Hispanic ethnicity associated with worse pediatric blepharokeratoconjunctivitis at a tertiary children's hospital in the United States.

PURPOSE: To compare the severity of corneal disease and complications associated with pediatric blepharokeratoconjunctivitis (PBKC) as well as barriers to care in Hispanic and non-Hispanic children.

METHODS

The medical records of all children <18 years of age who met broadened PBKC spectrum criteria at Children's Hospital Colorado between 2019 and 2024 were reviewed retrospectively. Patients self-reported as Hispanic or non-Hispanic ethnicity. Data were collected on patient demographics, corneal disease severity, and adverse outcomes associated with PBKC at the time of diagnosis and worst stage during their care.

RESULTS

A total of 405 records were reviewed. Of these, 175 children with PBKC were included, with 116 (66.3%) identifying as Hispanic, 52 (29.7%) as non-Hispanic, and 7 (4.0%) with unknown or unreported ethnicity. Hispanic children were more likely to have moderate and severe corneal disease at their worst stage than non-Hispanic children (P < 0.001). A higher proportion of Hispanic children required interpreter services (P < 0.001), lacked private insurance (P < 0.001), and resided in areas with lower median incomes (P = 0.004) and overall childhood opportunity indices (P < 0.001). Multivariable analysis showed moderate and severe corneal disease at the worst stage was associated only with Hispanic ethnicity (OR = 3.31; 95% CI, 1.53-7.14; P = 0.002).

CONCLUSIONS

In our patient cohort, Hispanic children are more frequently affected by PBKC, with worse corneal disease, in addition to, and independent of, experiencing differing social determinants of health compared with non-Hispanic children.