[How to live with keratoconus].
BACKGROUND
The article is based on an undergraduate thesis that was written within the framework of investigating problems of rehabilitation in the humanities department of Berlin's Humboldt University. It deals with the issue of whether and, if so, in what spheres of life, people suffering from keratoconus may have to expect changes in lifestyle and what possibilities exist for compensation. The paper is based on the "construct of compensating impairment of sight" according to Nater, a fundamentally resource-oriented approach. Impaired vision has restrictive effects on the quality of life, which can, however, be minimised by appropriate measures of compensation so that, at best, normality can be achieved or felt.


METHODS
In a Germany-wide written survey by questionnaire. The changes in lifestyle arising from the disease were registered and evaluated (n = 192).


RESULTS
Ophthalmologists, optometrists and opticians attending to keratoconus patients generally emphasise the medical or optical care, respectively. The results arrived at in this study extend the medically or optically oriented view and give insights into other spheres of life of those affected, their problems and their strategies of compensation. People suffering from keratoconus occupy an intermediate position between severe dysopia and normality. The most important means of compensation for people with KC is at present the rigid gas permeable contact lens. With its help, most KC patients enjoy normal eyesight, which has a favourable effect on all the results. If keratoconus develops vehemently, restrictions in the quality of life are more severe than in the case of a slow development of the disease. Contrary to the hypothesis proposed in the paper, the existence of a tight social network does not have much of an alleviating effect on the restrictions felt. A sympathetic communication of the diagnosis, however, will have a favourable effect on the patient in accepting the condition and integrating KC into his or her life.


CONCLUSIONS
In order to improve the situation of people suffering from KC, the best possible medical/optical care, the interdisciplinarity of all professions involved, and an early, sympathetic and medically well established communication of the diagnosis are essential as well as publicising the disease.
Wahrendorf
I
I
HU-Berlin, KL-Institut, Petersburger Strasse 66, 10249 Berlin. i.wahrendorf@gmail.com
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D017507:Comoros; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007640:Keratoconus / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D008019:Life Style; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*