Keratoconus problem in chlildren under 15 years of age Dragica Kosec Eye Clinic, University Medical Centre Ljubljana Slovenia

Introduction: Keratoconus is a relatively rare corneal disease 1 out of every 1-2,000 persons in the general population Keratoconus is generally first diagnosed in young people at puberty or in their late teens Tends to progress more rapidly in young patients Vision correction in the early phases is often possible with eyeglasses and contact lenses Amblyopia is poor vision in an eye that did not develop normal sight during early childhood Affecting approximately 2 or 3 out of every 100 people Amblyopia has three major causes: strabismus (misaligned eyes), unequal focus (refractive error), and cloudiness in the normally clear eye tissues

Purpose: The “trigger” for research? Amblyopic children who’s vision did not improve with standard treatment (correction, patching, exercises) despite good compliance. Keratometric values reviled keratoconus. The purpose of the study is to confirm that keratoconus may occur at a very young age, when the inadequate correction is the cause of amblyopia.

Methods Retrospectiv study of 107 patients, All patients were born after 1985, diagnosed with keratoconus, and who attended University eye clinic Ljubljana – department for contact lenses between january 1996 and december 2011 were identified. Age at first referral Gender Visual accuity Divided them into three groups: A: 0 – 5 years, B: 6 -10 years, C: 11 – 15 years of age.

Results – age of onset

Results - gender

Results – visual acuity

Results – drop out

Discusion CLEK study: an 8-year observational multi- center study of 1209 keratoconus patients, mean age at baseline of 39.3±10.9 years, the youngest was 12 years of age. 1638 keratoconus patients from different regions of Saudi Arabia referred to King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, between January 1999 and December 2010, Mean age at evaluation was 21.7 (range 14–49) years. H. Wagner, J.T. Barr, K. Zadnik, the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study Group published online 10 May 2007. Mussaed Alabdelmoneam, Retrospective analysis of keratoconus at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia, Clinical Optometry, Clinical Optometry 2012:4

Discusion Opening question of amblyopia treatment at the youngest children. Kids defend wearing contact lenses because they are less comfortable than glasses. Here the important role played by parents who have small children encouraged to wear contact lenses and even encouraged to take action to improve visual development. We didn`t find any paper where would be studied visual development at children with keratoconus.

Conclusion Our study suports that keratoconus is present also at very young children. It becomes suspicious when amblyopia is not improve with regular wearing glasses and even patching if necessary or if there is a greater changing of astigmatism value. With early detection and early appropriate correction with contact lenses we can improve vision and prevent development of severe amblyopia. For beter undestandibg of this problem further investigations have to be made.

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