Self-reported prevalence and risk factors associated with keratoconus among the adult population of Trinidad and Tobago: a cross-sectional study

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Abstract
Aim To determine the prevalence of keratoconus and its associated risk factors within the adult population of Trinidad and Tobago. Method A population-based cross-sectional study was conducted among adults in Trinidad and Tobago, utilizing the Keratoconus Risk Assessment Questionnaire (KRIS) for data collection. Data were exported to the Statistical Package for Social Sciences (SPSS) version 27 for analysis. Descriptive statistics were employed to summarize the variables, while logistic regression was used to identify associated risk factors, with a significance level set at p < 0.05. Results A total of 413 participants were included in the study, yielding a response rate of 97.4% (413/424). The prevalence of keratoconus (KC) was 1.5% (95% CI: 0.33 – 2.67%). The condition was more prevalent among females (98.5%), individuals aged 19–30 years (66.7%), and participants of mixed race (50%). Allergic or atopic diseases were identified as the most common established risk factor for KC, affecting 50.1% of all participants. Among those diagnosed with KC, eye rubbing emerged as the most common established risk factor. Family history of KC (95% CI: 1.841–48.352, p < 0.007) and the use of rigid contact lenses (95% CI: 8.696–286.051, p < 0.001) were statistically significant predictors of KC. Specifically, participants with a family history of KC were 49.8 times more likely to develop the condition (OR = 49.875), while those using rigid contact lenses were 9.4 times more likely (OR = 9.436). Conclusion The prevalence of KC in Trinidad and Tobago was found to be significant. Among the identified risk factors, atopy was the most common. Additionally, a positive family history and the use of rigid contact lenses were significant predictors of KC. Early screening for keratoconus in this country is strongly recommended to facilitate prompt detection and appropriate management of the condition.

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