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Definition and Diagnostic Criteria for Pediatric Blepharokeratoconjunctivitis

Nallely R Morales-Mancillas1, Fabiola Velazquez-Valenzuela2, Shigeru Kinoshita3

  • 1Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Pediatric and Strabismus Service, Monterrey, Mexico.

JAMA Ophthalmology
|December 21, 2023
PubMed

Insights

Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic eye condition. Experts established a unified name, definition, and diagnostic criteria to improve early recognition and treatment of this sight-threatening disease in children.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Ocular Surface Disease

Background:

  • Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic, sight-threatening inflammatory ocular surface disease.
  • Lack of unified terminology and diagnostic criteria leads to underdiagnosis and delayed treatment.
  • Nonspecific symptoms and difficulty differentiating from similar conditions complicate PBKC diagnosis.

Purpose of the Study:

  • To establish a consensus on the nomenclature, definition, and diagnostic criteria for PBKC.
  • To provide a unified framework for identifying and managing pediatric blepharokeratoconjunctivitis.
  • To reduce diagnostic confusion and improve early detection of PBKC.

Main Methods:

  • Quality improvement study utilizing the non-RAND modified Delphi method.
  • Expert panel consensus achieved through electronic surveys and virtual meetings.
  • International panelists included pediatric ophthalmologists and cornea specialists.

Main Results:

  • Consensus reached on the name "pediatric blepharokeratoconjunctivitis."
  • Agreed-on definition: a chronic, recurrent inflammatory eyelid margin disease with ocular surface involvement in children and adolescents.
  • Diagnostic criteria established, including symptoms and signs from eyelid margin, conjunctiva, and cornea.

Conclusions:

  • Agreed-upon nomenclature and diagnostic criteria aim to reduce diagnostic confusion.
  • Early recognition and adequate therapy can prevent sight-threatening complications of PBKC.
  • Proposed criteria require further validation with real patient data.
Abstract

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