Paediatric Keratoconus: An ERN-EYE Clinical Consensus Statement on Diagnosis, Treatment and Follow-Up Care

This clinical consensus statement, developed through the European Reference Network for Rare Eye Diseases (ERN-EYE), provides recommendations for the diagnosis, monitoring and management of paediatric keratoconus. Paediatric keratoconus is a corneal ectasia that typically presents during childhood or adolescence, often advancing rapidly and significantly affecting visual development. Despite its impact, standardised paediatric-specific guidelines are lacking. A multidisciplinary panel of experts from across Europe contributed to this statement through a structured Delphi process. The consensus reviews the current understanding of the physiopathology, diagnostic criteria, risk factors and classification systems of paediatric keratoconus. It outlines strategies for early detection and monitoring, emphasises the role of patient and family education and presents current treatment approaches, with specific recommendations for paediatric care. The aim of this document is to guide ophthalmologists, paediatricians and associated professionals in delivering timely and appropriate care, improving outcomes for children with keratoconus across Europe.