Ron Jans Clinical Cornea Research Award: Rise in the Incidence of Severe Pediatric Blepharokeratoconjunctivitis During the Covid 19 pandemic
Authors: Asim Ali 1, Ramez Barbara1, Sina Khalili2, Kamiar Mireskandari1. 1Hospital for Sick Children and University of Toronto, 2Hospital for Sick Children.
Author Disclosures: A. Ali: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); Santen Inc.. Any direct financial payments including receipt of honoraria; Description of relationship(s); Consultant. Funded grants or clinical trials; Name of for-profit or not-for-profit organization(s); Novartis. Funded grants or clinical trials; Description of relationship(s); Educational grant. R. Barbara: None. S. Khalili: None. K. Mireskandari: Any direct financial payments including receipt of honoraria; Name of for-profit or not-for-profit organization(s); Santen Inc.. Any direct financial payments including receipt of honoraria; Description of relationship(s); Speaker., Asim Ali: Not Current Ramez Barbara: Not Current Sina Khalili: Not Current Kamiar Mireskandari: Not Current
Abstract Body:
Purpose: Blepharokeratoconjunctivitis (BKC) is a chronic inflammatory disease of the lid margin with secondary conjunctival and corneal involvement, which may lead to irreversible vision loss. A history of recurrent chalazia is associated with BKC and a rise in the incidence of chalazia has been reported and linked to mask use since the emergence of the COVID-19 pandemic. Our aim was to assess the number of new presentations of severe BKC during the COVID-19 pandemic.
Study Design: A retrospective chart review of all patients under the age of 18 years old with severe BKC was performed between March 2010 and March 2022 at the Hospital for Sick Children, a tertiary referral paediatric hospital in Toronto, Ontario, Canada.
Methods: Institutional research ethics board approval was obtained. We defined severe BKC as corneal inflammation, new vessel formation, scarring, thinning and lipid deposits. Patients with only mild epitheliopathy and peripheral pannus were excluded. We only included patients with corneal complications secondary to severe BKC. The statistical analysis was conducted using a Poisson regression model using the R Project Program version 4.0.5. Results: A total of 257 children (161 females and 96 males) with severe BKC were included with an average age of 8 years at presentation. Since March 2020 there was a significant rise in the number of children presenting with severe BKC compared to the previous 10 years (IRR of 3.03, 95% confidence interval (CI) 2.35-3.89, p-value <0.001).
Conclusions: A tripling in the rate of new BKC presentations over the pandemic period is of concern and clinicians should be aware to aid early recognition and treatment of the disease to prevent vision loss. An increase in mask use is considered to be most important associated factor and warrants further research.
