IKA 2024: Pediatric prevalence of keratoconus

Andrew Morgenstern, OD, FAAO, FNAP, President and Co-founder of IKA, talked about his session at the meeting centering around the pediatric prevalence of keratoconus.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Andrew Morgenstern, OD, FAAO, FNAP:

Hi, how you doing? Andy Morgenstern here at the IKA Keratoconus Symposium in Bethesda, Maryland. I wanted to talk to you today about my session on pediatric prevalence of keratoconus. We're presenting data from our paper that was just published in Eye & Contact Lens in March of 2023. One of the things that we really wanted to look at, because there really was no data on the pediatric prevalence of keratoconus in the United States was, how prevalent is it in our community? What do eye doctors need to be aware of? Our paper looked at about 4000 childre–we scanned +4000 kids for the presence of keratoconic disease or if they were keratoconus suspect.

What we found out after researching in conjunction with the Illinois College of Optometry and the Chicago Public School System, was that the prevalence of the population that we looked at, alarmingly, was about 1 in 334 children. So it's to say there was a presence of keratoconic disease in 1 out of every 334 kids that we looked at. These were kids that were largely from disadvantaged socio-economic environment, which is to say that they really would not have gotten care, and they wouldn't have gotten detected, unless we actually did this study. The great news is, not only did we detect it, we found how prevalent it was, but we also got these kids that probably wouldn't ever have gotten care, care.

The good news is, is that we get to share this information with everybody not only here at the meeting, but publicly as well. What we're trying to do is tell our fellow eye care providers, that the prevalence of this disease is not what 1 in 2000, it is not a rare disease, not only in the community outside the United States, but is a common disease that people need to be aware of they need to use newer diagnostic technologies to be aware of this and also to identify it, manage it and treat it. If it needs to be treated outside the optometric office, we want to refer it off to ophthalmology, obviously for more higher level surgical care.

So look, the best thing to do. If we could identify these kids really it's a matter of getting these kids in front of screening devices. We know the best screening device out there is a Scheimpflug camera that looks at the elevation of the front surface, the back surface and the thickness of the cornea. We call those tomographies. Well, not every practice has a tomographer. Some practices may have something called a corneal topographer. Corneal topography is great. It's not going to look at the full cornea, but it's gonna give you an excellent starting point and an excellent idea of what's going on with the eye. And even if you don't have a topographer, use those clinical skills. Use that slit lamp, bust out your retina scope if you need to. Use the old manual keratometer do the best that you can to identify these kids. The reason why it's so important is that the earlier we identify it, the earlier we can get them cross-linking and we can stop the progression of the disease dead in its tracks.