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Pediatric corneal data show geographic gaps
A review of more than 46,000 children highlights uneven population representation and inconsistent measurement methods, raising questions about the applicability of existing reference values.
To review pediatric reference data for corneal thickness, curvature, and diameter, including demographic variation, geographic representation, and measurement methods.
Approach:
Review design: Scoping review of studies published from January 2000 through December 2024; 28 studies involving more than 46,000 healthy children younger than 18 years met inclusion criteria.
Measures assessed: The review examined central corneal thickness, curvature, and diameter, as well as differences by age, sex, race or ethnicity, and geographic location.
Key Findings:
Central corneal thickness was assessed in 25 studies involving more than 28,000 children; findings on age-related and sex-related differences were inconsistent.
Studies generally reported thinner corneas among Black children than White children, while findings across other ethnic groups varied.
Corneal curvature and diameter were generally relatively stable in childhood, but some studies reported age- or sex-related differences.
Only one study examined racial or ethnic differences in curvature, and none evaluated such differences in corneal diameter.
Seventeen of 28 studies were conducted in Asia. African populations were represented by two studies with comparatively small samples.
Measurement technologies and reporting practices varied, limiting direct comparisons across studies.
Interpretation:
The authors stated that demographic, methodological, and geographic factors influence interpretation of pediatric corneal measurements and that current evidence has limited generalizability across diverse populations.
Limitations:
Most studies were cross-sectional, limiting assessment of corneal development over time.
Differences in measurement technologies, age classifications, demographic reporting, and eye laterality complicated comparisons.
Geographic representation was uneven, and the review included only English-language publications.
Conclusion:
The authors called for standardized measurement and reporting procedures and longitudinal studies involving more geographically and ethnically diverse pediatric populations.
