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The following is a summary of “Corneal Opacity in the United States: An American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight) Study,” published in the January 2025 issue of Ophthalmology by Singh et al. 

Researchers conducted a retrospective study to assess case frequencies, underlying causes, and vision outcomes in individuals diagnosed with corneal opacity in the United States. 

They analyzed data from the IRIS® Registry, which included 79,887,324 individuals who sought treatment at eye clinics between January 1, 2013, and November 30, 2020. Patients diagnosed with corneal opacity were identified using International Classification of Diseases (ICD) Ninth and Tenth Revisions, codes of 371 (corneal scar) and H17 (corneal opacity). The analysis included demographic data such as age, sex, race, ethnicity, and geographical location. Clinical data assessed included laterality, cause, disease descriptors, and best-corrected visual acuity (VA) measured up to 1 year before (± 30 days), at the time of diagnosis, and 1 year after diagnosis (± 30 days). 

The results showed that 5,220,382 patients were diagnosed with corneal opacity or scars using H17 (ICD, Tenth Revision) and 371.0 (ICD, Ninth Revision) codes over 7 years. The case frequency of corneal opacity was 6,535 cases per 1,00,000 patients (6.5%). The mean age was 63.36 ± 18.14 years, with 57.6% of patients being female. Of the cohort, 38.39% had bilateral corneal opacity and 30.00% had unilateral opacity. Most affected individuals were White (69.13%), followed by Black or African American (6.84%). Corneal dystrophies (64.66%) were the leading cause of opacity. Visual acuity worsened significantly due to corneal opacity (0.46 ± 0.74 logarithm of the minimum angle of resolution [logMAR]) and did not fully return to baseline (0.37 ± 0.68 logMAR) after management (0.43 ± 0.77 logMAR). Multiple linear regression indicated worse vision outcomes for female patients compared to males, and for Asian, Black or African American, and American Indian or Alaska Native patients compared to White patients. Additionally, poorer outcomes were noted in patients with opacity caused by corneal malformations, degenerative disorders, edema, injury, and ulcers compared to those with hereditary corneal dystrophy. 

Investigators concluded the corneal opacity was diagnosed in 6.5% of patients in the IRIS Registry, predominantly linked to corneal dystrophies, and resulted in significantly worse vision outcomes compared to baseline. 

Source: sciencedirect.com/science/article/abs/pii/S0161642024004160