THIS Is What Causes Keratoconus To Get Worse

THIS Is What Causes Keratoconus To Get Worse

There are some things about keratoconus you just can't change.

  • It often develops at a young age. The younger you are, the more likely the keratoconus is going to get worse over time.
  • As the keratoconus gets worse, the more likely it will continue to get worse.
  • Keratoconus also can be related to your genetics.

But none of that you can change. You can't change your genes. You can't change how young you are or how severe your keratoconus is.

So what can you change?

Well, there is one key risk factor you can change that causes keratoconus to get worse: rubbing the eyes.

Eye Rubbing

Avoid rubbing the eyes. Period.

Any sort of rubbing can cause keratoconus to get worse. This of course includes grinding your eyeball with a knuckle on your hand. But even repetitive gentle rubbing of the eye can cause keratoconus to get worse. There is no rubbing that can be considered OK. Especially if you already have keratoconus in one or both eyes.

Eye rubbing is a well known risk factor for the development of keratoconus. In fact, individuals who rub their eyes are over three times more likely to develop keratoconus.

But rubbing the eyes also increases the risk that keratoconus can progress and become more severe. Eye rubbing has been linked to an end-stage event in advanced keratoconus called “hydrops” where the inside of the cornea cracks, the cornea fills with water, vision becomes blurry and the eye becomes painful.

Short story? Avoid rubbing the eyes.

What Does Eye Rubbing Do?

Within the cornea are support cells called keratocytes. These cells maintain the structural framework and volume of the cornea. When the number of these cells is ample, the cornea is strong and can maintain its shape.

Rubbing the eye causes these cells to die off. Inflammation generated from rubbing the eye contributes to this process. As these keratocyte cells die off, the cornea thins out and becomes weaker.

The end result is keratoconus. The cornea becomes too weak to maintain its shape. Prescription and vision become progressively blurry as the cornea changes shape and the keratoconus progresses.

Preventing Eye Rubbing

In many cases, there are certain things which lead to an urge to rub the eyes. I can tell you all day to stop rubbing your eyes, but if those triggers are still there, it can be hard to resist the urge. Therefore, to prevent the keratoconus from getting worse from rubbing the eyes, it is important to fix the reason why you rub the eyes in the first place.


Having itchy eyes is probably the number one reason why people will rub their eyes. When the eyes itch, there is an urge to scratch and rub them.

In fact, just having allergies is in of itself a risk factor for the development of keratoconus (likely because of rubbing of the eyes). This also extends to include other conditions related to allergies such as asthma and ezcema.

Fortunately treating allergies is pretty straightforward. Great over the counter eye drops exist which treat allergies very effectively. Any allergy symptoms outside of the eyes should be managed with other allergy medication. But avoid Benadryl (diphenhydramine) if you can since that can cause the eyes to dry out more.

Dry Eye / Irritation

The second biggest cause of eye rubbing just happens to be irritable and dry eyes.

One common cause for eye irritation (especially among individuals with keratoconus), is contact lens use.

Contact lenses can irritate the surface of the eye.

  • Allergens and debris can build up on contact lenses.
  • The contact lens solution can irritate the eye.
  • Contact lenses also can cause some mechanical rubbing on the cornea and the eyelid.

All of this can increase the amount of irritation and dry eye and increase the urge to rub the eyes to make them feel better. (Within our eyelids are tiny oil glands. Rubbing or massaging the eyelids can actually help those glands secrete those oils onto our eye, protect the surface of the eye and keep it from drying out. But not good if you are rubbing the cornea at the same time..)

But even just beyond the irritation, poor technique putting in and taking out the contact lens can cause you to rub the eyes even more.

As with allergies, there are simple treatments that can reduce the irritation, improve comfort and help keep you from rubbing the eyes. Starting an artificial tear eye drop and taking breaks from contact lenses are the best first step.

Also check out What To Do About Dry Eye From Contacts

The Real Way To Prevent Keratoconus From Getting Worse

Avoiding rubbing the eyes is definitely recommended. If you are in the habit of rubbing your eyes, its a good idea to break that habit now.

But just that alone isn't enough to prevent the keratoconus from getting worse (but it can slow the progression).

The real treatment for keratoconus is through a procedure called corneal cross linking.

This outpatient procedure uses ultraviolet light and a special eye drop to create strong bonds within the cornea. This strengthens the cornea to prevent it from getting worse.

Also check out The Complete Walk-through of the Corneal Cross Linking Procedure

If your keratoconus is getting worse, than you need corneal cross linking to stop the progression.


Rubbing the eyes is the biggest risk factor for keratoconus that you can change. Avoiding rubbing the eyes can help keep the keratoconus from getting worse. However, keratoconus can still get worse on its own - especially if you are young or already have bad keratoconus. Thus, the real way to treat keratoconus and keep it from getting worse is by strengthening it through the procedure corneal cross linking.

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