RT Journal Article SR Electronic T1 Prevalence of keratoconus in paediatric patients in Riyadh, Saudi Arabia JF British Journal of Ophthalmology JO Br J Ophthalmol FD BMJ Publishing Group Ltd. SP 1436 OP 1441 DO 10.1136/bjophthalmol-2017-311391 VO 102 IS 10 A1 Emilio Almeida Torres Netto A1 Wafa Majed Al-Otaibi A1 Nikki L Hafezi A1 Sabine Kling A1 Haya M Al-Farhan A1 J Bradley Randleman A1 Farhad Hafezi YR 2018 UL http://bjo.bmj.com/content/102/10/1436.abstract AB Background/aim Keratoconus (KC) is a ectatic corneal disorder with marked progression during childhood and puberty that may lead to severe visual loss. In addition to KC prevalence, estimate shows major geographical variations; recent studies using Scheimpflug technology are in contrast to the 1980s and 1990s literature. The present study aims to determine the prevalence of KC in paediatric patients in Riyadh, Saudi Arabia (KSA).Methods This prospective, cross-sectional, observational, multicentre study collected data from paediatric patients from 6 years and 21 years of age who were seen at multiple non-ophthalmic emergency departments within KSA. Bilateral corneal measurements were performed using a rotational Scheimpflug corneal tomography system. Two masked examiners established the diagnosis of KC using both objective and subjective screening criteria. Cohen’s kappa coefficient (κ) was used to qualitatively analyse the interexaminer agreement.Results There were 522 patients (1044 eyes) evaluated, with an average age of 16.8±4.2 years (range 6–21 years). KC prevalence was 5.56% for examiner 1 and 3.83% for examiner 2. The κ was 0.81 (almost perfect agreement), with discrepancy in nine cases, which were jointly evaluated and consensus obtained. Final KC prevalence was 4.79% (95% CI 2.96 to 6.62) or 1:21 patients.Conclusions The prevalence of KC among paediatric patients in the KSA is considerably higher than numbers reported from earlier studies and from similar studies in other countries. This increase might be due to geographical variations in disease prevalence or due to the ability of screening technology to detect undiagnosed KC with greater accuracy.