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. 2025 Nov 1;44(11):1440-1449.
doi: 10.1097/ICO.0000000000003940. Epub 2025 Aug 5.

Keratoconus in Sub-Saharan Africa: A Scoping Review

Angeline Rivkin  1   2 , Haley S D'Souza  1 , Larry Prokop  3 , Ashlie A Bernhisel  1
Affiliations

Keratoconus in Sub-Saharan Africa: A Scoping Review

Angeline Rivkin et al. Cornea. .

Abstract

Purpose: To assess the prevalence, associated conditions, diagnostic and treatment modalities, and provider education regarding the diagnosis and management of keratoconus (KCN) in sub-Saharan Africa (SSA) based on the currently available body of literature.

Methods: Peer-reviewed publications from any year and any language were included. The databases included Cochrane Database of Systematic Reviews, Embase, and Ovid. A separate search of African Journals Online was conducted using the same Medical Subject Heading (MeSH) terms as the database search. Additional publications were identified in the references during full-text extraction. The abstracts of all publications were evaluated by two reviewers. The full text was then examined by one reviewer for inclusion. A data extraction tool was used by a single reviewer to document the findings.

Results: Sixty-two publications were included in data extraction. Fourteen countries in SSA were represented. Prevalence was reported in eight SSA countries and ranged from 0% to 2.8%. The highest prevalence of 1.2% was found in a cross-sectional study in Banjul, Gambia. Diagnosis in urban areas is often made using slit lamps, although some sites had access to keratometry and/or topography, whereas rural areas use penlight exams alone. Penetrating keratoplasty was reported as an available treatment in 14 manuscripts, glasses and hard contact lenses in 10, and corneal cross-linking in two. Publications discussing provider education reported a knowledge gap.

Conclusions: There is a need for increased data on KCN in SSA to better inform public health policy to improve KCN patients' access to care and quality of life.

Keywords: corneal blindness; keratoconus prevalence; low-and-middle-income countries; public health.

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Conflict of interest statement

The authors have no funding or conflicts of interest to disclose.

References

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    1. JBI. Templates for Scoping Reviews. JBI; 2017. Available at: jbi.global/scoping-review-network/resources Accessed August 18, 2023.

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