Originally published in May 2023 NKCF Update

Doctors who diagnose and treat keratoconus spend part of each visit reminding patients that eye rubbing is to be avoided. Doctors have reported that some of their patients with keratoconus describe eye rubbing as a calming, almost enjoyable, experience. Others report some patients are not even aware they rub their eyes. 

Doctors remind their patients the friction and the micro-trauma that accompanies eye rubbing can further weaken a cornea that is genetically predisposed to thinning. 

Researchers in Poland compared patients with keratoconus to controls in a study aimed at learning more about keratoconus. 118 individuals with keratoconus and 73 with no eye disease underwent complete eye exams and answered an extensive survey. The doctors found that individuals with keratoconus did not have allergies at a higher rate than the control subjects, although this result conflicts with many previous studies. They did discover that those who worked outdoors or in dusty environments (like construction) were more likely to be affected by KC. 

As part of the survey, pictures that depicted eye rubbing were presented in ascending order of rubbing severity (See below). Study subjects were asked to select the picture that best represented how they rubbed their eyes. 72% of those without KC selected among photographs #1-4, and only 28% selected a photograph from #5-8. 55% of individuals with KC selected #5-8 to indicate their eye rubbing style. Those without KC most often selected #1 (28%) and those with keratoconus most often selected #8 (28.2%).

The authors did not find that eye rubbing changed over time. Adolescents with KC in the study had similar eye rubbing habits as adults with the disease. This study confirms that individuals with keratoconus have a harsher, more severe way of eye rubbing than most members of the public. 

Reference: Jaskiewicz K, Maleszka-Kurpiel M, et al, Non -allergic eye rubbing is a major behavioral risk factor for keratoconus. PLoS ONE 18:e0284454.