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The objective of this study was to determine the prevalence of keratoconus and the potential effect of genetic and environmental factors on its prevalence in households living in rural areas of Iran in a large population‐based study.

The present cross‐sectional study was performed in two Iranian rural populations. Two rural areas were randomly selected in the southwest and north of Iran. All individuals over one year of age were invited to participate in the study. The study population underwent a thorough eye examination, including visual acuity measurement, refraction, slit lamp biomicroscopy, and Scheimpflug imaging. The diagnosis of keratoconus was made based on Pentacam‐specific criteria, tomographic maps, and clinical findings. After detecting keratoconus cases, its prevalence in the study population was reported as a percentage with a 95% confidence interval (CI). For familial …