Prevalence And Pattern Of Keratoconus In Adult Population In Aswan Governorate

Abstract

Background: Keratoconus (KC) is a progressive corneal ectasia that causes thinning, steepening, and irregular astigmatism, with variable prevalence across ethnicities and geographic regions.

Objective: To assess the prevalence and pattern of KC in adults in Aswan Governorate and compare findings between Nubian and non-Nubian populations.

Methods: This community-based cross-sectional study included 976 participants aged 18–30 years from randomly selected Nubian and non-Nubian villages. Participants underwent visual acuity testing, auto-refraction, cycloplegic refraction, slit-lamp examination, and corneal tomography (Pentacam). KC was diagnosed based on corneal topography and tomography, and classified by Amsler–Krumeich criteria. Demographic, medical, and family history data were recorded. Statistical analysis was performed using SPSS 25, with p < 0.05 considered significant.

Results: KC was identified in 93 participants, yielding an overall prevalence of 9.5%. Prevalence was higher among Nubians (11.9%) than non-Nubians (8.6%). Astigmatism was the most common refractive error in KC eyes, followed by myopia, with significant ethnic differences in distribution (p < 0.001). KC prevalence increased with age and was significantly associated with positive medical history (p = 0.046) and family history of KC. Most cases were early-stage (Stages 1–2), and corneal thickness decreased progressively with KC severity. Nubian eyes exhibited greater posterior corneal elevation and decentration.

Conclusion: Keratoconus is highly prevalent in young adults in Aswan, with notable ethnic variations in corneal morphology and refractive patterns. Early detection and targeted screening are essential, particularly in populations with higher genetic susceptibility.