Management of Keratoconus in Down Syndrome and Other Intellectual Disability

Stephenson, Kirk; Power, Barry; Malata, Diana; Quill, Barry; Murphy, Conor C; Power, William

doi:10.1097/ico.0000000000002793

Cited by 6 publications

(6 citation statements)

References 31 publications

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“…However, no common pathophysiological pathways have been proven for these disorders, in contrast to the links between keratoconus and psychosis described above. Researchers point to the stereotypical behaviour of children with these conditions, among which the very frequent rubbing of the eyes can be found [22,23]. A slightly different light is shed on the problem in question by an Arab study comparing corneal parameters among children diagnosed with autism spectrum disorder to an age-adjusted group of normally developing patients.…”

Section: Keratoconus and Other Psychiatric Disordersmentioning

confidence: 99%

“…Jak dotąd nie dowiedziono jednak -w przeciwieństwie do opisanych powyżej powiązań stożka rogówki i psychozy -żadnych wspólnych szlaków patofizjologicznych dla omawianych zaburzeń. Naukowcy wskazują na stereotypowe zachowania dzieci z tymi dolegliwościami, wśród których można odnaleźć bardzo częste pocieranie oczu [22,23]. Nieco inne światło na omawiany problem rzuca arabskie badanie porównujące parametry rogówki wśród dzieci ze zdiagnozowanym spektrum autyzmu w stosunku do dostosowanej wiekowo grupy prawidłowo rozwijających się pacjentów.…”

Section: Stożek Rogówki a Pozostałe Zaburzenia Psychiczneunclassified

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Mental disorders in people with keratoconus

Florek

Pudło

Gościniewicz

et al. 2023

Curr Probl Psychiatry

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Introduction: There are many reports on the association of various psychiatric disorders with visual impairment. The association of dry eye syndrome with depressive disorders has been particularly well documented. In the context of keratoconus patients group, data on similar relationships are inconclusive. Attempts have also been made to assess the personality of patients suffering from keratoconus, and the first study in this area was produced as early as 1976. Material and methods: For the literature review, full-text medical databases, such as PubMed and Embase, were searched for articles on the association of keratoconus with depressive-anxiety disorder and personality disorder. Articles published within the last 30 years were considered. Results: The personality of patients with keratoconus has been a research issue for many years, but research to date has not clearly defined what personality traits characterise this particular group of patients. Research into the relationship between keratoconus and depressive-anxiety disorders has only recently been conducted, and the results - although inconclusive - suggest a co-occurrence of depressive symptoms with keratoconus. A different and interesting field for further research is the association of keratoconus with schizophrenia, as these diseases may have a common background. Conclusions: A review of the literature does not identify a 'keratoconus personality', but there are reports of specific functioning in patients with keratoconus. There are isolated reports in the literature regarding the co-occurrence of keratoconus and depressive-anxiety disorder. Keywords: depression, personality, anxiety, psychiatric disorders, keratoconus

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Section: Keratoconus and Other Psychiatric Disordersmentioning

confidence: 99%

Section: Stożek Rogówki a Pozostałe Zaburzenia Psychiczneunclassified

Mental disorders in people with keratoconus

Florek

Pudło

Gościniewicz

et al. 2023

Curr Probl Psychiatry

View full text Add to dashboard Cite

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Section: Management Of Keratoconus In Down Syndromementioning

confidence: 99%

“…In a group of 16 patients, they found that 18 of 32 eyes (56.3%) had an advanced disease which could not be treated, 11 of 32 (34.4%) eyes underwent CXL, and 1 of 32 eyes (3.1%) underwent penetrating keratoplasty. 88 Soeters et al 89 previously studied the efficacy of CXL in nine eyes from seven patients with Down syndrome and keratoconus. In 7 of 9 (77.8%) eyes, CXL was completed successfully, whereas in 2 of 9 (22.2%) eyes, the treatment was aborted due to insufficient corneal thickness (less than 400 µm) prior to ultraviolet-A irradiation.…”

Section: Management Of Keratoconus In Down Syndromementioning

confidence: 99%

Down syndrome: a review of ocular manifestations

et al. 2022

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Down syndrome is the most common genetically mediated intellectual disability. Although many physiologic and pathologic features of Down syndrome are discussed at length in the literature, the ocular manifestations of Down syndrome have seldom been discussed in a comprehensive fashion. Given that Down syndrome has ocular manifestations from the front to the back of the eye, it is important for physicians to become familiar with these manifestations, especially given the prevalence of Down syndrome. This review aims to discuss the varied ophthalmologic manifestations of Down syndrome – including strabismus, amblyopia, nystagmus, accommodation deficits, nasolacrimal duct obstruction, keratoconus, optic nerve pathology, neoplastic disease, and retinal pathology – to facilitate better care and visual outcomes in this important patient population.

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“…Cognitive and psychiatric factors, which may also include repetitive eye rubbing, have been scarcely evaluated thus far in the context of keratoconus. A few case reports and small studies regarding the coexistence of obsessive compulsive disorder (OCD), Tourette syndrome, anxiety, autism, and intellectual disability have been published . To our knowledge, the association between the aforementioned comorbidities and keratoconus has not been systematically evaluated.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric Comorbidities Associated With Keratoconus

Safir,

Hecht,

Heller

et al. 2023

JAMA Ophthalmol

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ImportanceEvaluating risk factors for keratoconus, often associated with recurrent eye rubbing, could generate hypotheses to be tested in future interventional trials.ObjectiveTo assess the risk for keratoconus associated with psychiatric comorbidities in adolescents and adults.Design, Setting, and ParticipantsThis population-based cross-sectional study included medical records of Israeli adolescents and adults in military service from January 2011 through December 2021.Main Outcomes and MeasuresThe prevalence of anxiety, obsessive compulsive disorder (OCD), autism, and attention-deficit/hyperactivity disorder (ADHD) was evaluated in individuals with and without keratoconus. The association between keratoconus and psychiatric comorbidities was tested using univariate and multivariant analyses.ResultsOverall, 940 763 adolescents and adults were included. Mean (SD) age was 17.56 (1.47) years, and 59.3% were male. Keratoconus was documented in 1533 individuals, with a prevalence of 0.16%. Patients with keratoconus were more likely to be diagnosed with ADHD compared with the general population (odds ratio [OR], 1.58; 95% CI, 1.38-1.81; P &lt; .001). After adjusting for age, sex, intellectual status, height, and weight, the results remained unchanged (hazard ratio, 1.46; 95% CI, 1.27-1.67; P &lt; .001). Stratification according to age showed an association between keratoconus and ADHD for males (OR, 1.62; 95% CI, 1.39-1.90; P &lt; .001) but not for females (OR, 1.29; 95% CI, 0.96-1.74; P = .09).Conclusions and RelevanceIn a large cohort of adolescents and adults, ADHD was associated with a diagnosis of keratoconus in male patients, even after adjusting for possible confounders. Although a causative effect could not be ascribed, these findings support further investigation into the potential value of education regarding eye rubbing in this population.

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Management of Keratoconus in Down Syndrome and Other Intellectual Disability

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 6 publications

References 31 publications

Mental disorders in people with keratoconus

Mental disorders in people with keratoconus

Down syndrome: a review of ocular manifestations

Psychiatric Comorbidities Associated With Keratoconus

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