Keratoconus prevalence in astigmatic adolescents
Reviewed by Ivan Yip

The authors from Israel performed a cross-sectional study of 896,377 adolescents aged 16–20 years who underwent refraction and topography/tomography between 2011 and 2022. A total of 1886 (0.21%) were diagnosed with keratoconus with increasing astigmatism level being strongly associated with keratoconus prevalence: 0.1% for 0.75-<2.00D to 17.4% for >5.00D. Each 1 dioptre increase in cylinder power above 2.00D was linked to a 1.76-fold increase in keratoconus odds. This is one of the largest studies to date to help identify early keratoconus. Although stopping short of recommending an astigmatism level for screening, the authors suggest that children with high astigmatism with any risk factors for keratoconus could form a screening cohort.

Keratoconus prevalence in astigmatic adolescents: findings from a nationwide screening setting.
Safir M, Nitzan I, Hanina Y, et al.
EYE 
2025;39:2958–62.