Knowledge of Early Keratoconus Diagnosis and Management in Nyanza and Western Kenya: Practitioners’ Perspective

Keratoconus is a bilateral, progressive corneal ectasia characterized by thinning and conical protrusion of the cornea. Its global prevalence is increasing, with higher rates reported in Africa, including Kenya. In Kenyan studies, most patients are diagnosed at advanced stages, where management is often costly, and complications are severe. Early detection enables more effective and affordable interventions with reduced risks. However, accurate early diagnosis requires advanced equipment and clinical expertise. In many low-resource settings, these factors are lacking, resulting in delayed diagnosis and poor outcomes. Strengthening early diagnostic capacity is essential to reduce the burden of advanced keratoconus and prevent avoidable visual impairment. The objective of this study was to assess the level of knowledge among eye care practitioners in the diagnosis and management of early-stage keratoconus in Nyanza and Western Kenya.

A cross-sectional study was conducted across hospitals in Nyanza and Western Kenya. A census sampling technique was employed to include all eligible eye care practitioners. Data were collected using a structured questionnaire and analysed using both descriptive and inferential statistical methods to evaluate knowledge levels and associated factors.

A total of one hundred and thirty-four practitioners completed the questionnaire. Regarding early keratoconus diagnosis, 36.6% demonstrated good knowledge, 60.4% had fair knowledge, and 3.0% exhibited poor knowledge. For early keratoconus management, 36.6% had good knowledge, 61.2% had fair knowledge, and 2.2% reported poor knowledge. A statistically significant association was observed between practitioners’ qualifications and knowledge in early keratoconus management (p=0.006).

A substantial number of practitioners demonstrated limited knowledge of early keratoconus, possibly due to the low rates of keratoconus services, which may ultimately limit their experience.

Most practitioners demonstrated only fair knowledge in the diagnosis and management of early keratoconus. Practitioners’ qualifications were significantly associated with knowledge in early keratoconus management.