Original Research

Keratoconus management at public sector facilities in KwaZulu-Natal, South Africa: Practitioner perspectives

Nonkululeko Gcabashe, Vanessa R. Moodley, Rekha Hansraj
African Vision and Eye Health | Vol 81, No 1 | a698 | DOI: https://doi.org/10.4102/aveh.v81i1.698 | © 2022 Nonkululeko Gcabashe | This work is licensed under CC Attribution 4.0
Submitted: 12 August 2021 | Published: 30 March 2022

About the author(s)

Nonkululeko Gcabashe, Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Durban, South Africa
Vanessa R. Moodley, Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Durban, South Africa
Rekha Hansraj, Discipline of Optometry, School of Health Science, University of KwaZulu-Natal, Durban, South Africa


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Abstract

Background: Keratoconus (KC) is a non-inflammatory, self-limiting corneal ectasia that causes reduced visual acuity and if left undiagnosed and/or untreated may lead to visual impairment. Optometrists remain the first point of contact for affected patients, making appropriate timeous care essential.

Aim: To investigate keratoconus management in the public sector in KwaZulu-Natal, South Africa.

Setting: Public sector eye care facilities in KwaZulu-Natal, South Africa.

Methods: In a quantitative, cross-sectional study, a questionnaire was distributed to optometrists employed by the Department of Health in KwaZulu-Natal (DoH-KZN). Data on practitioner demographic profile and clinical competence, facility attendance statistics, resources available and KC clinical protocols were collected.

Results: The response rate was 36 (71%). The optometrists’ mean age was 30.19 ± 4.53 years, and 80% of them had work experience of less than 10 years. The majority of the health facilities (63.9%) reported a monthly attendance of 51–300 patients, and, of these, 72% of the respondents reported seeing only between 1 and 10 keratoconic patients. A lack of equipment and/or fitting of contact lenses being disallowed by the DoH-KZN were cited by the majority (61%) as the reason for routinely referring KC patients to optometrists in private practice.

Conclusion: This study highlights a deficiency in the minimum standard of optometric care for KC in the public sector in KZN, primarily because of a lack of equipment and resources. It is recommended that the management of KC at all levels of the public health system be reviewed to improve the quality of service for keratoconic patients.


Keywords

keratoconus; keratoconus services; practitioner perspectives; vernal keratoconjunctivitis; public sector, health facilities

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