{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:39:54Z","timestamp":1790789994701,"version":"4.1.0"},"reference-count":67,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Keratoconus is an ectatic corneal disease that affects both men and women, usually at a young age. Risk factors such as eye rubbing, environmental and genetic factors contribute to its pathogenesis. Keratoconus presents a variable prevalence, being as high as 5% of the population in the Middle East. In this review, an English-language search for keratoconus epidemiology was undertaken using the PubMed database. We present and discuss the findings of the most relevant epidemiological studies on keratoconus and describe its characteristics and risk factors, correlating them with its pathogenesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjopt.sjopt_204_21","type":"journal-article","created":{"date-parts":[[2024,5,20]],"date-time":"2024-05-20T06:29:15Z","timestamp":1716186555000},"page":"3-6","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":76,"title":["Keratoconus epidemiology"],"prefix":"10.4103","volume":"36","author":[{"given":"Jos\u00e9 A. P.","family":"Gomes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo F.","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz L.","family":"Lamazales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-2-20240830","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1097\/ICU.0b013e32832c3be7","article-title":"Advances in anterior segment imaging and analysis","volume":"20","author":"Salom\u00e3o","year":"2009","journal-title":"Curr Opin Ophthalmol"},{"key":"R2-2-20240830","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.jtos.2017.05.003","article-title":"TFOS DEWS II epidemiology report","volume":"15","author":"Stapleton","year":"2017","journal-title":"Ocul Surf"},{"key":"R3-2-20240830","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1038\/eye.2015.63","article-title":"Keratoconus: An inflammatory disorder?","volume":"29","author":"Galvis","year":"2015","journal-title":"Eye (Lond"},{"key":"R4-2-20240830","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1111\/opo.12237","article-title":"Risk factors for keratoconus in Israel: A case-control study","volume":"35","author":"Gordon-Shaag","year":"2015","journal-title":"Ophthalmic Physiol Opt"},{"key":"R5-2-20240830","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/0002-9394(86)90817-2","article-title":"A 48-year clinical and epidemiologic study of keratoconus","volume":"101","author":"Kennedy","year":"1986","journal-title":"Am J Ophthalmol"},{"key":"R6-2-20240830","first-page":"1","article-title":"Clinical and epidemiological features of keratoconus genetic and external factors in the pathogenesis of the disease","volume":"178","author":"Ihalainen","year":"1986","journal-title":"Acta Ophthalmol Suppl"},{"key":"R7-2-20240830","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1111\/j.1600-0420.2007.00981.x","article-title":"Incidence and prevalence of keratoconus in Denmark","volume":"85","author":"Nielsen","year":"2007","journal-title":"Acta Ophthalmol Scand"},{"key":"R8-2-20240830","first-page":"38","article-title":"Epidemiology of keratoconus in the Urals","volume":"114","author":"Gorskova","year":"1998","journal-title":"Vestn Oftalmol"},{"key":"R9-2-20240830","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ajo.2016.12.015","article-title":"Age-specific incidence and prevalence of keratoconus: A nationwide registration study","volume":"175","author":"Godefrooij","year":"2017","journal-title":"Am J Ophthalmol"},{"key":"R10-2-20240830","first-page":"407","article-title":"Prevalence of keratoconus patients in Japan","volume":"89","author":"Tanabe","year":"1985","journal-title":"Nippon Ganka Gakkai Zasshi"},{"key":"R11-2-20240830","first-page":"S307","article-title":"Epidemiology of keratoconus and corneal topography in normal young male subjects","volume":"36","author":"Santiago","year":"1995","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R12-2-20240830","doi-asserted-by":"crossref","first-page":"9","DOI":"10.5005\/jp-journals-10025-1070","article-title":"Prevalence of Keratoconus amoung young Arab students in Israel","volume":"3","author":"Barbara","year":"2014","journal-title":"Int J Keratoconus Ectatic Corneal Dis"},{"key":"R13-2-20240830","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1038\/sj.eye.6700652","article-title":"Influence of ethnic origin on the incidence of keratoconus and associated atopic disease in Asians and white patients","volume":"18","author":"Georgiou","year":"2004","journal-title":"Eye (Lond"},{"key":"R14-2-20240830","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1136\/bjo.2005.074955","article-title":"Incidence and severity of keratoconus in Asir province, Saudi Arabia","volume":"89","author":"Assiri","year":"2005","journal-title":"Br J Ophthalmol"},{"key":"R15-2-20240830","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1097\/ICO.0b013e31823f8d3c","article-title":"Epidemiology of keratoconus in an Iranian population","volume":"31","author":"Ziaei","year":"2012","journal-title":"Cornea"},{"key":"R16-2-20240830","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3109\/09286586.2011.560747","article-title":"Prevalence and associated factors of keratoconus in Jerusalem: A cross-sectional study","volume":"18","author":"Millodot","year":"2011","journal-title":"Ophthalmic Epidemiol"},{"key":"R17-2-20240830","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/00006324-195901000-00002","article-title":"A keratoscopic survey of 13, 395 eyes","volume":"36","author":"Hofstetter","year":"1959","journal-title":"Am J Optom Arch Am Acad Optom"},{"key":"R18-2-20240830","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.ajo.2009.06.024","article-title":"Prevalence and associations of keratoconus in rural maharashtra in central India: The central India eye and medical study","volume":"148","author":"Jonas","year":"2009","journal-title":"Am J Ophthalmol"},{"key":"R19-2-20240830","doi-asserted-by":"crossref","first-page":"e39313","DOI":"10.1371\/journal.pone.0039313","article-title":"Prevalence and associations of steep cornea\/keratoconus in Greater Beijing. The Beijing Eye Study","volume":"7","author":"Xu","year":"2012","journal-title":"PLoS One"},{"key":"R20-2-20240830","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.jfo.2011.03.016","article-title":"Keratoconus screening in a Lebanese students' population","volume":"35","author":"Waked","year":"2012","journal-title":"J Fr Ophtalmol"},{"key":"R21-2-20240830","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1097\/ICO.0b013e3182a0d014","article-title":"Prevalence of keratoconus in a population-based study in Shahroud","volume":"32","author":"Hashemi","year":"2013","journal-title":"Cornea"},{"key":"R22-2-20240830","doi-asserted-by":"crossref","first-page":"385","DOI":"10.3109\/09286586.2013.848458","article-title":"Topographic keratoconus is not rare in an Iranian population: The tehran eye study","volume":"20","author":"Hashemi","year":"2013","journal-title":"Ophthalmic Epidemiol"},{"key":"R23-2-20240830","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1111\/opo.12147","article-title":"The prevalence of keratoconus in a young population in Mashhad, Iran","volume":"34","author":"Hashemi","year":"2014","journal-title":"Ophthalmic Physiol Opt"},{"key":"R24-2-20240830","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.1136\/bjophthalmol-2017-311391","article-title":"Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia","volume":"102","author":"Torres Netto","year":"2018","journal-title":"Br J Ophthalmol"},{"key":"R25-2-20240830","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1146\/annurev-vision-121219-081723","article-title":"Genetic and environmental risk factors for keratoconus","volume":"6","author":"Lucas","year":"2020","journal-title":"Annu Rev Vis Sci"},{"key":"R26-2-20240830","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/0039-6257(84)90094-8","article-title":"Keratoconus and related noninflammatory corneal thinning disorders","volume":"28","author":"Krachmer","year":"1984","journal-title":"Surv Ophthalmol"},{"key":"R27-2-20240830","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.clae.2008.07.001","article-title":"30 years of contact lens prescribing for keratoconic patients in Turkey","volume":"32","author":"Bilgin","year":"2009","journal-title":"Cont Lens Anterior Eye"},{"key":"R28-2-20240830","doi-asserted-by":"crossref","first-page":"753","DOI":"10.3928\/1081597X-20121011-01","article-title":"Progression of keratoconus and efficacy of pediatric [corrected] corneal collagen cross-linking in children and adolescents","volume":"28","author":"Chatzis","year":"2012","journal-title":"J Refract Surg"},{"key":"R29-2-20240830","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.ajo.2012.01.025","article-title":"Scalability and severity of keratoconus in children","volume":"154","author":"L\u00e9oni-Mespli\u00e9","year":"2012","journal-title":"Am J Ophthalmol"},{"key":"R30-2-20240830","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1016\/S0181-5512(04)96213-4","article-title":"Keratoconus: What happens with older patients.?","volume":"27","author":"Pobelle-Frasson","year":"2004","journal-title":"J Fr Ophtalmol"},{"key":"R31-2-20240830","first-page":"2537","article-title":"Baseline findings in the collaborative longitudinal evaluation of keratoconus (CLEK) study","volume":"39","author":"Zadnik","year":"1998","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R32-2-20240830","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/opo.12448","article-title":"High prevalence and familial aggregation of keratoconus in an Iranian rural population: A population-based study","volume":"38","author":"Hashemi","year":"2018","journal-title":"Ophthalmic Physiol Opt"},{"key":"R33-2-20240830","first-page":"842","article-title":"The \u201cforme fruste\u201d of keratoconus","volume":"73","author":"Amsler","year":"1961","journal-title":"Wien Klin Wochenschr"},{"key":"R34-2-20240830","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1097\/ICO.0b013e31817f815a","article-title":"Keratoconus clinical findings according to different age and gender groups","volume":"27","author":"Ertan","year":"2008","journal-title":"Cornea"},{"key":"R35-2-20240830","doi-asserted-by":"crossref","first-page":"1473","DOI":"10.1097\/ICO.0000000000002546","article-title":"Keratoconus prevalence in families: A french study","volume":"39","author":"Lapeyre","year":"2020","journal-title":"Cornea"},{"key":"R36-2-20240830","first-page":"609","article-title":"Hereditary diseases in keratoconus","volume":"159","author":"Laqua","year":"1971","journal-title":"Klin Monbl Augenheilkd"},{"key":"R37-2-20240830","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.clae.2007.03.001","article-title":"Collaborative longitudinal evaluation of keratoconus (CLEK) study: Methods and findings to date","volume":"30","author":"Wagner","year":"2007","journal-title":"Cont Lens Anterior Eye"},{"key":"R38-2-20240830","doi-asserted-by":"crossref","first-page":"7803029","DOI":"10.1155\/2017\/7803029","article-title":"Molecular and histopathological changes associated with keratoconus","volume":"2017","author":"Khaled","year":"2017","journal-title":"Biomed Res Int"},{"key":"R39-2-20240830","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1136\/bjo.2007.124388","article-title":"Oestrogen-induced changes in biomechanics in the cornea as a possible reason for keratectasia","volume":"91","author":"Spoerl","year":"2007","journal-title":"Br J Ophthalmol"},{"key":"R40-2-20240830","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.survophthal.2005.02.005","article-title":"Sex hormone receptors in the human eye","volume":"50","author":"Gupta","year":"2005","journal-title":"Surv Ophthalmol"},{"key":"R41-2-20240830","first-page":"1573","article-title":"Changes in intraocular pressure and central corneal thickness during pregnancy: A systematic review and Meta-analysis","volume":"10","author":"Wang","year":"2017","journal-title":"Int J Ophthalmol"},{"key":"R42-2-20240830","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1007\/s00417-003-0674-0","article-title":"Refractive changes in pregnancy","volume":"241","author":"Pizzarello","year":"2003","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R43-2-20240830","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.jcrs.2018.08.036","article-title":"Late-onset progression of keratoconus after therapy with selective tissue estrogenic activity regulator","volume":"45","author":"Torres-Netto","year":"2019","journal-title":"J Cataract Refract Surg"},{"key":"R44-2-20240830","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.1111\/j.1755-3768.2012.02448.x","article-title":"Keratoconus in 18 pairs of twins","volume":"90","author":"Tuft","year":"2012","journal-title":"Acta Ophthalmol"},{"key":"R45-2-20240830","doi-asserted-by":"crossref","first-page":"8365","DOI":"10.1167\/iovs.14-16115","article-title":"Heritability of corneal shape in twin study","volume":"55","author":"Ambr\u00f3sio","year":"2014","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"R46-2-20240830","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1097\/00003226-199907000-00010","article-title":"Discordance for keratoconus in two pairs of monozygotic twins","volume":"18","author":"McMahon","year":"1999","journal-title":"Cornea"},{"key":"R47-2-20240830","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/S0896-1549(03)00099-3","article-title":"The genetics of keratoconus","volume":"16","author":"Rabinowitz","year":"2003","journal-title":"Ophthalmol Clin North Am"},{"key":"R48-2-20240830","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1038\/sj.eye.6702692","article-title":"The Dundee University Scottish Keratoconus study: Demographics, corneal signs, associated diseases, and eye rubbing","volume":"22","author":"Weed","year":"2008","journal-title":"Eye (Lond"},{"key":"R49-2-20240830","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/OPX.0b013e31828da95c","article-title":"Is consanguinity a risk factor for keratoconus?","volume":"90","author":"Gordon-Shaag","year":"2013","journal-title":"Optom Vis Sci"},{"key":"R50-2-20240830","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1111\/j.1755-3768.2012.02400.x","article-title":"Update on the keratoconus genetics","volume":"91","author":"Nielsen","year":"2013","journal-title":"Acta Ophthalmol"},{"key":"R51-2-20240830","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1038\/eye.2013.278","article-title":"The pathogenesis of keratoconus","volume":"28","author":"Davidson","year":"2014","journal-title":"Eye (Lond"},{"key":"R52-2-20240830","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1097\/ICO.0b013e318198384f","article-title":"Mechanisms of rubbing-related corneal trauma in keratoconus","volume":"28","author":"McMonnies","year":"2009","journal-title":"Cornea"},{"key":"R53-2-20240830","doi-asserted-by":"crossref","first-page":"795738","DOI":"10.1155\/2015\/795738","article-title":"The genetic and environmental factors for keratoconus","volume":"2015","author":"Gordon-Shaag","year":"2015","journal-title":"Biomed Res Int"},{"key":"R54-2-20240830","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1097\/ICO.0b013e3181cb410b","article-title":"The association of keratoconus with immune disorders","volume":"29","author":"Nemet","year":"2010","journal-title":"Cornea"},{"key":"R55-2-20240830","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/cxo.12005","article-title":"Characteristics of 244 patients with keratoconus seen in an optometric contact lens practice","volume":"96","author":"Shneor","year":"2013","journal-title":"Clin Exp Optom"},{"key":"R56-2-20240830","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1097\/ICO.0b013e3180de1e04","article-title":"Evaluation of the corneal topographic characteristics of keratoconus with orbscan II in patients with and without atopy","volume":"26","author":"Kaya","year":"2007","journal-title":"Cornea"},{"key":"R57-2-20240830","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/0021-8707(70)90059-6","article-title":"A study of the occurrence of atopic traits in patients with keratoconus","volume":"46","author":"Lowell","year":"1970","journal-title":"J Allergy"},{"key":"R58-2-20240830","first-page":"991","article-title":"Keratoconus and atopic diseases","volume":"10","author":"Gasset","year":"1978","journal-title":"Ann Ophthalmol"},{"key":"R59-2-20240830","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1016\/j.ophtha.2020.08.020","article-title":"Prevalence of keratoconus based on scheimpflug imaging: The raine study","volume":"128","author":"Chan","year":"2021","journal-title":"Ophthalmology"},{"key":"R60-2-20240830","doi-asserted-by":"crossref","first-page":"1493","DOI":"10.1016\/j.jcrs.2011.03.040","article-title":"Computerized corneal tomography and associated features in a large New Zealand keratoconic population","volume":"37","author":"Jordan","year":"2011","journal-title":"J Cataract Refract Surg"},{"key":"R61-2-20240830","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1007\/s004179900111","article-title":"Manifest diabetes and keratoconus: A retrospective case-control study","volume":"238","author":"Seiler","year":"2000","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"R62-2-20240830","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1016\/j.ophtha.2005.10.009","article-title":"Is there an association between diabetes and keratoconus?","volume":"113","author":"Kuo","year":"2006","journal-title":"Ophthalmology"},{"key":"R63-2-20240830","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1097\/ICO.0000000000000167","article-title":"Another look at the association between diabetes and keratoconus","volume":"33","author":"Kosker","year":"2014","journal-title":"Cornea"},{"key":"R64-2-20240830","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1097\/ICO.0000000000000623","article-title":"Group of Panelists for the Global Delphi Panel of Keratoconus and Ectatic Diseases. Global consensus on keratoconus diagnosis","volume":"34","author":"Gomes","year":"2015","journal-title":"Cornea"},{"key":"R65-2-20240830","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1016\/S0161-6420(91)32070-0","article-title":"Keratoconus associated with floppy eyelid syndrome","volume":"98","author":"Donnenfeld","year":"1991","journal-title":"Ophthalmology"},{"key":"R66-2-20240830","doi-asserted-by":"crossref","first-page":"382","DOI":"10.4103\/0301-4738.116054","article-title":"Epidemiology of keratoconus","volume":"61","author":"Gokhale","year":"2013","journal-title":"Indian J Ophthalmol"},{"key":"R67-2-20240830","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s00063-004-1086-6","article-title":"Concomitant diseases in primary joint hypermobility syndrome","volume":"99","author":"Skoumal","year":"2004","journal-title":"Med Klin (Munich"}],"container-title":["Saudi Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/sjopt.sjopt_204_21","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:37:26Z","timestamp":1787769446000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/sjopt.sjopt_204_21"}},"subtitle":["A review"],"short-title":[],"issued":{"date-parts":[[2022,1]]},"references-count":67,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/sjopt.sjopt_204_21","relation":{},"ISSN":["1319-4534"],"issn-type":[{"value":"1319-4534","type":"print"}],"subject":[],"published":{"date-parts":[[2022,1]]}}}