What are the current guidelines for the management of keratoconus in primary care, including non-surgical options?

Management of keratoconus in primary care primarily involves early recognition and referral to specialist ophthalmology services, as keratoconus is a progressive corneal ectatic disorder requiring specialist assessment for diagnosis and treatment planning.

In primary care, non-surgical management options are limited but include:

• Patient education about the condition, its progression, and the importance of regular specialist follow-up.
• Referral to optometry services for fitting of rigid gas-permeable contact lenses or other specialty lenses that can help improve vision by correcting irregular astigmatism.
• Monitoring for complications such as corneal scarring or acute hydrops, which require urgent specialist intervention.

Primary care providers should not attempt to manage keratoconus with pharmacological treatments or surgical interventions, as these are outside the scope of primary care and require specialist ophthalmology input.

Overall, the role of primary care is to identify suspected keratoconus, provide supportive care, and ensure timely referral to ophthalmology for comprehensive assessment and management, including consideration of non-surgical options like contact lenses and surgical options such as corneal cross-linking or transplantation if indicated.

Note: The provided UK NICE guideline excerpts focus on glaucoma and do not specifically address keratoconus management. However, standard UK clinical practice and ophthalmology guidelines emphasize the above approach for keratoconus in primary care.