A groundbreaking study from the International Keratoconus Academy reveals that keratoconus occurs far more frequently in pediatric populations than historically believed, with significant implications for early screening and intervention. In "Unraveling the Mysteries of the Irregular Cornea," Jennifer S. Harthan, OD, discussed her team’s research and findings.

Researchers examined children ages 3–18 from Chicago Public Schools using advanced Scheimpflug corneal tomography. The prevalence of keratoconus was found to be 1 in 251 children, while keratoconus plus suspected cases reached 1 in 72—substantially higher than classic estimates of 1 in 2,000.

Early onset keratoconus carries a poorer prognosis, with faster progression and increased risk of corneal transplant rejection. The study utilized posterior corneal elevation and pachymetric distribution data, which detect disease before anterior surface changes impact vision. Traditional diagnostic methods like retinoscopy and keratometry often miss subclinical cases.  

These findings emphasize the critical need for comprehensive corneal tomography screening in pediatric eye examinations. Early detection enables timely corneal collagen crosslinking intervention, which can halt disease progression and prevent vision loss. The study's predominantly minority, low-income population highlights potential disparities requiring further investigation across diverse demographics.

“Pediatric keratoconus progresses more rapidly and has worse outcomes, yet it is often missed by traditional diagnostic methods. The significance of this study demonstrate that the prevalence of KC far exceed historical estimates and underscore the importance of routine corneal tomography in pediatric eye exams to enable early detection and timely corneal crosslinking,” says Dr. Harthan.