Title: The Demographic Burden of Pediatric Blepharokeratoconjunctivitis (BKC)

Introduction: Risk factors for pediatric blepharokeratoconjunctivitis (BKC) and its outcomes are poorly characterized. This large multicenter retrospective study aims to determine risk factors for a poor outcome for patients with pediatric BKC.

Question: Are there identifiable risk factors associated with worse initial presentation of pediatric BKC?

Aims: To characterize the demographics and presenting vision of patients with pediatric BKC.

Methods: A retrospective, multi-center case series of 493 pediatric patients with BKC between 2011-2022. Demographics of all pediatric patients seen by the ophthalmology departments were also collected.

Results: Patients with BKC presented at mean age of 8 ± 4 yrs. 59% were female. Mean distance between study site and patient home was 44 ± 127 mi. Mean presenting best visual acuity was 20/40 OU. Larger distance corresponded to worse initial visual acuity (P < .05). Compared to the general pediatric ophthalmology population, patients with BKC were more likely to be Spanish-speaking, Hispanic, and have public health insurance (all P < .001). These risk factors were also associated with younger presentation (all P < .01).

Conclusion: Compared to the general pediatric ophthalmology population, patients with BKC are more likely to be Spanish-speaking, Hispanic, and have public insurance. Within the BKC population, these are the same risk factors for younger presentation. Further distance from institution is associated with worse initial visual acuity.