The loss of vision that occurs with Keratoconus can be devastating for adults, but even more so in children. The eye condition is usually diagnosed during the teenage years, but it can present in children who are much younger. The pediatric form of the disease presents even more challenges since it is often under-diagnosed at early ages and, when it is, there is poor compliance with the recommended treatment. In addition to the physical impact on vision as the disease progresses, it can also have a negative impact on the child's social and educational development.
Treatment during the early stages of the eye disease is typically limited to glasses or contact lenses, with the need to change lens prescriptions increasing in frequency as the progression continues. Once the condition can no longer be controlled in this way, a procedure known as collagen crosslinking may be used to prevent the condition from progressing. After a decade of performing the cross-linking procedure in adults, it has been deemed safe and effective and is now being used to treat pediatric patients as well as adults.
Another modern treatment that is used to treat the eye disease is Keratoconus inserts. During a simple surgical procedure, a small clear disc is placed over the cornea to flatten the cone shape. This procedure is often performed in combination with the collagen crosslinking procedure. In adults, these procedures have proven to be a much safer and more effective alternative to risky corneal transplants. While avoiding a corneal transplant for your child should also be a priority, there are unique characteristics that occur with pediatric Keratoconus that should also guide your decision.
How Keratoconus Varies in Pediatric Patients
According to an article in the Indian Journal of Ophthalmology, the process by which the cornea takes on a cone shape begins well before the diagnosis is made. Those patients who develop the disease earlier in childhood experience a much higher rate and speed of progression. This fact has led to the conclusion that treating patients with pediatric Keratoconus early on may produce greater benefits than waiting until the disease has had time to progress. Children have an even poorer prognosis than adults when a corneal transplant is used to treat the condition. This is one reason that the collagen-crosslinking procedure has gained interest as a treatment for pediatric Keratoconus patients. Another is that the research that has been performed on the use of the procedure in children has shown to be effective without producing any adverse effects.
For parents who must make the decision about the best Keratoconus treatment for their child, experts recommend having the cross-linking process performed immediately after the diagnosis has been made. The results of the procedure are comparable in children when compared with adults, but there is evidence that the procedure may not offer the same long-term stability that is achieved in adults. Still, the potential to require re-treatment down the road is minimal in comparison to postponing initial treatment that could allow the condition to progress and cause damage that cannot be reversed.