INFLUENCE OF SOCIOECONOMIC FACTORS ON THE DIAGNOSIS OF KERATOCONUS
Published 2026 - 30th ESCRS Winter Meeting
Reference: PP01.05 | Type: Presented Poster & Poster | DOI: 10.82333/7b76-nj91
Authors: Sabrina Stojanov* 1 , Matthias Bolz 1 , Nino Hirnschall 1 , Leon Pomberger 1
1Ophthalmology and Optometry,Johannes Kepler Universität,Linz,Austria;Ophthalmology and Optometry,Kepler Universitätsklinikum Linz,Linz,Austria
Purpose
The study aimed to document the clinical stage of keratoconus at first ophthalmologic presentation at Kepler University Hospital and to identify demographic and geographic factors influencing early diagnosis and treatment. By analyzing these factors, the study sought to highlight gaps in care and support improved early detection and management.
Setting
This study was conducted in Austria, where limited demographic and geographic data on keratoconus currently exist. The study setting included patients treated at Kepler University Clinic in Linz, Austria, to evaluate geographic differences in disease presentation and access to ophthalmological care.
Methods
A cohort of 105 keratoconus patients underwent MS-39 corneal tomography and best-corrected visual acuity assessment. Residential categories were used as proxies for socio-economic status and access to care. Corneal and visual parameters were compared across residential groups.
Results
Patients from medium-sized and small urban centers showed the poorest corneal tomography outcomes, with the highest anterior and posterior Kmax values, the lowest minimum corneal thickness (Thmin), and reduced visual acuity compared with patients from peripheral regions or regional centers.
In the right eye (OD), medium-sized urban centers demonstrated the most severe changes (Kmax anterior 56.33 ± 14.63 D [Mean 55.40; Range 43.91–85.08]; Kmax posterior −9.87 ± 2.75 D [Mean 10.82; Range 6.60–14.40]), accompanied by Thmin 447.50 ± 199.75 µm [Mean 468.00; Range 228.00–549.00]) and reduced epithelial thickness index (ETI) 40.05 ± 26.51 [Mean 79.89; Range 14.90–79.89]).
A similar pattern was observed for the left eye (OS): medium-sized centers again had the most advanced disease Kmax anterior 62.19 ± 12.80 D [Mean 63.31; Range 48.38–83.01]. Kmax posterior −11.47 ± 2.40 D Thmin 426.17 ± 76.80 µm; ETI 40.09 ± 19.16, while small urban centers showed moderately better but still compromised parameters Kmax anterior 51.15 ± 6.16 D [Mean 56.39; Range 44.36–56.39]. Kmax posterior −8.84 ± 1.34 D [Mean 10.26; Range 7.59–10.26]; Thmin 474.00 ± 47.03 µm [Mean 452.00; Range 442.00–528.00]; ETI 26.98 ± 13.60 [Mean 26.58; Range 13.58–40.78].
The most favorable outcomes were seen in patients from regional centers. These results indicate that poorer keratoconus outcomes are not solely related to geographic distance but may be influenced by socioeconomic disparities affecting access to specialized care, health literacy, and timely diagnosis.
Conclusion
Regional differences in keratoconus diagnostic outcomes in Austria appear driven by socio-economic and structural factors rather than by simple urban versus rural dichotomies. Patients from socio-economically disadvantaged urban settings present with more advanced disease at diagnosis. These findings underscore the need for targeted screening strategies, equitable distribution of ophthalmic services, and improved awareness programmes to reduce disparities in keratoconus care.