Pediatric keratoconus progresses faster and more aggressively than adult-onset cases. Early detection and treatment prevents years of vision loss. CHOC and UCI Medical Center referral center.
- CHOC Referral Center
- Pediatric Scleral Lens Fitting
- Cross-Linking Coordination
- Ages 8+ Treated
- 35+ Years Experience
- Insurance Accepted
Medically Reviewed by Dr. Alexander Bonakdar, O.D.
Why Keratoconus in Children Requires Urgent Attention
Keratoconus typically begins during puberty (ages 10–15) and progresses most rapidly during the teenage years. In children, the disease is often more aggressive than in adults — corneal thinning and steepening can advance quickly, sometimes within months rather than years.
Research published in the British Journal of Ophthalmology found that patients diagnosed before age 15 have a significantly higher risk of requiring corneal transplant if cross-linking is not performed early. Children also face a unique challenge: they may not realize their vision is abnormal because they have never experienced normal sight.
At the Keratoconus Vision Center, Dr. Bonakdar regularly treats pediatric patients referred from CHOC (Children's Hospital of Orange County) and UCI Medical Center — families who need a specialist experienced in fitting scleral lenses on young eyes and coordinating early cross-linking.
Pediatric vs. Adult Keratoconus
Warning Signs Parents Should Watch For
If your child shows any of these signs, a keratoconus screening is recommended.
Frequent prescription changes
New glasses or contacts needed every few months — the most common early indicator in children.
Chronic eye rubbing
Present in over 90% of pediatric keratoconus cases. Often linked to allergies or habitual behavior.
Squinting or head tilting
Children compensate for distorted vision by changing their viewing angle.
Difficulty seeing the whiteboard
Teachers may notice the child struggling before parents do. Academic performance often declines.
Light sensitivity
Complaints about bright lights, glare from screens, or difficulty with outdoor activities.
One eye significantly worse
Asymmetric vision — one eye may need a much stronger prescription than the other.
Family history matters: If a parent has keratoconus, each child has a ~10% chance of developing it. Screening with corneal topography should begin by age 10.
Treatment Approach for Children
Detect Early
Corneal topography screening identifies keratoconus before significant vision loss occurs. Recommended for all children with risk factors by age 10.
Stop Progression
Corneal cross-linking halts keratoconus in its tracks. In children, early CXL preserves more corneal tissue and prevents the need for transplant.
Restore Vision
Scleral lenses fitted to the stabilized cornea restore clear vision — allowing children to read, play sports, and succeed in school.
The Eye Rubbing Connection
Chronic eye rubbing is present in over 90% of pediatric keratoconus patients. The mechanical force weakens corneal collagen fibers and accelerates thinning.
Children rub their eyes for many reasons: allergies (itchy eyes), eczema, habitual behavior, screen fatigue, or sleeping face-down. Managing the underlying cause is a critical part of treatment.
What Parents Can Do
- •Treat allergies aggressively (antihistamine drops, oral medication)
- •Teach the "press, don't rub" technique for itchy eyes
- •Monitor and gently redirect eye rubbing behavior
- •Address eczema around the eyes with dermatology support
- •Encourage back-sleeping instead of face-down
90%+
of pediatric keratoconus patients rub their eyes chronically
Source: Navel et al., Clinical Ophthalmology, 2019
Understanding Keratoconus
Learn about keratoconus diagnosis, treatment options, and what to expect from specialty contact lens management.
Understanding Your Keratoconus Diagnosis: Causes, Symptoms & Treatment Options
Insurance Plans We Accept
We work with most major vision and medical insurance providers to maximize your benefits.
Vision Plans
- VSP (Vision Service Plan)
- EyeMed
- Davis Vision
- Spectera
- Superior Vision
- Avesis
Medical Plans
- Medicare
- Blue Shield of California
- Anthem Blue Cross
- United Healthcare
- Cigna
- Aetna
- Tricare
*Medical insurance is often used for medically necessary contact lenses.
Concerned About Your Child's Vision?
Schedule a pediatric keratoconus evaluation. Corneal topography screening takes 15 minutes and can detect keratoconus before vision is significantly affected.
Call us: (714) 558-0641
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