Keratoconus in children

Keratoconus is a disease of young people and most common and most aggressive in children (8 to 15 years) and adolescents (10 to 19 years).

Children and Adolescents

Disease onset

Keratoconus is a disease of young people and most common and most aggressive in children (8 to 15 years) and adolescents (10 to 19 years). It is therefore very important to carry out regular follow-up checks here.

Our group has one of the longest international experiences in the treatment of keratoconus in children and adolescents. This particular age group requires special care and attention because the risk of postoperative complications such as infection can be greatly increased.

Keratoconus very often begins with the hormonal changes in puberty. However, it is also quite possible that the disease is already evident in a 9-year-old child. In 2012, the ELZA member Prof. Farhad Hafezi showed in a scientific study that keratoconus progresses in children and adolescents with a frequency of almost 90% and worsens vision

A 15-year-old boy with a decrease in visual acuity in his right eye who started 3 months earlier. The left picture shows the cornea during the first visit. The patient and his parents were asked to follow up after 4 weeks. Unfortunately, they did not reappear until after 3 months. The right picture shows the massive deterioration after 3 months.

An 11-year old girl that presented initially with a central ectasia and a distinct reduction in visual acuity (left image). An immediate CXL procedure was advised but the parents decided to wait 12 weeks. The right image depicts the massive worsening afterv 12 weeks.

Importance of early screening

Only 20 years ago we had to tell a person affected by keratoconus that there is no possibility to stop the progression of the disease. Today, CornealCross-Linking (CXL) enables us to stop keratoconus early enough to maintain vision. All the more important now is early detection.

Since keratoconus is a familial disorder, it is important to examine the children of adult keratoconus patients as nearly as possible. We can screen as early as 3-4 years of age.

What to do?