{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T12:53:08Z","timestamp":1785761588114,"version":"3.56.0"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>Purpose: Keratoconus is a progressive corneal ectatic disorder that causes visual impairment, particularly in adolescents and young adults. Evidence on its epidemiology in Latin America and the Caribbean remains limited. This study aimed to estimate the prevalence of keratoconus and evaluate associated factors, including eye rubbing, sex, family history, and allergy history, in the region. Methods: A systematic search of PubMed, Scopus, PsycINFO, and Google Scholar was conducted on 15 December 2025 for observational studies published up to December 2025. Study selection and data extraction were performed independently by two reviewers, with disagreements resolved by consensus. Study quality was assessed using the Newcastle\u2013Ottawa Scale. Pooled prevalence estimates and odds ratios (ORs) were calculated using a random-effects model with variance-stabilizing transformation. Heterogeneity was assessed using the I2 statistic, and publication bias was explored using funnel plots and Egger\u2019s test. Results: Seven prevalence studies were included in the primary meta-analysis following exclusion of three studies from the previous version of the review, with no additional eligible prevalence studies identified in the updated search. One additional nationwide registry-based study from Colombia was identified but excluded from the primary prevalence synthesis because it reported incidence derived from administrative diagnostic coding rather than clinically assessed prevalence. Among the seven prevalence studies, reported prevalence ranged from 0.50% to 2.88%. The pooled prevalence of keratoconus was 2.07% (95% CI: 1.53\u20132.79), with substantial heterogeneity (I2 = 71.9%). Subgroup analyses suggested that prevalence estimates varied by study design, with lower estimates observed in community- and school-based studies and higher estimates in clinic-based studies. No statistically significant associations were identified for eye rubbing, sex, family history, or allergy history; however, these analyses should be interpreted cautiously due to small sample sizes, heterogeneous exposure definitions, and wide confidence intervals. Conclusions: Keratoconus prevalence estimates in Latin America and the Caribbean remain variable and should be interpreted cautiously due to substantial heterogeneity, differences in study design, variability in diagnostic criteria, and differences in case ascertainment. The findings highlight important evidence gaps and support the need for well-designed population-based studies using standardized diagnostic criteria to inform screening strategies, early detection, and eye-care planning in the region.<\/jats:p>","DOI":"10.3390\/vision10030049","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T11:50:21Z","timestamp":1785757821000},"page":"49","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence and Associated Factors of Keratoconus in Latin America and the Caribbean: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3881-7502","authenticated-orcid":false,"given":"Kingsley","family":"Ekemiri","sequence":"first","affiliation":[{"name":"Department of Optometry, Faculty of Health Sciences, Abia State University, Uturu P.M.B. 2000, Nigeria"},{"name":"Optometry Unit, Department of Clinical Surgical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, St Augustine City P.O. Box 139, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chioma","family":"Ekemiri","sequence":"additional","affiliation":[{"name":"School of Nursing, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, St Augustine City P.O. Box 139, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5444-9970","authenticated-orcid":false,"given":"Deo","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Caribbean Eye Institute, Igneri Road, Valsayn City 0000, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin","family":"Seemongal-Dass","sequence":"additional","affiliation":[{"name":"Ophthalmology Unit, Department of Clinical Surgical Sciences, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, St Augustine City P.O. Box 139, Trinidad and Tobago"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melkamu Temeselew","family":"Tegegn","sequence":"additional","affiliation":[{"name":"Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar P.O. Box 196, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Hartman","sequence":"additional","affiliation":[{"name":"Department of Optometry, Eye Q Stylist Optician, Bridgetown City BB11000, Barbados"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2223-1313","authenticated-orcid":false,"given":"Genalin","family":"Ang","sequence":"additional","affiliation":[{"name":"Department of Optometry, Faculty of Health Sciences, University of Guyana, Georgetown City P.O. Box 101110, Guyana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0160-0809","authenticated-orcid":false,"given":"Onohomo","family":"Adebo","sequence":"additional","affiliation":[{"name":"Department of Optometry, Faculty of Health Sciences, University of Guyana, Georgetown City P.O. Box 101110, Guyana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obinna","family":"Awiaka","sequence":"additional","affiliation":[{"name":"The Office of the Registrar, Optometrists and Dispensing Opticians Registration Board of Nigeria, Abuja City 900101, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obinna","family":"Ebere","sequence":"additional","affiliation":[{"name":"Department of Optometry, Faculty of Health Sciences, Abia State University, Uturu P.M.B. 2000, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oluwasola Michael","family":"Ojo","sequence":"additional","affiliation":[{"name":"Department of Optometry & Vision Science, Faculty of Health Sciences, University of Ilorin, Ilorin City P.M.B. 1515, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2751-6127","authenticated-orcid":false,"given":"Chigozie John","family":"Ekenze","sequence":"additional","affiliation":[{"name":"Department of Optometry, Faculty of Health Sciences, Imo State University, Owerri P.M.B. 2000, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"101559","DOI":"10.1016\/j.clae.2021.101559","article-title":"Keratoconus: An updated review","volume":"45","author":"Carracedo","year":"2022","journal-title":"Contact Lens Anterior Eye"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/s41572-024-00565-3","article-title":"Keratoconus","volume":"10","author":"Singh","year":"2024","journal-title":"Nat. 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