This study evaluated the prevalence of blepharokeratoconjunctivitis (BKC) and prevalence of amblyopic risk factors with comparison of these rates to rates in the general US paediatric population. The authors evaluated the rate of patient reported symptoms in patients with and without corneal changes with BKC. This was a single-centre retrospective study of 381 children. Ten (2.6%) had ≥1 chalazia and BKC with active corneal disease including corneal neovascularisation, infiltrate and/or ulceration. Relative risk was 445 compared to the general paediatric ocular surface inflammatory disease rate of 0.006%. Patient reported signs and symptoms included eye pain, redness, photophobia and blurred vision. Using these signs and symptoms as a screening tool for presence of corneal changes with BKC, sensitivity was 90% and specificity 71.5%. Using presence of multiple chalazia as a screening tool, sensitivity was 30% and specificity was 71.5%. Chalazion and visual significant refractive error occurred in 10% of patients <4 years of age and 22% of those aged 4–9 years. Relative risk for significant refractive error with chalazia was 1.78 and 1.90 for both age groups respectively. The authors conclude the rate of corneal changes associated with BKC in children is higher than the general population but low in chalazion cohorts. Symptoms are those that can be ascertained by case history questions. Associations exist for refractive error in children aged 4–9 years and remote visual acuity screening should be considered for these. Thus, telehealth can be of use as an alternative to in-person assessment of such cases.
Risks to visual function from blepharokeratoconjunctivitis
Reviewed by Fiona Rowe
Prevalence of blepharokeratoconjunctivitis and refractive amblyopia risk factors in children with chalazia: safety considerations in telehealth management.
CONTRIBUTOR
Fiona Rowe (Prof)
Institute of Population Health, University of Liverpool, UK.
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