Incidence and Prevalence of Keratoconus Rises Globally

Within the past decade, the incidence and prevalence of keratoconus have risen significantly, affecting male patients, younger populations and geographic regions such as Africa, West Asia and South Asia. Photo: Brian Chou, OD, and Jerome Legerton, OD. Click image to enlarge. Diagnostic technology has advanced greatly over the years, allowing clinicians to identify ocular diseases and abnormalities such as keratoconus earlier and more effectively. This surge in diagnostic breakthroughs has allowed researchers to more precisely determine the rates of conical corneas among larger populations. Since the incidence of keratoconus has not been analyzed through a systemic literature synthesis using multiple datasets, researchers from Canada conducted a study to outline current incidence and prevalence trends on a global scale.Researchers examined results from 55 studies collected from various databases. They determined both the incidence and prevalence among different age groups, sexes and geographic regions. Additionally, they reported on the years when keratoconus rates spiked between 1959 and 2023.Findings published in Cornea highlighted an increase in keratoconus rates around the world. The highest prevalence rate was reported post-2020, with 1,155.2 people diagnosed per 100,000. Prior to then (2015 to 2019), the highest incidence rate reported was just 15.2 newly diagnosed individuals per 100,000. Interestingly, studies from 2015 to 2019 reported a significant drop in prevalence (266.7 per 100,000), with rates from 2010 to 2014 reporting nearly double the number of cases (446.8 per 100,000).“There was a dip seen in the 2015 to 2019 period, which included the largest number of studies,” explained the authors in their paper. “This could be explained by sampling variability, wherein the largest number of studies reported prevalence between 2015 and 2019. This may have provided a more accurate representation of true prevalence, adjusting for overestimations in other periods.”Besides an increase to the global burden of keratoconus in recent years, this study highlighted how rates impact various groups. Overall, the incidence of this condition was four newly diagnosed patients per 100,000, and the prevalence was 289.1 diagnosed patients per 100,000. Male patients were determined to have higher odds of keratoconus compared to female patients. Individuals in the 20 to 29 age group were found to be the most affected by this condition, posting the highest prevalence (525.5 per 100,000) and incidence (20.8 per 100,000) among all other age groups.To determine the prevalence of keratoconus globally, researchers examined data by continent and subregion. Africa had the highest prevalence rate, with 2,414.3 diagnosed patients per 100,000. Europe had the lowest rate, with 36.9 diagnosed patients per 100,000. Asia had the most significant difference in prevalence when divided into subregions. The highest rates were found in West (682 per 100,000) and South Asia (1,374.5 per 100,000), and the lowest rate was found in East Asia (12.7 per 100,000). Incidence rates for Africa and North America were not reported in the examined studies; therefore, researchers could not determine these rates in their analysis.“These findings highlight the need for targeted screening programs, resource allocation for keratoconus management and increased awareness, particularly in high-prevalence regions and among young adults,” concluded the authors in their study. “Future studies should understand the causes of geographic and temporal variations in keratoconus prevalence, which can aid in improving prevention and treatment strategies.”Click here for the journal source. Sriranganathan A, Chan C, Dhillon J, et al. Global incidence and prevalence of keratoconus: A systematic review and meta-analysis. Cornea. August 20, 2025. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.