Prevalence of Keratoconus Among a Palestinian Tertiary Student Population

Mohammad M. Shehadeh*, 1, 3, Vasilios F. Diakonis1, 2, Sara A. Jalil3, Rania Younis3, Jamal Qadoumi3, Liana Al-Labadi3
1 Vardinoyannion Eye Institute of Crete (VEIC), Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
2 Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, FL, USA
3 Faculty of Medicine and health sciences, An-Najah National University, Nablus, Palestine

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© Shehadeh et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Ophthalmology Department, An-Najah National University Hospital, Nablus- West Bank- Palestine; Tel: +970 9 2389687; Fax: +970 9 2389684; E-mail:



To screen for keratoconus and potential associated risk factors in a tertiary student population sample.

Population and Methods:

This cross sectional study included 1234 students attending An-Najah National University (Nablus, West Bank, Palestine), that were randomly selected from a total of 20,000 university students. 634 (51.3%) student participants responded by completing a self-administered questionnaire and were assessed by means of corneal topography. Following initial evaluation, participants were referred for Pentacam evaluation if they demonstrated either a mean keratometry of more than 45 diopters, corneal astigmatism of more than 2 diopters and/or if asymmetric topographic patterns were present. Pentacam images were analyzed by an experienced ophthalmologist based on a number of indices and the participants were classified as normal, keratoconus suspects, and keratoconus patients.


A total of 620 participants (mean age, 20.1±1.6 years) were included in this study, 379 (61.1%) were females and 241 (38.9%) were males. Nine subjects were diagnosed with keratoconus, demonstrating a prevalence of 1.5%. 52 (8.4%) participants showed at least one abnormal pentacam index, and were considered as KC suspects.


Keratoconus is a prevalent disease among the tertiary Palestinian student population. This may be related to a combination of genetic and environmental factors. The results of this study signal the need for public health outreach and intervention for keratoconus.

Keywords: Keratoconus, pentacam, prevalence, risk factors, topography.