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Childhood-onset allergic eye disease linked to greater ocular morbidity

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Key Takeaways

  1. Childhood-onset allergic eye disease was associated with greater ocular morbidity, including higher rates of limbal involvement, keratoconus, limbal stem cell deficiency, and steroid-induced glaucoma.
  2. Complication risks were substantially higher with childhood-onset disease, with increased odds of keratoconus, limbal stem cell deficiency, and steroid-induced glaucoma compared with adult-onset disease.

Adults with childhood-onset allergic eye disease (AED) had higher rates of ocular complications than those with adult-onset disease, according to a retrospective study.

Although vernal keratoconjunctivitis was the most common allergy type in both groups, childhood-onset disease was associated with greater limbal involvement and higher odds of several complications.

Of the 5030 adults included, 4475 (89%) had adult-onset AED and 555 (11%) had childhood-onset disease. Male predominance was observed in the childhood-onset group, while no gender difference was seen among those with adult-onset disease.

Limbal involvement occurred more frequently in patients with childhood-onset AED than in those with adult-onset disease (45% vs 16%; P < 0.0001). The most common comorbidities in the childhood-onset group were keratoconus (14.05%), limbal stem cell deficiency (7.74%), and steroid-induced glaucoma (6.66%). In the adult-onset group, the most common comorbidities were ptosis (2.19%), keratoconus (1.87%), and steroid-induced glaucoma (1.29%).

Compared with adult-onset disease, childhood-onset AED was associated with higher odds of keratoconus, limbal stem cell deficiency, and steroid-induced glaucoma (P < 0.001 for all).

Reference

Donthineni PR, Das AV, Basak S, et al. Allergic Eye Disease in Adults: Differences in Clinical Profile Based on the Age of Onset. Cornea. 2026;doi: 10.1097/ICO.0000000000004278. Epub ahead of print. PMID: 42644482.

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