ANZEF Grant Round 2024 Recipient

Slowing the Cone: Arresting keratoconus on the Coast

Led by A/Prof Graham Wilson, Rachel Cook, Dr Jason Rodier and Dr Sheng Hong, Gisborne Hospital – AUD$36,100

Project location: Gisborne, Tairawhiti or East Coast, Aotearoa New Zealand

Keratoconus is a progressive corneal ectasia which causes irregular astigmatism in teenagers. This results in the need for glasses, contact lenses or corneal graft surgery, but sometimes visual impairment is significant. Keratoconus is a complex eye disease where late diagnosis, poor surveillance and delayed treatment can result in preventable vision loss, disproportionally impacting the young patient’s quality of life, employment options and adversely affecting public health resources.

In New Zealand, Māori have a prevalence of keratoconus 4-times higher than the general population. The East Coast of the North Island of New Zealand (known as Tairawhiti) is a remote and predominantly rural region with Māori making up 52% of the population (the highest of any region in NZ). In addition, the East Coast was severely impacted by Cyclone Gabrielle in 2023 which closed roads and made access to eye care extremely challenging.

This project will create a targeted screen for keratoconus in Tairawhiti school children using a pentacam mobile topographer delivered by a trained nurse at the schools. Detected keratoconus subjects will be offered immediate corneal collagen cross-linking in Gisborne to minimise the visual impact.

Early detection of keratoconus reduces the costs involved with treatment and lessens the burden of disease from keratoconus. It can also promote better educational achievement as well as greater ability to meet driving and employability standards. As such, this program will contribute to greater equity and opportunities for Māori individuals in addition to helping improve the eye health and wellbeing of these groups.