality of life was significant, requiring time off work and support for daily activities. The case illustrates the importance of thorough physical examination and clinical suspicion in Primary Health Care for early diagnosis. It highlights the role of FPs in preventing the progression of the disease and collaborative management with ophthalmology to improve the prognosis and quality of life of patients.