Factors Associated with Pediatric Keratoconus - A Population-Based Nested Case-Control Study.

Authors

Or Ben-Shaul, Sharon Schwartz, Adi Segal, Nili Stein, Michael Hyams, Michael Mimouni

Published in

Ophthalmic epidemiology. Pages 1-8. Jul 31, 2026. Epub Jul 31, 2026.

Abstract

This study aimed to assess factors associated with pediatric keratoconus in a large, population-based cohort.
This retrospective population-based nested case-control study utilized data from "Clalit" healthcare provider, Israel's largest. The records of patients diagnosed with keratoconus before age 18 between 2005 and 2020 were reviewed. Demographic data, socioeconomic status, smoking habits, and the presence of systemic conditions that may be linked with keratoconus were collected and analyzed. Univariable and multivariable conditional logistic regression were employed to identify the factors associated with the development of keratoconus.
Overall, 1953 pediatric keratoconus patients with a mean age of 14.2 years of which 60.8% were male were included. There were 19,530 age-matched healthy subjects in the control group. In multivariable analysis, male gender (OR = 1.54, p < 0.001), asthma (OR = 1.41, p < 0.001), intellectual disability (OR = 2.39, p < 0.001), atopic dermatitis (OR = 1.39, p < 0.001), and allergy (OR = 1.28, p < 0.001) were significantly associated with pediatric keratoconus. Smoking (OR = 0.73, p = 0.007), middle socioeconomic status (SES) (OR = 0.71, p = 0.001), and high SES (OR = 0.57, p = 0.001) were inversely associated with pediatric keratoconus. Diabetes mellitus showed no significant association with keratoconus risk (OR = 1.01, 95% CI: 0.40-2.58, p = 0.982).
Male gender, asthma, intellectual disability, allergy, and atopic dermatitis were linked with increased risk, while smoking, middle SES, and high SES were inversely associated with pediatric keratoconus. These findings provide valuable insights into possible areas of focus for early detection and preventative interventions in high-risk populations.

PMID:
42536967
Bibliographic data and abstract were imported from PubMed on 01 Aug 2026.

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