Clinical Perspective on Keratoconus Treatment: A Case Study

At Parkhurst NuVision, we always aim to be at the forefront of new technology. We love to provide refractive solutions to patients who were previously told they had no options. Come along with us on this 3-year journey as we help this young Hispanic male overcome his progressive keratoconus to obtain 20/20 unaided vision!

At his first appointment in May 2020, the patient presented with unaided vision of 20/60 in both eyes and signs indicating mild to moderate keratoconus, worse in the left eye. We recommended corneal crosslinking as a prophylactic measure against further degeneration.  

 

 

The patient returned in December 2020 to undergo the corneal crosslinking procedure in the left and right eyes, respectively.  After many subsequent visits, his keratoconus stabilized in June 2021 and we referred him back to his primary care optometrist for ongoing management with glasses and contact lenses. 

 

The patient returned to Parkhurst Nuvision in August 2023, happy with the outcome of his crosslinking procedure and looking for potential solutions to get away from glasses and contacts. Fortunately because the crosslinking procedure had halted his keratoconus in the mild to moderate stage, we had options!  Given the complexity of the patient’s mixed astigmatic prescription and higher order aberrations from his keratoconus, topography-guided Photorefractive Keratectomy (PRK) emerged as the preferred treatment choice.

 

He  underwent bilateral topography-guided PRK in November 2023 to meticulously reshape the corneal surface and correct his refractive error. Three months post-PRK, the patient attained unaided visual acuity of 20/15 in the right eye and 20/20 in the left, marking a substantial success in his quest for clarity. Besides his great unaided vision, the patient regained his independence as he now felt confident enough to drive at night without the significant glare and halos from his previously irregular corneas and high astigmatic correction.