KERATOCONUS: CONTEMPORARY UNDERSTANDING AND PREVENTIVE STRATEGIES (LITERATIRE REVIEW)

Abstract

Purpose – to synthesize current knowledge regarding keratoconus pathogenesis, epidemiology, risk factors, and early detection strategies, with emphasis on preventive medicine approaches relevant to clinical practice in Central Asia, including Uzbekistan.

A comprehensive review of contemporary scientific literature was conducted, analyzing molecular mechanisms, environmental and genetic risk factors, global epidemiological patterns, and advanced diagnostic technologies for keratoconus. Special attention was given to modifiable risk factors and screening strategies applicable to resource- varied settings.

Keratoconus pathogenesis involves extracellular matrix degradation, oxidative stress, cellular senescence, and biomechanical compromise. Key modifiable risk factors include chronic eye rubbing, ultraviolet exposure, and atopic conditions. Global prevalence is 289.1 per 100,000 persons, with significant regional variation – highest in Africa and West Asia. Advanced imaging technologies including Scheimpflug tomography, anterior segment optical coherence tomography (AS- OCT), and biomechanical assessment enable early detection. Artificial intelligence (AI) algorithms achieve >95% sensitivity and specificity for keratoconus identification. Risk-stratified screening targeting individuals with family history, atopic disease, and systemic associations enables timely intervention with corneal collagen cross-linking.

Conclusion
Keratoconus prevention requires integrated approaches combining public health interventions addressing modifiable risk factors, risk- based screening programs utilizing advanced diagnostic technologies, and early therapeutic intervention. Implementation of comprehensive screening and prevention programs in Uzbekistan and Central Asia could substantially reduce keratoconus-related visual disability.