TY  - JOUR
SP  - 39
VL  - 142
Y1  - 2023/12/21/
AV  - public
N1  - This version is the author accepted manuscript. For information on re-use, please refer to the publisher?s terms and conditions.
TI  - Definition and Diagnostic Criteria for Pediatric Blepharokeratoconjunctivitis
N2  - Importance: Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic, sight-threatening inflammatory ocular surface disease. Due to the lack of unified terminology and diagnostic criteria, nonspecific symptoms and signs, and the challenge of differentiation from similar ocular surface disorders, PBKC may be frequently unrecognized or diagnosed late. Objective: To establish a consensus on the nomenclature, definition, and diagnostic criteria of PBKC. Design, Setting, and Participants: This quality improvement study used expert panel and agreement applying the non-RAND modified Delphi method and open discussions to identify unified nomenclature, definition, and definitive diagnostic criteria for PBKC. The study was conducted between September 1, 2021, and August 14, 2022. Consensus activities were carried out through electronic surveys via email and online virtual meetings. Results: Of 16 expert international panelists (pediatric ophthalmologists or cornea and external diseases specialists) chosen by specific inclusion criteria, including their contribution to scientific leadership and research in PBKC, 14 (87.5%) participated in the consensus. The name proposed was "pediatric blepharokeratoconjunctivitis," and the agreed-on definition was "Pediatric blepharokeratoconjunctivitis is a frequently underdiagnosed, sight-threatening, chronic, and recurrent inflammatory eyelid margin disease associated with ocular surface involvement affecting children and adolescents. Its clinical spectrum includes chronic blepharitis, meibomitis, conjunctivitis, and corneal involvement ranging from superficial punctate keratitis to corneal infiltrates with vascularization and scarring." The diagnostic criteria included 1 or more suggestive symptoms accompanied by clinical signs from 3 anatomical regions: the eyelid margin, conjunctiva, and cornea. For PBKC suspect, the same criteria were included except for corneal involvement. Conclusions and Relevance: The agreements on the name, definition, and proposed diagnostic criteria of PBKC may help ophthalmologists avoid diagnostic confusion and recognize the disease early to establish adequate therapy and avoid sight-threatening complications. The diagnostic criteria rely on published evidence, analysis of simulated clinical cases, and the expert panel's clinical experience, requiring further validation with real patient data analysis.
UR  - http://dx.doi.org/10.1001/jamaophthalmol.2023.5750
ID  - discovery10191374
PB  - AMER MEDICAL ASSOC
EP  - 47
A1  - Morales-Mancillas, Nallely R
A1  - Velazquez-Valenzuela, Fabiola
A1  - Kinoshita, Shigeru
A1  - Suzuki, Tomo
A1  - Dahlmann-Noor, Annegret H
A1  - Dart, John KG
A1  - Hingorani, Melanie
A1  - Ali, Asim
A1  - Fung, Simon
A1  - Akova, Yonca A
A1  - Doan, Serge
A1  - Gupta, Noopur
A1  - Hammersmith, Kristin M
A1  - Tan, Donald TH
A1  - Paez-Garza, J Homar
A1  - Rodriguez-Garcia, Alejandro
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Ophthalmology
KW  -  CHILDHOOD OCULAR ROSACEA
KW  -  ACNE ROSACEA
KW  -  EYE DISEASE
KW  -  DELPHI
KW  -  CHILDREN
KW  -  CONSENSUS
KW  -  MANAGEMENT
KW  -  CONJUNCTIVITIS
KW  -  STAPHYLOCOCCI
KW  -  KERATITIS
IS  - 1
JF  - JAMA Ophthalmology
SN  - 2168-6165
ER  -