title: Demographics of older keratoconics in Wales and their mortality rates-Where are the older keratoconics?
abstract: OBJECTIVE
  The aim of this study was to identify keratoconics at least 40 years of age attending Welsh optometric hospital services, look at their demographics and mortality rates, and test the hypothesis that they die earlier than the general population.
  
  
  METHODS
  Keratoconic patients born before 1972 were identified retrospectively through contact lens services across 5 hospitals in Wales, United Kingdom. Patients' notes were reviewed to confirm the diagnosis and collect demographic data. The Exeter patient registration system was used to trace if patients were deceased or alive. General population data was obtained from the Office for National Statistics.
  
  
  RESULTS
  A total of 202 keratoconics at least 40years of age were identified. The mean age was 50.8years, 62% of patients were male and 97% Caucasian. Mean age at diagnosis was 28.7 years. Two patients were deceased, one died in 2012 and one in 2013. In 2012 mortality rates for studied patients and the general populations were 0.005 and 0.019, respectively (p 0.03).
  
  
  CONCLUSIONS
  Mortality rates for the identified keratoconics were found to be significantly lower than the mortality rates for the general population in 2012. Collected data represents 52% of expected keratoconics over the age of 40, calculated based on disease prevalence, study inclusion criteria and population numbers within the regions included in the study. Thus suggesting the reason for lack of older keratoconics in the National Health Service optometric clinics could be non-attendance rather than higher mortality rates.
authors.affiliation: Singleton Hospital, Swansea, United Kingdom. Electronic address: mzpopiela@doctors.org.uk.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Popiela
authors.affiliation: University Hospital of Wales, Cardiff, United Kingdom.
authors.forename: Tafadzwa
authors.initials: T
authors.lastname: Young-Zvandasara
authors.affiliation: AbergeleStanley Eye Unit, Abergele, United Kingdom.
authors.forename: Elias
authors.initials: E
authors.lastname: Veepanat
authors.affiliation: AbergeleStanley Eye Unit, Abergele, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Saunders
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003261:Contact Lenses / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data*; D009907:Optometry / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D014852:Wales / Q000453:epidemiology
keywords: Demographics; Keratoconics; Mortality rates