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

J AAPOS. 2026 Feb;30(1):104741. doi: 10.1016/j.jaapos.2026.104741. Epub 2026 Feb 12.

Abstract

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.

MeSH terms

  • Adolescent
  • Blepharitis* / diagnosis
  • Blepharitis* / ethnology
  • Child
  • Child, Preschool
  • Colorado / epidemiology
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Hispanic or Latino* / statistics & numerical data
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Infant
  • Keratoconjunctivitis* / diagnosis
  • Keratoconjunctivitis* / ethnology
  • Male
  • Retrospective Studies
  • Severity of Illness Index
  • Tertiary Care Centers / statistics & numerical data
  • United States / epidemiology