title: Prevalence of Keratoconus Among a Palestinian Tertiary Student Population.
abstract: OBJECTIVE
  To screen for keratoconus and potential associated risk factors in a tertiary student population sample.
  
  
  METHODS
  This cross sectional study included 1234 students attending An-Najah National University (Nablus, West Bank, Palestine), that were randomly selected from a total of 20,000 university students. 634 (51.3%) student participants responded by completing a self-administered questionnaire and were assessed by means of corneal topography. Following initial evaluation, participants were referred for Pentacam evaluation if they demonstrated either a mean keratometry of more than 45 diopters, corneal astigmatism of more than 2 diopters and/or if asymmetric topographic patterns were present. Pentacam images were analyzed by an experienced ophthalmologist based on a number of indices and the participants were classified as normal, keratoconus suspects, and keratoconus patients.
  
  
  RESULTS
  A total of 620 participants (mean age, 20.1±1.6 years) were included in this study, 379 (61.1%) were females and 241 (38.9%) were males. Nine subjects were diagnosed with keratoconus, demonstrating a prevalence of 1.5%. 52 (8.4%) participants showed at least one abnormal pentacam index, and were considered as KC suspects.
  
  
  CONCLUSIONS
  Keratoconus is a prevalent disease among the tertiary Palestinian student population. This may be related to a combination of genetic and environmental factors. The results of this study signal the need for public health outreach and intervention for keratoconus.
authors.affiliation: Vardinoyannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Faculty of Medicine and health sciences, An-Najah National University, Nablus, Palestine.
authors.forename: Mohammad M
authors.initials: MM
authors.lastname: Shehadeh
authors.affiliation: Vardinoyannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece; Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
authors.forename: Vasilios F
authors.initials: VF
authors.lastname: Diakonis
authors.affiliation: Faculty of Medicine and health sciences, An-Najah National University, Nablus, Palestine.
authors.forename: Sara A
authors.initials: SA
authors.lastname: Jalil
authors.affiliation: Faculty of Medicine and health sciences, An-Najah National University, Nablus, Palestine.
authors.forename: Rania
authors.initials: R
authors.lastname: Younis
authors.affiliation: Faculty of Medicine and health sciences, An-Najah National University, Nablus, Palestine.
authors.forename: Jamal
authors.initials: J
authors.lastname: Qadoumi
authors.affiliation: Faculty of Medicine and health sciences, An-Najah National University, Nablus, Palestine.
authors.forename: Liana
authors.initials: L
authors.lastname: Al-Labadi
keywords: Keratoconus; pentacam; prevalence; risk factors; topography.