Keratoconus in kids or teens? What to do?
Hearing the words that your child has keratoconus can be daunting. What does it mean? Will this affect his future? Keratoconus is a progressive corneal thinning condition, making the outer transparent part of the eye look like a cone. The instability of the corneal structure in susceptible patients may lead to the worsening of keratoconus. Keratoconus is usually diagnosed in the 2nd decade of life, but we have also seen an increased number of patients referred to us who are still in their teens. The youngest keratoconus patient recorded in publications was a 4-year-old boy.
When we have kids in our chair, we discuss cross-linking, which stabilizes the keratoconus progression; and contact lenses for vision rehabilitation. We also discuss issues of eye itchiness. An important thing to consider too is to stop your child from eye rubbing. Eye rubbing is associated with keratoconus and its progression. Manage the reason why he rubs his eyes. Is it an allergy? Could it be his hair is irritating his eyes? Is it eyelashes poking his eyes? Is it mannerism? In kids, the advancement of the condition is more aggressive than adults, so we extensively advise controlling the situation and then contact lens wear. Without cross-linking, the rate of the changing of contact lenses will be higher, as the increased curving (steepening) of the cornea will need an alteration of the contact lens fitting.
Our clinic’s youngest was 9 years old. An ophthalmologist referred him to us for contact lens fitting. His cone was so steep that we cannot fit him with a GP (gas permeable lens) anymore as the lenses pop out. Since he was still young, and the goal is to delay corneal transplant for as long as possible, we fitted him with scleral contact lenses. The scleral lenses allowed him to see well for far and near, which significantly helped his studies. If you think that 9-year-old is too young to wear contact lenses, not really, kids follow instructions well. The safety of contact lens wear is similar to adults, if not better.
Contact lenses for keratoconus patients can improve their self-esteem. Some keratoconus patients feel down due to their blurred vision, so we encourage parents to explore contact lenses for them to wear. These will help your child reach his potential.
There are several contact lens options for keratoconus patients; visit our clinic for an evaluation to know which one will work best for you. We will be with you on this journey.
You can reach us via the following:
- Kankariya VP, Kymionis GD, Diakonis VF, Yoo SH. Management of pediatric keratoconus – evolving role of corneal collagen cross-linking: an update. Indian J Ophthalmol. 2013;61(8):435-440. doi:10.4103/0301-4738.116070
- Sabti S, Tappeiner C, Frueh BE. Corneal Cross-Linking in a 4-Year-Old Child With Keratoconus and Down Syndrome. Cornea. 2015 Sep;34(9):1157-60. doi: 10.1097/ICO.0000000000000491. PMID: 26165788.
- Walline JJ, Lorenz KO, Nichols JJ. Long-term contact lens wear of children and teens. Eye Contact Lens. 2013 Jul;39(4):283-9. doi: 10.1097/ICL.0b013e318296792c. PMID: 23771010.
- Wu Y, Tan Q, Zhang W, Wang J, Yang B, Ma W, Wang X, Liu L. Rigid gas-permeable contact lens-related life quality in keratoconic patients with different grades of severity. Clin Exp Optom. 2015 Mar;98(2):150-4. doi: 10.1111/cxo.12237. Epub 2014 Dec 29. PMID: 25557946.
- Picot C, Gauthier AS, Campolmi N, Delbosc B. Qualité de vie des patients équipés en verres scléraux [Quality of life in patients wearing scleral lenses]. J Fr Ophtalmol. 2015 Sep;38(7):615-9. French. doi: 10.1016/j.jfo.2014.10.018. Epub 2015 May 20. PMID: 26001955.