Study highlights need for improved pediatric keratoconus screening

Older children with lower visual acuity, oblique astigmatism, and corneal abnormalities are more likely to have abnormal or borderline keratoconus screening results on Pentacam imaging, according to a study.

The retrospective analysis, conducted at a single center, included 78 children aged 3-18 years who underwent eye exams and initial Scheimpflug imaging (Pentacam).

Most patients (94%) were referred for screening due to high or progressive astigmatism. Notably, 70% of participants had at least 1 abnormal or borderline Pentacam index suggestive of keratoconus. The study found that older children, particularly those with lower visual acuity, oblique astigmatism, and corneal abnormalities, were more likely to exhibit abnormal imaging results. On average, the children presented with 4.9 diopters of astigmatism, and 86% showed with-the-rule astigmatism.

The findings highlight the importance of age and visual indicators in identifying at-risk patients and suggest that most children suspected of keratoconus have abnormal imaging parameters.

Reference
Zhao SH, Berkowitz C, Ralay Ranaivo H, Laurenti K, Bohnsack BL, Basti S, Rossen JL. Evaluation of parameters for early detection of pediatric keratoconus. BMC Ophthalmol. 2024;24(1):463. doi: 10.1186/s12886-024-03714-0. PMID: 39434060.