Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment

Funding informationThis work was done under the approval of EAACI with a TF budget 2015-18. AbstractThe treatment and management of ocular allergy (OA) remain a major concern for different specialties, including allergists, ophthalmologists, primary care physicians, rhinologists, pediatricians, dermatologists, clinical immunologists, and pharmacists.We performed a systematic review of all relevant publications in MEDLINE, Scopus, and Web Science including systematic reviews and meta-analysis. Publications were considered relevant if they addressed treatments, or management strategies of OA.A further wider systematic literature search was performed if no evidence or good quality evidence was found. There are effective drugs for the treatment of OA; however, there is a lack an optimal treatment for the perennial and severe forms. Topical antihistamines, mast cell stabilizers, or double-action drugs are the first choice of treatment. All of them are effective in reducing signs and symptoms of OA. The safety and optimal dosing regimen of the most effective topical anti-inflammatory drugs, corticosteroids, are still a major concern. Topical calcineurin inhibitors may be used in steroid-dependent/resistant cases of severe allergic keratoconjunctivitis.Allergen-specific immunotherapy may be considered in cases of failure of first-line treatments or to modify the natural course of OA disease. Based on the current wealth of publications and on the collective experience, recommendations on management of OA have been proposed.

show abstract

“…Visual rehabilitation in early and moderate stages consists of spectacles, contact lenses, and intracorneal ring implantation …”

Section: Resultsmentioning

confidence: 99%

Management of ocular allergy

Leonardi

Silva

Formigo

et al. 2019

Allergy

107

View full text Add to dashboard Cite

show abstract

“…In Lebanon, El-Khoury et al reported an incidence of 0.53% in children 14 years or younger who were diagnosed in a tertiary referral eye center. 2 Another study conducted in southwestern Nigeria reported 0.08% prevalence of blindness among school children due to KC. 3 A recent study was conducted in Saudi Arabia reported 4.79% prevalence among the pediatric age group.…”

Section: Introductionmentioning

confidence: 98%

<p>Prevalence of Subclinical Keratoconus Among Pediatric Egyptian Population with Astigmatism</p>

Sidky¹,

Hassanein²,

Eissa³

et al. 2020

OPTH

View full text Add to dashboard Cite

Purpose: To report the prevalence of subclinical keratoconus (KC), and KC suspects, in pediatric Egyptian population with astigmatic error ≥2 diopters (D), with the use of CSO Sirius tomographer. Methods: A cross-sectional study that included all the children aged 6-18 years with an astigmatic error of ≥2 D who attended the pediatric ophthalmology clinic for routine checkups during the period between March 2017 and December 2017 was done. All subjects underwent comprehensive ophthalmic examination, and corneal imaging using CSO Sirius instrument, a pentacam with Scheimpflug technology. Results: There were 547 subjects enrolled in our study. Mean age was 11.34 ± 3.03 (range 6-18) years. There were 278 subjects (50.8%) between 6 and 12 years, and 269 subjects (49.2%) between 12 and 18 years. Males represented 48.4% and females represented 51.6% of patients. Among all the subjects, there were 26 (4.8%) KC patients, 24 (4.4%) KC suspects, and 497 (90.9%) were normal. Conclusion: Prevalence of subclinical KC among pediatric age group with astigmatism is relatively high, hence the importance of corneal tomography screening of children with astigmatic error ≥2 D.

show abstract

“…Keratoconus is a degenerative corneal disease which more observed in men [3,5,7,8]. This situation is based on our patient population's majority is men.…”

Section: Discussionmentioning

confidence: 99%

“…Retinal reflection scattering is the earliest findings of keratoconus and corneal reflection on the nasal cornea when a penlight is shone from the temporal side as Rizutti's sign is other early findings [4]. Ocular allergy and itching are play a role in keratoconus etiology [5]. The prevalence of keratoconus in the middle-eastern countries is much higher than in the regions of the world.…”

Section: Introductionmentioning

confidence: 99%

Untitled

2018

JOCR

View full text Add to dashboard Cite

Purpose:To determine demographic characteristic feature of keratoconus, degree of keratoconus which impairment the visual acuity and to explore patient who lives in hot climate suffer from keratoconus symptoms. Methods:This study include 210 patients which diagnosed keratoconus, is liable for our hospital's patient population among 2015 to 2018. Routine ophthalmological examination was performed and autokeratorefractive error, best spectacle corrected visual acuity (BSCVA), demographic features was determined. At the end of the study number of applications and complaint to hospital were considered.Results: 81.4% patients were in the range of 20-30 years. Except 15 patients all of them were male. There were unilateral keratoconus in 66 patients. BSCVA was 4/10 and below with Snellen lines in 21.75% eye; Spherical equivalent was 3 Dioptre and below in 216 eye (61.01%). Keratometric measures were determined 44.00 Dioptre till in 120 eye (33.89%). Purely, 64 patient were performed cross-linking, corneal ring etc. Conclusion:Keratoconus is a degenerative corneal disorder which is occured more often in young men as it is in our study. Bilateral involvement is frequently determined. BSCVA is 8/10 and below in 68.85%. Spherical equivalent 3.00 Dioptre and below eye is 59.01%, that's why ophthalmologists are alert of early diagnosis of keratoconus. We observed that these patients suffered from subjective complaint constantly because of hot climate of the region we live in.

show abstract

Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment

Abstract: The incidence of pediatric keratoconus indicates that increased awareness for keratoconus among children is needed, mainly in cases of family history of keratoconus, ocular allergy/pruritus, poor CDVA, corneal hydrops, and/or high astigmatism. [J Refract Surg. 2016;32(8):534-541.].

Cited by 49 publications

References 34 publications

Management of ocular allergy

Management of ocular allergy

<p>Prevalence of Subclinical Keratoconus Among Pediatric Egyptian Population with Astigmatism</p>

Untitled

Contact Info

Product

Resources

About