title: Is keratoconus more severe in pediatric population?
abstract: OBJECTIVE
  To compare the ophthalmic parameters and the severity of keratoconus (KC) in pediatrics and adults at the time of initial diagnosis in an Iranian population.
  
  
  METHODS
  KC was diagnosed via slit-lamp examination and Pentacam imaging. In a retrospective observational study, consecutive patients were divided into two groups of pediatrics (<18 years old) and adults (>18 years old). Topographic, keratometric, and tomographic parameters, and severity of KC at the time of diagnosis were compared in both groups. Severity of KC was classified according to Amsler-Krumeich classification.
  
  
  RESULTS
  One hundred fifty-eight eyes of 158 pediatric patients and 343 eyes of 343 adults with KC were studied. The mean ages of the pediatric and adult patients were 15 ± 1.9 and 22 ± 1.9 years, respectively (p < 0.001). The results revealed that pediatric patients had significantly higher values of anterior and posterior mean, flat and steep keratometry, astigmatism, and maximum elevation and significantly lower central and thinnest corneal thickness (p < 0.05). No significant difference was found regarding sphere, cylinder, manifest refraction spherical equivalent, and uncorrected and best-spectacle corrected visual acuity between the groups (p > 0.05). Pediatric patients had a significantly more severe KC than adult patients according to Amsler-Krumeich classification (p = 0.001).
  
  
  CONCLUSIONS
  Our findings suggest that KC is more severe in pediatrics, hence the fact that they should be closely monitored and intensively treated.
authors: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran. moh@naderan.com.
authors: Mohammad
authors: http://orcid.org/0000-0001-5774-4607
authors: M
authors: Naderan
authors: Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran.
authors: Mohammad Taher
authors: MT
authors: Rajabi
authors: Zarrinbakhsh Eye Clinic, Tehran, Iran.
authors: Parviz
authors: P
authors: Zarrinbakhsh
authors: School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
authors: Mahgol
authors: M
authors: Farjadnia
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D003315:Cornea / Q000473:pathology*; D019781:Corneal Topography / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007492:Iran / Q000453:epidemiology; D007640:Keratoconus / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D033401:Microscopy, Acoustic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Adults; Keratoconus; Keratometry; Pediatrics; Severity; Tomography; Topography