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Factors Associated with Pediatric Keratoconus - A Population-Based Nested Case-Control Study
Or Ben-Shaul1,2, Sharon Schwartz1, Adi Segal1,2
1Department of Ophthalmology, Lady Davis Carmel Medical Center, Haifa, Israel.
Ophthalmic Epidemiology
|July 31, 2026
Summary
Pediatric keratoconus risk is higher in males and those with asthma, intellectual disability, atopic dermatitis, or allergies. Conversely, smoking and higher socioeconomic status were linked to a reduced risk of pediatric keratoconus.
Area of Science:
- Ophthalmology
- Pediatrics
- Epidemiology
Background:
- Keratoconus is a progressive thinning of the cornea, often diagnosed in adolescence.
- Pediatric keratoconus presents unique challenges for diagnosis and management.
- Understanding associated factors is crucial for early detection and intervention.
Purpose of the Study:
- To identify demographic, socioeconomic, and clinical factors associated with pediatric keratoconus.
- To analyze risk and protective factors in a large, population-based cohort of children and adolescents.
- To inform targeted screening and prevention strategies for pediatric keratoconus.
Main Methods:
- Retrospective, population-based nested case-control study.
- Utilized data from Israel's largest healthcare provider, covering 2005-2020.
- Employed univariable and multivariable conditional logistic regression analysis.
Main Results:
- Male gender, asthma, intellectual disability, atopic dermatitis, and allergies were significantly associated with increased pediatric keratoconus risk.
- Smoking, middle, and high socioeconomic status (SES) showed an inverse association with pediatric keratoconus.
- Diabetes mellitus did not demonstrate a significant association with keratoconus risk.
Conclusions:
- Specific comorbidities and demographic factors increase the risk of pediatric keratoconus.
- Factors like smoking and higher SES may offer a protective effect.
- Findings support targeted interventions for early detection in at-risk pediatric populations.