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Blepharokeratoconjunctivitis in childhood: corneal involvement and visual outcome
A Rodríguez-García1, S González-Godínez2, S López-Rubio2
1Cornea and Ocular Surface Service, Ophthalmology and Visual Sciences Institute, School of Medicine, Tecnológico de Monterrey, Monterrey, Mexico.
Insights
Blepharokeratoconjunctivitis (BKC) in children can lead to corneal involvement and vision loss. Early detection of risk factors like photophobia and hordeolum is crucial for better visual outcomes.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Corneal Diseases
Background:
- Blepharokeratoconjunctivitis (BKC) is a common condition in children.
- Corneal involvement can significantly impact visual acuity in pediatric patients.
- Understanding risk factors and outcomes is essential for effective management.
Purpose of the Study:
- To determine the prevalence, severity, and risk factors of corneal involvement in pediatric BKC.
- To assess the visual impact of BKC with corneal disease in children.
- To compare outcomes with previous reports.
Main Methods:
- Retrospective, observational, case-control study.
- Analysis of clinical records of 114 children (≤16 years) with BKC.
- Logistic regression used to identify risk factors for corneal affection.
Main Results:
- Corneal involvement occurred in 39.5% of pediatric BKC patients, ranging from superficial keratitis to perforation.
- Risk factors for corneal affection included photophobia, hordeolum, female gender, and asymmetric disease.
- Children with corneal involvement had worse visual acuity at presentation compared to those without.
Conclusions:
- Pediatric BKC with corneal disease is associated with later diagnosis and poorer visual outcomes than previously reported.
- Early diagnosis and prompt treatment are vital to prevent long-term visual impairment.
- Identifying and managing risk factors can mitigate severe consequences.
Purpose:
The main objective of this study is to describe the prevalence, degree and risk of corneal involvement, and visual impact in a pediatric population with blepharokeratoconjunctivitis (BKC).
Methods:
Retrospective, observational, case-control study. Clinical records of patients ≤16 years old with BKC seen between 2006 and 2012 were reviewed. The prevalence and relative risk of corneal involvement was evaluated between patients with and without corneal affection through a univariate and multivariate analysis with logistic regression. Visual acuity at presentation and at last follow-up visit was also analyzed.
Results:
One hundred and fourteen children with BKC, with a male-to-female ratio of 1 : 1 and a mean age at diagnosis of 9.13 years. The mean follow-up time was 26.4 (±25) months. Corneal involvement was present in 39.5% of patients, varying from superficial punctate keratitis to perforation. Corneal changes were not seen in children under 4 years old. The risk of corneal affection was greater in patients with photophobia, hordeolum, female gender and asymmetric disease (OR of 2.69, 11.6, 2.35 and 2.77, respectively). The mean best-corrected visual acuity at presentation was 0.20 (corneal affected group), compared to 0.11 (unaffected group; P=0.02).
Conclusions:
Our study showed an older age at time of diagnosis and a worse visual outcome in patients with BKC and corneal disease compared with previous reports. Early diagnosis and detection of risk factors for corneal involvement, as well as adequate treatment, is mandatory to prevent serious long-term visual repercussions in children with BKC.
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