Screening Preadolescents for Keratoconus Risk Factors in a Low-Resource Setting.

Area of Science:

• Ophthalmology
• Public Health
• Pediatric Eye Care

Background:

• Keratoconus (KC) diagnosis relies on corneal signs, refraction, and imaging.
• KC prevalence varies globally, necessitating early detection for management, especially in low-income settings.
• Accessible diagnostic options are crucial to prevent visual impairment.

Purpose of the Study:

• To determine the prevalence of KC in primary school children in Harare.
• To identify prevalent KC risk factors within this population.
• To evaluate a novel scoring system for KC risk assessment.

Main Methods:

• A questionnaire collected demographic, ocular history, and KC risk factor data from 1,153 children aged 6-12.
• A novel informed risk score calculation was applied to screen for KC.
• Informed consent and assent were obtained prior to participation.

Main Results:

• The prevalence of KC was found to be 626/100,000 among primary school children in Harare.
• Key risk factors identified include reduced visual acuity, vernal keratoconjunctivitis, itchy eyes, eye rubbing, and atopy.
• The informed risk score calculation demonstrated value in screening for KC.

Conclusions:

• The prevalence of KC in Harare's school-aged children is notably high (626/100,000).
• Early screening for KC in school-aged children is beneficial, particularly using evidence-based practices.
• This approach can aid in managing KC and preventing visual impairment, even without advanced technology.