Screening Preadolescents for Keratoconus Risk Factors in a Low-Resource Setting
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Published on: November 12, 2015
Lynett Erita Masiwa1, Vanessa Moodley
1University of Zimbabwe (L.E.M.), Harare, Zimbabwe; and University of Kwa Zulu Natal (V.M.), Durban, South Africa.
Insights
The prevalence of keratoconus (KC) in Harare primary school children is high at 626/100,000. Early screening using a novel risk score system can identify children at risk and prevent vision impairment.
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.
Background:
Diagnosis of keratoconus (KC) involves the identification of corneal signs, refraction, and corneal imaging. The prevalence of KC ranges between 0.4 per 100,000 and 4,790, depending on geographical location and ethnicity. Diagnosis of KC should occur early for appropriate management with relatively affordable, accessible options to prevent visual impairment in low-income settings.
Method:
Written consent and assent were obtained from subjects before a questionnaire was administered to collate demographics, general and ocular history of subjects, and keratoconus risk factors. A novel scoring system was applied to identify subjects at a higher risk of developing KC and document KC risk factors prevalent in Harare using an informed risk score calculation.
Results:
Thousand one hundred fifty-three subjects aged between 6 and 12 years were seen. The prevalence of KC was found to be 626/100,000 in primary school children resident in Harare. Reduced visual acuity, vernal keratoconjunctivitis, itchy eyes, eye rubbing, and atopy are the most prevalent KC risk factors identified in this community. Informed risk score calculation proved valuable in the screening for KC.
Conclusion:
The prevalence of KC in primary school children in Harare is 626/100,000, which is relatively high. School-aged children stand to benefit from the early screening for KC based on evidence-based practices in the absence of advanced clinical instrumentation.
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