Evolving Clinical Care for the Individual with Keratoconus - A Researcher’s Perspective
Jason D. Marsack PhD, FAAO, FSLS, Assistant Professor, College of Optometry, University of Houston
ABSTRACT: When considering the development of novel correction strategies for individuals with highly aberrated eyes (e.g. keratoconus), two questions to consider are: 1) what goal is the individual trying to achieve with the optical correction and 2) what attributes in an optical correction will best allow the individual to achieve these goals? The underlying premise that ties these two questions together is that
patient needs vary, and are not simply based on optical or visual performance. Cost, comfort, wear time,
complexity of the care regimen and aesthetics are all factors that, along with visual and optical performance, play a role in the patient’s satisfaction with the correction. This presentation describes several research projects related to the development of novel correction strategies for highly aberrated eyes, and considers how each type of correction might meet the varied needs of an individual. In this presentation, keratoconus is used as a model of the ‘highly aberrated eye’, but individuals experiencing pellucid marginal degeneration, poor refractive surgery outcomes or cornea trauma also fit in this category. This presentation will 1) describe how the level of optical aberration present in an eye is measured and reported; 2) consider the optical consequence of high levels of ocular aberration from the patient’s point of view; 3) describe the correction strategies currently employed in the clinic when correcting the highly aberrated eye; 4) expose the audience to novel correction strategies under development for the highly aberrated eye, such as
wavefront guided scleral contact lenses, template-based contact lens corrections and objectively derived
spectacle corrections and 5) discuss the advantages/limitations of currently available corrections and these novel forms of correction.
BIOGRAPHY: Dr. Marsack completed a PhD in Physiological Optics and Vision Science at The University of Houston, College of Optometry, where he is currently a member of the faculty. His research interests include optical aberration of the eye, custom and pseudo-custom correction of optical aberration, measurement of visual performance, optically-based metrics predictive of visual performance, custom scleral contact lenses and objectively optimized spectacle lenses. He and his collaborators are currently focused on developing novel approaches for improving visual performance for individuals suffering corneal conditions that result in reduced vision (e.g. keratoconus, pellucid marginal degeneration, poor refractive surgery outcomes and ocular trauma). Several of these approaches will be presented during this seminar.
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