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REVIEW ARTICLE
Year : 2021  |  Volume : 69  |  Issue : 2  |  Page : 214-225

Pediatric keratoconus - Current perspectives and clinical challenges


1 Cornea Consultant, Aravind Eye Hospital & Postgraduate Institute, Tirunelveli, Tamil Nadu, India
2 Prof of Ophthalmology, Cornea, Cataract & Refractive Services, Dr R P Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
3 Cornea Consultant, Aravind Eye Hospital & Postgraduate Institute, Coimbatore, Tamil Nadu, India

Correspondence Address:
Dr. Murugesan Vanathi
Prof of Ophthalmology - Cornea, Cataract and Refractive Surgery Services, Dr R P Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1263_20

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Keratoconus is an ectatic corneal disease characterized by progressive stromal thinning, irregular astigmatism, and defective vision. It can be unilateral or bilateral with asymmetric presentation. It starts at puberty and either progresses rapidly to an advanced stage of the disease or stops in case of delayed onset and slow progression. Pediatric keratoconus is more aggressive than in adults and the management protocols differ because of various rationales such as accelerated progression, advanced stage of disease at the time of diagnosis and co-morbidities. It poses a burden to the society as it affects the quality of life, social, and educational development in children. Hence early diagnosis, recognition of progression, and timely intervention with collagen crosslinking is imperative to arrest the worsening. Association with systemic syndromes and ocular comorbidities can be of concern in pediatric keratoconus. Severe ocular allergy when associated hastens progress and complicates timely intervention of crosslinking treatment and compliance to contact lens wear. Keratoplasty in pediatric keratoconus has good outcomes but can encounter frequent suture-related concerns. This article discusses the epidemiology, etiopathogenesis, clinical challenges, and current perspectives of management of pediatric keratoconus.


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