Incidence of Keratoconus

Keratoconus is a relatively common eye disorder characterized by the thinning and bulging of the cornea, leading to vision loss. The prevalence of keratoconus varies globally, with rates ranging from 0.2 per 100,000 in Russia to 33 per 1,000 in Iran. A meta-analysis reported a global prevalence of 1.4 per 1,000, with higher rates in Asian and Middle Eastern populations. In pediatric populations, the prevalence ranges from 5.2 per 1,000 in New Zealand to 47.9 per 1,000 in Saudi Arabia. Keratoconus is also a common indication for keratoplasty in many countries.

The etiology of keratoconus is multifactorial, involving environmental and genetic factors such as atopy, eye rubbing, and exposure to ultraviolet rays. Genetic transmission plays a significant role, with familial aggregation noted in several studies. The mode of inheritance is often autosomal dominant with incomplete penetrance and variable expression, although autosomal recessive inheritance has also been suggested.

Management of keratoconus has evolved significantly over the years. Traditionally, treatment options included spectacles, rigid contact lenses, and keratoplasty for advanced cases. However, a groundbreaking technique called corneal cross-linking (CXL) using the Dresden protocol has revolutionized keratoconus management. CXL involves strengthening the corneal tissue through the application of a photosensitizing chemical activated by ultraviolet light.

In recent years, various treatment protocols and techniques have been developed to enhance the efficacy and safety of CXL. These include accelerated CXL and transepithelial CXL. Early stages of keratoconus can be managed with glasses or contact lenses, while progressive cases may require corneal collagen cross-linking to halt or slow down the disease progression. In advanced stages, corneal transplantation may be necessary to restore sight.

Despite ongoing research and advancements in treatment modalities, there is no known prevention for keratoconus. Regular eye examinations are crucial for early detection and management of this condition. Overall, while keratoconus poses challenges to vision health, advancements in treatment options offer hope for improved outcomes and quality of life for individuals affected by this common eye disorder.