Keratoconus Management in Primary Eye Care: Why Early Detection and Referral Are Now the Standard of Care

By Katie Gilbert Spear, OD, MPH

Keratoconus management has undergone a fundamental shift over the last decade—one that carries significant clinical and legal implications for optometrists practicing in primary care settings.

For many years, our role was largely reactive. We corrected vision with glasses or contact lenses and monitored patients as the disease progressed. Today, that approach is no longer sufficient. With the FDA approval of corneal cross-linking (CXL) in 2016 and subsequent updates to professional guidelines, the standard of care has changed—and with it, our responsibilities as optometrists.

This article outlines why early identification of keratoconus is now essential, how corneal cross-linking has reshaped management, and what optometrists must understand from both a patient-care and legal-risk perspective.