Background: Finnish current care Guidelines do not have any recommendations regarding the diagnosis, treatment, assessment, or management of keratoconus. One international practice pattern exists, nevertheless, it is not designed only for the use of optometrists but also for ophthalmologists. Because the education of optometrists and the professional description and legal rights of optometrist practise in different parts of the world varies the international guideline cannot be straight adapted to the optometrist practise in Finland and a need for a national is justified.

Purpose: The purpose of this study by the Integrative review was to determine and combine appropriate information concerning keratoconus assessment and management, aiming to produce knowledge to be used in the development phase of the study. The purpose of the Research development was to create a clinical guideline concerning keratoconus assessment and management to the use of optometrists in Finland, aiming to select the relevant methods for optometrist practise in Finland. The guidelines should support the utilization of Finnish optometrists as a part of efficient eye health care.

Methods: The primary literature search for the Integrative literature review was conducted by EBSCOhost web source using Academic Search Premier, CINAHL and MEDLINE databases. The search was limited to texts published in English and only texts published between 2013-2023 were accepted. The search resulted in 441 records to undergo further exclusion. PRISMA 2020 Flow Diagram was used to demonstrate the final eighteen articles and one guideline selected and analysed. The results of the literature review were used in the Research Development phase.

Results: The result of this study provides means for Finnish optometrists to identify the clinical signs of keratoconus and tools to assess the severity of the disease. It points out the significance of referral and co-management with ophthalmologists and helps decide the proper management methods provided by optometrists. The personal competence of the practitioner is highlighted. This study provides a baseline proposal for further development of a national guideline.

Conclusions: The competence of optometrists as clinical healthcare professionals is confirmed by this Research Development. Optometrists existing knowledge and capabilities can be utilized more frequently, including in KC assessment and management, providing relief in otherwise overcrowded Eye health care in Finland.