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Many people with keratoconus also have allergies, and eye doctors have long suspected that itching and rubbing play a role. A large study published in the American Journal of Ophthalmology in September 2026, led by researchers at the University of Toronto, looked at that link in a big, diverse group of Americans.

What the researchers did

The team used the National Institutes of Health’s All of Us Research Program. They scored each person from 0 to 3 based on how many of three allergic (“atopic”) conditions they had: asthma, eczema (atopic dermatitis) and hay fever (allergic rhinitis).

• A long-term group of 283,040 adults without keratoconus was followed for a median of 9 years; 498 developed keratoconus.
• A second snapshot group included 508,527 adults, 741 of whom had keratoconus.

What they found

• Each added allergic condition raised the risk of a new keratoconus diagnosis by about 59%.
• Among people aged 18 to 40, the link was stronger, about 74% per condition, and new cases were diagnosed at a median age of 38.
• Allergic conjunctivitis (itchy eye allergy) on its own was linked to nearly three times the odds of keratoconus.
• In most people with both, the allergy diagnosis came first.

The authors were careful to note a limitation: people who see doctors more often are more likely to be diagnosed with everything. When they matched patients for how often they used health care, the link weakened, although that analysis was small and could not rule out a real effect.

What this means for you

• If you have asthma, eczema or hay fever and notice blurry or changing vision, ask for a corneal shape scan (topography), not only a new glasses prescription.
• Treat itchy eyes. Cold compresses and allergy drops recommended by your eye doctor can reduce the urge to rub.
• Do not rub your eyes, especially with knuckles. Pat or press gently with a cool cloth instead.
• Family members of people with keratoconus should have their corneas checked.

For reliable explanations of retinal conditions that can also blur vision, see this retina education site.

In my keratoconus patients, controlling allergy and stopping eye rubbing is one of the first things we work on together.

Source: Cumulative Atopic Disease Burden and Keratoconus: Cross-Sectional and Longitudinal Associations in the All of Us Research Program (American Journal of Ophthalmology (PubMed), 09/06/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Most keratoconus research measures corneal shape and visual acuity. Fewer studies ask the simple question: what is it like to live with this condition for years? A team from the University of South-Eastern Norway did exactly that, and their findings may be encouraging for anyone newly diagnosed.

How the study was done

Researchers held in-depth, one-on-one interviews with 13 adults with keratoconus: six women and seven men, from their 20s to their 70s. Everyone had been diagnosed for at least 5 years and had a range of treatment histories and types of vision correction. Some were recruited through a Norwegian keratoconus Facebook group and others through optometrists in private practice. The interviews were analyzed for shared themes.

Five themes

• A good life with keratoconus: participants described full lives despite the condition.
• Contact lenses as a “game changer”: the right lens made a major difference to daily vision.
• Persistent symptoms and emotional impact: keratoconus still affected daily activities and feelings.
• Coping strategies: people found practical and personal ways to adapt.
• Eye care is key: a good relationship with knowledgeable eye care professionals mattered.

The authors concluded that keratoconus affects daily functioning and vision-related quality of life, but that living well is possible through appropriate eye care, personal acceptance, and coping strategies. They suggest these insights can reassure people who are newly diagnosed.

Keep the limits in mind

This was a small, qualitative study in one country, and participants chose to take part. It describes experiences; it does not compare treatments.

My advice if you have keratoconus

• Do not give up on contact lenses after one bad fit. Specialty designs, including scleral and hybrid lenses, exist for irregular corneas, and fitting can take several visits.
• Avoid eye rubbing, and treat itchy allergies so you are less tempted to rub.
• Keep regular corneal scans so any change is caught early.
• Talk about frustration or anxiety; it is common and worth addressing.

For more reading on eye health, see oakparklasik.com.

Source: Living Well with Keratoconus: Implications for Person-Centred Eye Care (Ophthalmic and Physiological Optics (PubMed), 09/12/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

In keratoconus, the cornea thins and bulges into a cone shape. That irregular surface distorts light, so glasses often cannot give clear vision. Scleral lenses are large, rigid gas-permeable lenses that vault over the cornea and rest on the white of the eye. The space underneath is filled with saline, creating a smooth new optical surface. A small study published in October 2026 looked at how much they helped vision, and what happened to dry eye measures, over a month.

What the researcher did

In this prospective study from Saudi Arabia, 18 people with keratoconus were fitted with scleral lenses in both eyes and asked to wear them at least 8 hours a day for one month. One eye per person was studied. Vision, a dry eye symptom questionnaire (OSDI), tear production (Schirmer test), and tear breakup time were measured.

What the study found

• Vision improved immediately when the lenses went in. On average, eye-chart scores went from about 20/100 to about 20/25 equivalent, and the gain held at one month.
• Dry eye symptom scores dropped substantially, from about 45 to about 25.
• Tear production and tear breakup time increased modestly.
• All 18 participants completed follow-up, and no complications were reported.

Keep it in perspective

This was a small study with no comparison group, so the author notes the dry eye changes should be seen as associations rather than proof that the lenses caused them. One month is also short; long-term comfort and eye health need ongoing follow-up.

Tips for scleral lens wearers

• Use only the preservative-free saline your fitter recommends to fill the lens.
• Learn proper insertion and removal tools and techniques, and clean lenses as instructed.
• Report foggy vision, redness, or pain; fit adjustments are common, especially early on.
• Keep regular exams so your doctor can check the cornea and how the keratoconus is behaving over time.

For more plain-language reading on eye health, see thousandoakslasik.com.

Source: Changes in Visual Acuity and Dry Eye Parameters Following One Month of Scleral Lens Wear in Patients with Keratoconus: A Prospective Observational Study from Saudi Arabia (Healthcare (Basel) (PubMed), 10/03/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Keratoconus is a condition in which the clear front window of the eye, the cornea, thins and bulges into a cone shape, blurring vision. It is known to be more common in people with Down syndrome, and it can be harder to notice in children who may not report blurry vision. A study published in November 2026 in the journal Cornea describes a dedicated screening program for children with Down syndrome in Ireland.

How the program worked

From March 2019 to April 2026, children with Down syndrome were referred to a keratoconus screening program in Dublin. The program used corneal tomography, a scan that maps the shape and thickness of the cornea. The researchers reviewed records for all 45 children screened. The average age was 13.5 years.

What they found

• Useful scans were obtained in 40 of 45 children (88.9%), showing that outpatient screening was workable for most.
• At the first visit, 15 children (33.3%) had keratoconus or suspected keratoconus.
• During follow-up, 2 children with initially normal scans developed suspicious findings, and 3 children progressed to confirmed keratoconus.
• In total, 18 of 45 children (40%) screened positive over time.

The authors concluded that repeated tomography-based checks should be part of routine eye care for children with Down syndrome, because a reassuring first scan did not rule out later changes.

What families can do

• Ask your child’s eye doctor whether corneal tomography screening is appropriate, and how often to repeat it.
• Watch for frequent eye rubbing, squinting, head tilting, or glasses that never seem to help; mention these at visits.
• Treat eye allergies and discourage eye rubbing, which is linked to keratoconus.
• If keratoconus is found, a cornea specialist can explain the options for monitoring, vision correction with glasses or specialty lenses, and other treatments suited to your child.

This was a single-center study with a small group, so the exact percentages may not apply everywhere. But the message is clear: for children with Down syndrome, regular corneal checks matter. For more plain-language reading on eye health, see lalasikcost.com.

Source: Diagnostic Yield and Longitudinal Performance of a Dedicated Keratoconus Screening Program for Children With Down Syndrome (Cornea (PubMed), 11/03/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Sjögren’s syndrome is an autoimmune disease in which the immune system attacks the glands that make tears and saliva. Severe dry eye is one of its hallmark symptoms. A network meta-analysis published in Frontiers in Immunology compared topical treatments for the eye in Sjögren’s and found that some drops, such as autologous serum and cyclosporine, may help different symptoms.

What a network meta-analysis does

Most studies compare one treatment to a placebo. A network meta-analysis pools many studies and uses statistics to compare several treatments with each other, even if they were never tested head to head. It gives a broader picture of how options stack up.

The options studied

• Cyclosporine drops, which calm inflammation and can help the eye make more natural tears over time
• Autologous serum drops, made from a patient’s own blood, which contain growth factors and nutrients similar to natural tears
• Other anti-inflammatory and lubricating drops

The takeaway is that there is no single best drop for everyone. Different treatments may do better for symptoms, surface staining, or tear production, so care should be personalized.

Why this matters for keratoconus patients

People with keratoconus often wear specialty contact lenses such as scleral or rigid lenses. Dry eye from any cause, including autoimmune disease, can make those lenses uncomfortable and affect corneal health. Controlling the eye surface is part of good keratoconus care and helps patients get the most out of their lenses.

Signs you should be evaluated

• Constant gritty or burning eyes
• Dry mouth along with dry eyes
• Difficulty tolerating contact lenses
• Light sensitivity

Help from Khanna Vision Institute

Dr. Khanna’s team evaluates dry eye and keratoconus together, so treatment fits your whole eye. Patients come to us from Los Angeles, Beverly Hills, Westlake Village, and Thousand Oaks.

More eye-health articles at Better Vision At Any Age.

Source: Comparative efficacy and safety of topical therapies for ocular involvement in Sjögren's syndrome: a systematic review and network meta-analysis (Front Immunol (PubMed), 09/10/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Keratoconus is a condition in which the cornea, the clear front window of the eye, becomes thinner and bulges into a cone shape, distorting vision. Eye rubbing has long been discussed as a risk factor. A study from the University of Osaka, with a collaborator from the Rothschild Foundation in Paris, suggests that asking “Do you rub your eyes?” may miss much of the story.

What the researchers did

Koh and colleagues studied 304 Japanese outpatients diagnosed with keratoconus in at least one eye. Each completed a structured questionnaire about current and past habits, followed by a face-to-face interview with a physician. Questions covered reasons, duration, frequency, technique, and where on the eye the pressure was applied.

What they found

• 91.4% of patients reported some form of mechanical eye stimulation.
• These habits were usually long-standing; 75.9% had them for more than 10 years.
• Itching was the most common trigger (75.9%), but many behaviors had nothing to do with itching.
• Fingertips (56.1%) and knuckles (48.6%) were commonly used.
• The inner corner of the eye was the most common site (70.1%).
• About one-third reported pressure habits such as pressing or massaging the eyes when tired.

The authors proposed “mechanical ocular stimulation” as a broader framework than eye rubbing, and said asking about current and past behaviors in detail may improve assessment and counseling.

Questions worth asking yourself

• Do you press on your eyes when you are tired, or rub the inner corners with a knuckle?
• Do itchy, allergic eyes make you rub without thinking?

What helps

In my practice I ask about these habits in detail, not just with a yes-or-no question. Treating itch and allergy, using cool compresses instead of rubbing, and building awareness can reduce the urge. Tell your eye doctor about any habit, even one that seems minor, and keep your scheduled corneal mapping visits so changes are caught early.

For more plain-language eye-health reading, see malibulasik.com.

Source: Beyond Eye Rubbing: Mechanical Ocular Stimulation Is Highly Prevalent in Keratoconus (Eye & Contact Lens (PubMed), epub 09/29/2026). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.

Keratoconus in children and teens often moves faster than the same diagnosis in adults, and many kids are already in a moderate or advanced stage by the time someone names it. In 2026, the European Reference Network for Rare Eye Diseases (ERN-EYE) published a clinical consensus statement on how to spot, confirm, and follow paediatric keratoconus—work built by a multidisciplinary panel across eight European countries using a structured Delphi process.

Why timing matters in kids

The cornea is still changing through adolescence. Progressive near-sightedness, a shifting astigmatism axis, or against-the-rule / oblique myopic astigmatism that worsens over months should raise suspicion. Best-corrected acuity can still look normal early on, so waiting for a bad eye chart alone is not enough. Family history of keratoconus and persistent ocular allergy—especially atopic disease with rubbing—are extra reasons to look carefully.

How the consensus frames screening and diagnosis

• Corneal tomography (including Scheimpflug imaging of the front and back of the cornea) belongs in the work-up when recent-onset corneal astigmatism appears, and—drawing on the Global Consensus on Keratoconus and Ectatic Diseases—when children ages 6–18 have more than 2 diopters of astigmatism on subjective refraction.
• Retinoscopy remains valuable: a scissoring reflex or oil-droplet sign can flag suspicion even in a child who cannot sit for a full map, and it may be the only practical screen in a non-cooperative patient.
• Diagnosis rests on clinical exam plus imaging; posterior elevation and focal thinning support ectasia on tomography or OCT.
• For families with known keratoconus, earlier exams around ages 8–13 make sense, with yearly follow-up once astigmatism appears—even if that astigmatism still looks “regular” on a simple refraction.

Follow-up rhythm the experts agreed on

After a paediatric diagnosis, the statement emphasizes close monitoring: roughly every three to four months at first, then about yearly until age 18, with more frequent visits if measurements show progression. Collaboration between paediatricians and eye doctors helps catch kids who present first with allergy, rubbing, or “just another glasses change.” Patient and family education—especially stopping eye rubbing—is part of care, not an afterthought.

James, a teen whose astigmatism jumped twice in one school year, is the kind of story that should trigger mapping, not another routine glasses update alone. Munson’s sign (a V-shaped lower-lid notch on downgaze) is a late, nonspecific clue; useful imaging should already have answered the question long before that appears.

What families can do now

• Bring old prescriptions so your doctor can see how fast the cylinder and axis are moving.
• Mention allergy, rubbing, and any relative with keratoconus at the visit.
• Ask whether topography or tomography is appropriate—not only a Snellen chart and phoropter.
• Keep follow-up appointments; paediatric ectasia is a moving target through the teen years.

For more regional eye-health reading, browse 1800realdoctor.com.

Source: Paediatric Keratoconus: An ERN-EYE Clinical Consensus Statement on Diagnosis, Treatment and Follow-Up Care (Ophthalmology and Therapy / PubMed PMID 42538519; ERN-EYE / ESCRS coverage). This article is an educational summary written by Khanna Vision Institute and is not a substitute for medical advice.