IKA 2024: Keratoconus treatment and diagnosis in the pediatric population

Barry Eiden, OD, FAAO, FSLS, President and Co-founder of IKA, talked about his session at the meeting centering around the pediatric prevalence of keratoconus, the importance of early diagnosis, and the impact this can have on practices.

Video Transcript:

Editor's note: The below transcript has been lightly edited for clarity.

Barry Eiden, OD, FAAO, FSLS:

Hi, I'm Dr. Barry Eiden. I'm one of the co-chairs at the IKA keratoconus symposium here in Bethesda, Maryland. It's unbelievably attended and I'm so excited to report to you about one of the sessions that I'll be moderating, which is on the importance of pediatric eye exams and keratoconus. Our session is going to emphasize the importance of early diagnosis because now we have effective treatments that can stop and halt progression of this disease and the outcome is to preserve vision. We have a number of phenomenal speakers on our panel, including Dr. Ann Ostrovsky, an ophthalmologist, who deals a lot with pediatric patients. Jennifer Harthan from the Illinois College of Optometry, who is our lead author on our pediatric prevalence paper. And Dr. Andrew Morgenstern, one of my co-chairs at the IKA meeting here.

Within our session on the importance of pediatric eye care in keratoconus diagnosis, we're going to have emphasis in a variety of areas. First, we're going to talk about new information on the prevalence of pediatric keratoconus. At the IKA and Illinois College of Optometry study group we did a study of over 2100 school-aged individuals from ages 3 to 18 looking at the prevalence of tomographic keratoconus utilizing Scheimpflug imaging, and we found amazingly high rates of prevalence–one in a bit over 300 in terms of definitive keratoconus. That will be our first session talking about how prevalent this disease is, then we're going to get into treatment elements. Dr. Ostrovsky is going to talk about cross-linking in kids and other forms of surgical intervention. We're going to have a session on diagnostic technologies and how important early diagnosis with sensitive instrumentation is. And then we're going to have a panel to end up our session, which will be talking about the implications of high prevalence and our ability to treat early and preserve vision. How that's going to impact pediatric eye exams, and screening for keratoconus.

There is a significant impact on what our practice pattern should be. If keratoconus is as prevalent as we're finding out it to be within the pediatric population, in essence, we need to change the way we look at kids in terms of what we do during our eye exams. We'll have to be thinking about all of the risk factors for keratoconus, whether it be family history or clinical findings that might suggest early keratoconus. But more importantly, we're going to have to incorporate sensitive technologies that can pick up early keratoconus before it affects vision to any significant degree. We have to develop instrumentation that's both sensitive, yet affordable so that we can get widespread adaptation of these kinds of technologies.

I think another thing that we have to consider is all right, we know the keratoconus in the pediatric population is quite high in terms of prevalence. We secondly, know that we have the ability through technology to detect keratoconus very early before vision is significantly affected. Now we have to talk about treatment. We know that we have treatments, corneal cross-linking, that can stop, halt progression of the disease. But we have to make sure that if we're going to treat patients at very early phases, that the risks associated with those treatments are minimized. So we have to develop technologies that have minimal risk, but high efficacy so that we can apply them early on, even in cases of what would be measured as normal vision.