Prevalence and risk factors of keratoconus among school children in Oman: a population-based study

To investigate the prevalence and risk factors of keratoconus (KC) among Omani school children. The cross-sectional, population-based, descriptive design study assessed a cohort of school students, aged 9 to 18 years from the Al Buraimi Governorate of Sultanate of Oman. They underwent comprehensive ocular examination, including auto-kerato-refractometry (ARK), retinoscopy, and corneal topography. Firth’s penalized (bias-reduced) logistic regression was used to identify independent predictors of KC and keratoconus suspect (KCS) status. A total of 733 students participated (mean age 13.95 ± 2.19 years) and 67.4% were males. The prevalence of KC was 1.6% (95% CI: 0.85% – 2.84%), and 5.0% (95% CI: 3.58% – 6.89%) were classified as keratoconus suspect (KCS). Frequent eye rubbing (OR = 12.89, 95% CI: 3.45–70.12; p < 0.001) and parental consanguinity (OR = 14.74, 95% CI: 3.36–138.98; p < 0.001) were significant independent predictors of KC (model AUC = 0.91). No covariate was independently associated with KCS status after adjustment (model AUC = 0.60). Keratoconus prevalence in this Omani school-age cohort is consistent with reports from the Middle East and, confirms a higher burden than in Western populations. Consanguinity and frequent eye rubbing as significant predictors of KC emphasize the value of genetic counselling and risk-factor awareness.