Eye rubbing the critical factor in keratoconus

Damien Gatinel MD

Chronic and vigorous eye rubbing is the main and necessary causative factor of keratoconus rather than just another risk factor among others in the evolution of the condition, according to Damien Gatinel MD, PhD, speaking at the World Ophthalmology Congress (WOC) in Barcelona.

“The time has come to challenge the common conception of keratoconus as a dystrophy of unknown genetics and biomolecular substratum. I believe that keratoconus is primarily a mechanical and behavioural disease in which sleeping position plays a prominent role as well by triggering some rubbing and reducing the corneal resistance over time,” said Dr Gatinel.

Summing up his theory as “no rub, no cone”, Dr Gatinel said that his clinical experience looking at dozens of case histories and dealing with patients is that the absence of rubbing would actually prevent keratoconus from occurring in the first place.

“We believe the problem is that eye rubbing has been positioned as a risk factor, but when you think about it the other risk factors for keratoconus are more risk factors for eye rubbing than keratoconus itself. Eye rubbing is the only risk factor that is exerted directly against the cornea, and the force that is applied can sometimes be as high as the force in a car tyre,” he said.

Dr Gatinel said that not every eye rubber will develop keratoconus but that patients with an existing thin and weak cornea are particularly vulnerable. He stressed that patients should be warned of the deleterious effects of chronic and vigorous eye rubbing.

Tags: keratoconus