Abstract
Purpose :
Pediatric blepharokeratoconjunctivitis (BKC) is a common chronic inflammatory disease of the ocular surface involving the lid margin, the conjunctiva, and the cornea. Severe BKC can result in corneal stromal thinning, scarring, and amblyopia. We performed a retrospective case series to determine the corneal topographic characteristics of children with moderate to severe BKC.
Methods :
Corneal topography of pediatric patients with moderate to severe BKC who had no other systemic or ocular diagnosis between March 2008 and June 2019 were reviewed. The diagnosis of moderate to severe BKC was determined according to the grading scale previously described (Hamada et al 2012). Corneal topography, pachymetry, and asymmetry indices were analyzed.
Results :
36 eyes of 21 children were included. The mean (±SD) keratometry value (K) was 44.21±2.61 Diopters (D). Mean flat K, mean steep K, and mean maximum K were 42.61±2.63D, 46.00±3.17D, and 51.00±5.29D, respectively. 67% of children had a maximum K ≥47.2D. Mean topographic astigmatism (TA) was 3.39±2.60D, and 61% of eyes had astigmatism >2D. Using indices comparing the superior and inferior corneal topographic characteristics, the index of height decentration (IHD), index of surface variance (ISV) and index of vertical asymmetry (IVA) were found to be abnormal in 83%, 69%, and 64% of cases, respectively. In addition, mean corneal thickness (CT) at apex was 528.83±72.18 microns (µm). Mean thinnest CT was 487.00±88.28µm, and 47% of eyes had a thinnest CT <500µm.
Conclusions :
Children with moderate to severe BKC have a high incidence of abnormal corneal topography with steep corneas and reduced corneal thicknesses compared to the healthy pediatric population. Corneal topography could be an important tool in the evaluation of visual function in children with moderate to severe BKC.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.