Gupta Yogita, Shanmugam Chandradevi, K Priyadarshini, Mandal Sohini, Tandon Radhika, Sharma Namrata
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India.
Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Delhi, India; LV Prasad Eye Institute, Bhubaneswar, Odisha, India.
Surv Ophthalmol. 2025 Mar-Apr;70(2):296-330. doi: 10.1016/j.survophthal.2024.10.003. Epub 2024 Oct 12.
Keratoconus is a common pediatric corneal disease, leading to vision impairment and amblyopia. Compared to its adult counterpart, pediatric keratoconus has an advanced presentation, rapid progression, higher incidence of complications such as corneal hydrops, and greater potential impact on the quality of life. It typically manifests during puberty and can evolve rapidly to more severe stages if left untreated. This rapid progression underscores the importance of early diagnosis through regular screening in pediatric populations and vigilant monitoring of pediatric keratoconus suspects. Concomitant ocular allergies, ocular anomalies, systemic diseases (e.g. syndromes), and poor compliance with contact lenses might impede prompt intervention and frequently postpone rehabilitation. Corneal collagen crosslinking is a crucial intervention in the management of pediatric keratoconus because it strengthens the corneal microstructure and halts the disease progression. When conservative measures fail, keratoplasty remains a viable option with generally favorable outcomes, though with unique challenges in post-operative care, including concerns related to sutures, long-term graft survival and need for repeated examinations under anesthesia. A multidisciplinary approach involving ophthalmologists, optometrists, pediatricians, and other healthcare professionals, focusing on early diagnosis and timely intervention, is essential for the comprehensive management of pediatric keratoconus and to mitigate its impact on children's lives.
圆锥角膜是一种常见的儿童角膜疾病，可导致视力损害和弱视。与成人圆锥角膜相比，儿童圆锥角膜病情进展更严重、发展迅速、诸如角膜水肿等并发症的发生率更高，对生活质量的潜在影响更大。它通常在青春期发病，如果不治疗，可迅速发展到更严重的阶段。这种快速进展凸显了通过对儿童群体进行定期筛查以及对圆锥角膜疑似病例进行密切监测来实现早期诊断的重要性。同时存在的眼部过敏、眼部异常、全身性疾病（如综合征）以及对隐形眼镜的依从性差，可能会妨碍及时干预，并常常推迟康复。角膜胶原交联是治疗儿童圆锥角膜的关键干预措施，因为它能强化角膜微观结构并阻止疾病进展。当保守治疗失败时，角膜移植仍是一种可行的选择，总体预后通常良好，不过术后护理存在独特挑战，包括与缝线、长期植片存活以及在麻醉下进行反复检查的需求相关的问题。一种由眼科医生、验光师、儿科医生和其他医疗保健专业人员参与的多学科方法，侧重于早期诊断和及时干预，对于儿童圆锥角膜的综合管理以及减轻其对儿童生活的影响至关重要。
