Sociodemographic and clinical characteristics of keratoconus: multi-centric study from India

This study aimed to determine if the sociodemographic and clinical characteristics of patients with keratoconus had changed in recent times.

This prospective multicentre study was conducted at four tertiary eye institutes in India between October 2022 and September 2023. Only patients newly diagnosed with keratoconus were included in the study.

The mean age of the 421 patients was 23.5 ± 8.9 years, and there were 249 (59.1%) male and 170 (40.9%) female patients. The highest prevalence (44.89%) was observed between the ages of 20 and 29. Females were younger than males (P = 0.040). The onset of symptoms preceded the diagnosis by 2.7 ± 4.3 years. A total of 298 patients (70.8%) were from the urban areas. The majority of patients (79.1%) belonged to the middle socioeconomic class (P < 0.001), and 251 (59.6%) had obtained a graduate or higher degree (P < 0.001). The most common sign in mild keratoconus was scissors reflex. Binocular vision impairment was absent in 259 patients (61.5%), whereas the rest had some degree of impairment. Keratoconus was asymmetrical in 36.1% of the patients. Clinical signs were absent in 5% of the patients.

Despite advances in corneal imaging and awareness about keratoconus, patients were still being diagnosed in the third decade of life. The presence of scissors reflex in patients coming for refraction should alert eyecare professionals to the presence of keratoconus, and corneal tomography should be advised in these patients.