title: Pediatric Keratoconus in a Tertiary Referral Center: Incidence, Presentation, Risk Factors, and Treatment.
abstract: OBJECTIVE
  To report the incidence, clinical presentation, risk factors, and treatment outcome of pediatric keratoconus in a tertiary referral eye hospital in Beirut, Lebanon.
  
  
  METHODS
  In this retrospective study, the authors evaluated all patients with keratoconus 14 years or younger newly diagnosed at the Beirut Eye Specialist Hospital, Beirut, Lebanon, between January 2010 and December 2014. The incidence of pediatric keratoconus among all pediatric patients and among patients with keratoconus of all ages was assessed. Patients with pediatric keratoconus were evaluated for keratoconus stage, initial presentation, uncorrected distance visual acuity, corrected distance visual acuity (CDVA), corneal topography, and pachymetry. Patients were classified according to different treatment regimen groups and different follow-up visits were evaluated.
  
  
  RESULTS
  During 5 years, 16,808 patients were examined, of whom 2,972 were 14 years or younger. A total of 541 patients were diagnosed as having keratoconus; of those, 16 were 14 years or younger at the time of diagnosis. Hence, the incidence of keratoconus was 0.53% among pediatric patients and 3.78% among adult patients (> 14 years). Initial presentation was during routine checkup (1 of 16) for allergic conjunctivitis (3 of 16), reduced vision (10 of 16), and corneal hydrops (mimicking keratitis) (2 of 16). Except for 2 patients lost to follow-up, all eyes received corneal cross-linking treatment and 16 eyes received additional intracorneal ring segment implantation.
  
  
  CONCLUSIONS
  The incidence of pediatric keratoconus indicates that increased awareness for keratoconus among children is needed, mainly in cases of family history of keratoconus, ocular allergy/pruritus, poor CDVA, corneal hydrops, and/or high astigmatism. [J Refract Surg. 2016;32(8):534-541.].
authors: Sylvain
authors: S
authors: El-Khoury
authors: Youssef
authors: Y
authors: Abdelmassih
authors: Adib
authors: A
authors: Hamade
authors: Elise
authors: E
authors: Slim
authors: Carole G
authors: CG
authors: Cherfan
authors: Elias
authors: E
authors: Chelala
authors: Jamal
authors: J
authors: Bleik
authors: Elias F
authors: EF
authors: Jarade
mesh_terms: D000293:Adolescent; D002648:Child; D019781:Corneal Topography; D003432:Cross-Linking Reagents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D007640:Keratoconus / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D017319:Photosensitizing Agents / Q000627:therapeutic use; D019736:Prostheses and Implants; D012017:Referral and Consultation; D012189:Retrospective Studies; D012256:Riboflavin / Q000627:therapeutic use; D012307:Risk Factors; D062606:Tertiary Care Centers; D014466:Ultraviolet Rays; D014792:Visual Acuity / Q000502:physiology
chemical_list: D003432:Cross-Linking Reagents; D017319:Photosensitizing Agents; D012256:Riboflavin