EPIDEMIOLOGICAL ASPECTS OF KERATOCONUS IN CHILDREN

epidemiological study and importance of surveillance in the follow-up of pediatric keratoconus at the 20 août 1953 hospital of the casablanca university hospital center.

Keratoconus is the disease of corneal biomechanical failure. It is a non-inflammatory, idiopathic corneal dystrophy resulting from localized thinning and ectasia, with a slowly progressive course. Often bilateral, it threatens visual prognosis.

We carried out a retrospective study of patients whose keratoconus was diagnosed before the age of 18 in the pediatric ophthalmology department of the August 20 Hospital of the Casablanca University Hospital Center. Age, sex, reason for consultation, personal and family history, allergic terrain, ocular friction, optical and surgical management and monitoring were recorded. 

115 children's files were studied. All patients were under 18 years of age. The mean age was 12.17 years. Children were more frequently male (53%), with an associated allergic background (60%). Among the children, 37% reported rubbing their eyes. 5 cases had a family history of keratoconus. Among the children, 89 (77%), including 114 eyes, benefited from Epi-off cross-linking (100%), 25% bilaterally, predominantly in the right eye (53%). Complications: central haze 46 cases, herpetic ulcer 1 case, abscess 1 case, corneal scar 3 cases, bacterial conjunctivitis 2 cases. The mean follow-up period was 2.5 years. 26 children required only clinical and Pachymetry monitoring, with no need for cross-linking.

To detect the disease at an early stage, corneal topography could be systematically performed in young, allergic, eye-rubbing boys with recent-onset corneal astigmatism. Clinical and topographical follow-up can help avoid an escalation of complications such as hydrops or corneal opacities leading to keratoplasty.