Keratoconus (KC) is a bilateral and often asymmetric disease which can progress to
corneal thinning and protrusion. Keratoconus in children appears to be more aggressive
than in adults. Research on pediatric keratoconus is limited, and treatments rely
on research and experience in adult populations. The current study aimed to provide
an analysis on the distribution of the corneal tomography measurements in an underserved,
Black and LatinX, primarily low-income pediatric population.
This was a prospective study approved by the Illinois College of Optometry’s IRB.
A total of 2133 children, presented to a school-based vision clinic within the Chicago
Public Schools, were included in the analysis and were classified into three age groups:
3–6 years, 7–12 years, and 13–18 years. Four specific tomography measurements were
obtained from the Pentacam (BAD Final D, ART-Max, I-S Ratio, and Thinnest Point Asymmetry).
The mean front corneal astigmatism of the study cohort was −1.39D ± 1.45. Tomography
indices means were 0.95 ± 0.74 for BAD Final D, 457.34 ± 94.83 for ART-Max, 0.01 ± 0.68
for I-S ratio, and 9.60 ± 25.55 for Thinnest Point Asymmetry. A statistically significant
difference was observed among age groups for BAD Final D (p < 0.001), ART-Max (p < 0.001) and Thinnest Point Asymmetry (p = 0.006).
This study provided the first set of normative data for a pediatric population on
the four tomography measurements, offering a reference for potential diagnosis of
keratoconus for Black and LatinX children. Further study could include evaluation
of additional races along with a comparison with the adult data, which will provide
guidance on evaluating the current keratoconus diagnosis criteria to aid early diagnosis
of keratoconus in the pediatric population.