title: Blepharokeratoconjunctivitis in childhood: corneal involvement and visual outcome.
abstract: OBJECTIVE
  The main objective of this study is to describe the prevalence, degree and risk of corneal involvement, and visual impact in a pediatric population with blepharokeratoconjunctivitis (BKC).
  
  
  METHODS
  Retrospective, observational, case-control study. Clinical records of patients ≤16 years old with BKC seen between 2006 and 2012 were reviewed. The prevalence and relative risk of corneal involvement was evaluated between patients with and without corneal affection through a univariate and multivariate analysis with logistic regression. Visual acuity at presentation and at last follow-up visit was also analyzed.
  
  
  RESULTS
  One hundred and fourteen children with BKC, with a male-to-female ratio of 1 : 1 and a mean age at diagnosis of 9.13 years. The mean follow-up time was 26.4 (±25) months. Corneal involvement was present in 39.5% of patients, varying from superficial punctate keratitis to perforation. Corneal changes were not seen in children under 4 years old. The risk of corneal affection was greater in patients with photophobia, hordeolum, female gender and asymmetric disease (OR of 2.69, 11.6, 2.35 and 2.77, respectively). The mean best-corrected visual acuity at presentation was 0.20 (corneal affected group), compared to 0.11 (unaffected group; P=0.02).
  
  
  CONCLUSIONS
  Our study showed an older age at time of diagnosis and a worse visual outcome in patients with BKC and corneal disease compared with previous reports. Early diagnosis and detection of risk factors for corneal involvement, as well as adequate treatment, is mandatory to prevent serious long-term visual repercussions in children with BKC.
authors.affiliation: Cornea and Ocular Surface Service, Ophthalmology and Visual Sciences Institute, School of Medicine, Tecnológico de Monterrey, Monterrey, Mexico.
authors.forename: A
authors.initials: A
authors.lastname: Rodríguez-García
authors.affiliation: Ophthalmology and Visual Sciences Institute, School of Medicine, Tecnológico de Monterrey, Monterrey, Mexico.
authors.forename: S
authors.initials: S
authors.lastname: González-Godínez
authors.affiliation: Ophthalmology and Visual Sciences Institute, School of Medicine, Tecnológico de Monterrey, Monterrey, Mexico.
authors.forename: S
authors.initials: S
authors.lastname: López-Rubio
mesh_terms: D001762:Blepharitis / Q000453:epidemiology* / Q000503:physiopathology; D016022:Case-Control Studies; D002648:Child; D002908:Chronic Disease; D003316:Corneal Diseases / Q000453:epidemiology* / Q000503:physiopathology; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007637:Keratoconjunctivitis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014792:Visual Acuity / Q000502:physiology*