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Keratoconus: definition, causes and risk factors


Keratoconus is an eye disease whose symptoms stem from a deformation of the cornea.

see: keratoconus in brief

This deformation is responsible for astigmatism, an appearance (increase) in myopia, and various symptômes visuels some of which are not corrected by wearing glasses: splitting of bright images on a dark background (such as the outline that appears splitted or tripled from the moon in the sky), persistent visual blur, etc.

The primitive cause of keratoconus is mechanicsAll patients who develop keratoconus have rubbed their eyes excessively in duration, intensity and frequency: these patients are often allergic, and more generally have risk factors for eye rubbingchronic diseases: atopy, dry eyes, night work, prolonged screen work, etc.

Irreversible biomechanical lesions caused by friction appear all the faster as the cornea is initially thinner and less resistant.

The diagnosis of keratoconus is confirmed by an examination of corneal topography (study of the shape and variations in corneal curvature and thickness).


Contrary to what is taught in classical treatises and many specialities:

Keratoconus is a condition originally mechanicalnot primitively genetic: corneal deformation is induced by eye rubbingexcessive corneal deformation. At the beginning, the deformation inflicted by friction is of an elastic nature (reversible when friction stops). Above a certain threshold (which depends on the intensity of friction and the native characteristics of the cornea) the deformation becomes "deformed". plastic« i.e. permanent

Indeed, friction acts both on the plane mechanics (disorganization of the weft of the collagen fibers of the cornea) and biomolecular (mechanical cytotoxicity, cellular reaction with cytokine secretion and pro-inflammatory enzymes). These mechanisms combine to cause progressive thinning and a reduction in corneal stiffness, which are at the origin of the plastic deformation of the cornea.

This deformation explains the development or evolution of astigmatism, which is usually myopic in nature.

Visual symptoms of Keratoconus

Example of Visual symptoms that may have a beginner Keratoconus searched. 


The perception with an eye of a doubling, or multiple images, ghosts, around the light sources, can make search for the presence of a Keratoconus: these symptoms reflect the presence of an astigmatism said irregular. The duplication and ghosting can be mitigated with a correction of glasses but they do not disappear completely (contrary to the symptoms caused by a simple astigmatism regular, correcgible in glasses). Beware, these symptoms are not specific to Keratoconus. A beginner cataract can also cause a slight duplication of perceived images.

When it is of corneal origin, any sensation of duplication or multiple images is not necessarily a sign of a keratoconus, but reflects a certain degree of reduction in the optical quality of the cornea. For example, superficial keratitis can cause the same type of symptoms.

The more the keratoconus is evolved, the more pronounced the intensity of these visual abnormalities is. In the casemajority of keratoconus, images "drool" mainly downwards or obliquely downwards. More about the vision of an eye reached by Keratoconus here

There is an urgent need to redefine the keratoconus

The classic but partially erroneous definition of the keratoconus diverts us from the real challenge of stabilizing and preventing the progression of the disease; the eviction of the eye rubbingexcessive.

The keratoconus, from the Greek Kératos for cornea and conus for cone shape, is defined classically as a bilateral, asymmetric, non-inflammatory corneal dystrophy (unknown cause). The keratoconus is characterized by a thinning and progressive deformation of the cornea. In optical terms, this deformation induced in theregular and irregular astigmatism (optical aberrations of high degree) caused by a marked alteration of the geometry of the cornea. Relegating them eye rubbingto a subordinate role (that of a "risk factor") is a serious error with serious public health consequences. This confuses correlation and causality, as if UV rays were considered a risk factor for sunburn, whereas they are the main cause.


Keratoconus evolved from the left eye. It is much more difficult if not impossible to identify the beginners and moderately advanced forms with the naked eye. The use of corneal topography is essential.

An alternative and modern redefinition of the keratoconus is required.

For the classic, descriptive and functional definition of the keratoconus, the author of this site proposes to substitute a more causal definition. The keratoconus is characterized by the appearance of a corneal deformation responsible for visual symptoms and evocative topographical signs.

This deformation is directly related to the action of Repeated eye rubbing, responsible for a Mechanical stress of the cornea.  

Keratoconus is not a primary dystrophy, nor a genetic disease, but a Mechanical condition of origin: Without friction, without repeated mechanical stress, there is no occurrence of deformation of the corneal dome, and therefore of keratoconus (See page dedicated the role of eye rubbing repeated with respect to the incidence of Keratoconus, see article  « Eye rubbing. a sine qua non for keratoconus?« , see article"No Rub, no Cone, the Keraotconus Conjecture".

A site is totally dedicated to understanding the origin, as well as the modern management of the keratoconus: https://defeatkeratoconus.com/.

De nombreux case of Keratoconus are presented and illustrate the fact that eye rubbingare an essential and necessary element for the genesis of the keratoconus.

In particular, the study of the strictly unilateral forms of the disease, which do exist, simply allows us to deduce the essential element that is necessary to trigger the keratoconus. Patients who rub one eye and spare the other (or only slightly rub it) have a unilateral keratoconus.

These observations are instructive. Here is an example of this:

keratoconus unilateral

In this example, the patient rubbed against the phalanges - typical and particularly deleterious actfor years, almost exclusively his right eye (he sleeps with his head resting on the same side, which may explain the sensations of chronic irritation that led the patient to rub his eye vigorously, especially in the morning when he wakes up...). The mechanical energy carried by the phalanges causes an architectural disorganization of the corneal tissue, and a local inflammation which are responsible after a certain time for an irregular but isometric (without distention) thinning and deformation of the cornea. This one cambered in the lower paracentral region and flattened at the peripheral level; these modifications can be appreciated here in a macroscopic way at the insepction of a macro photo in profile of the cornea of the right eye. This camber increases the refractive effect of the cornea. Irregularity is responsible for the appearance of significant astigmatism. The left eye is free of keratoconus but has a fine cornea: this characteristic (congenital) is able to make the cornea more vulnerable to the action of unwanted friction.


However, the majority of patients tend to rub both eyes, but often asymmetrically: invariably, the most rubbed eye is the most affected (the cornea is thinner and deformed). The most rubbed eye is often the one that undergoes the most compression at night in casea sleeping position on the belly or side.

The stop of friction guarantees the absence of progression of corneal deformation, which confirms the direct responsibility and indispensability of friction in the induction of the keratoconus.


In conclusion:

 The keratoconus is not an idiopathic dystrophy but a syndrome whose topographic expression reflects plastic deformation of the cornea, caused by mechanical stress represented by eye rubbingrepeated

This explanation has the merit of simplicity and is compatible with all the data published in the medical literature. It is crucial to explain to patients who are affected and at risk (allergic, night workers, on screen, etc.) not to rub their eyes. This simple prescription has the potential to eradicate this disease, and to stop its progression.

This explanation of keratoconus is not popular with some practitioners who recommend that certain surgical procedures be performed, sometimes at the first consultation, during diagnosis, because it calls into question the validity of their interventionist attitude. It is never urgent to perform cross linking, ring placement or laser photoablation.

To consider keratoconus as a pathology whose main origin is mechanical is a paradigmatic disruption in the ophthalmological world that is not yet fully accepted, far from it. In addition to the aspects related to the loss of certain indications such as cross-linking, the weight of teaching or certain specious reasoning hinders the adoption of a theory that could nevertheless save from the progression and appearance of the keratoconus many eyes. Some practitioners argue, for example, that friction could be the consequence of keratoconus! This position is difficult to defend since a simple interrogation of patients with keratoconus invariably reveals that friction always precedes, by several months or years, the appearance of the first symptoms of keratoconus. 


There is only one emergency in Keratoconus: stop any unwanted eye friction

The disease (caused by friction) no longer progresses as soon as they stop, and with the correction of the sleeping position (stop sleeping on the stomach or side, with the head stuck in the pillow, the arm or the hand in contact with the orbits etc.). 

Cross linking, which is supposed to harden corneal tissue (in clinical practice this effect is not demonstrated), is not a logical response to keratoconus. The continuation of forttements after cross linking leads to the aggravation of the keratoconus. 



The keratoconus in brief

Justification of the mechanical hypothesis of Keratoconus

Rebuttal of classical theory: Marfan syndrome 

Keratoconus and corneal topography

Vision correction and Keratoconus

Suspicious forms of Keratoconus

Keratoconus subclinical

Consulter des case documentés avec suivi de kératocône (en anglais)

175 responses to "Keratoconus"

  1. M S says:

    With the agreement of my daughter, let me contact you about her. 31 years old, she consulted recently an ophthalmologist due to a feeling of eyestrain. The preliminary diagnosis was 'severe astigmatie' then was replaced suddenly by ' eye disease: Keratoconus. Before the concern of my daughter on the loss of eyesight, the doctor softened line by saying that it was nothing serious: at best it would have glasses, at worst a surgery. The met specialist offers him a cross linking, without explaining the disease and its evolution and without explaining why an alternative solution such as glasses or lenses cannot be considered. My daughter refuses this method.

    She is aware that his view may decrease and is sometimes embarrassed by too bright light but it is surprised to hear that glasses would be nothing while so far, she reads of very fine print. She admits to need and is ready to wear glasses or lenses although she thinks not having enough tears to support the latter.
    For the record, my daughter had consulted a ophtalmogue at age 18 for reasons of ophthalmic migraines; He had not diagnosed anything like this and had just advocated orthoptics sessions. Once the sessions were done, my daughter did not feel any more eye fatigue until recently.

    Reading your articles about the cross linking and Keratoconus answers and confirms anxiety on this technique too often proposed as soon as the first consultation.
    I discover that the keratoconus is often provoked by the eye rubbing and repeated eyes, practice exercised for many years by my daughter. It also lacks tears (dry eye) that it compensates by drops. Following this announcement, she no longer rubs her eyes because she wants to stop the evolution of the keratoconus.

  2. Dr. Damien Gatinel says:

    I would advocate the lenses or glasses actually port. Keratoconus is a proven stage but a priori equipment in rigid lenses should be linked back Visual acuity corrected at a satisfactory level.
    It is of course crucial to stop all eye rubbing. If this recommendation is respected, the keratoconus should no longer evolve. A transplant does not seem to me to be considered in the future.

  3. M.T says:

    At first I wanted to thank you for all the information you give on Keratoconus, this allowed me to reassure certain fears.
    I would like to know if boxing type combat sports can be practiced when we are suffering from keratoconus?

    Kind regards

  4. Dr. Damien Gatinel says:

    The practice of boxing and combat sports is possible in case of Keratoconus; It is suitable as always to protect the eyes from the live hits.

  5. Emilie says:

    My son has the disease "keratoconus", he has had a transplant both eyes for 7 years. He's got a visual deficit. It does not support lenses, since every time it puts on lenses, it itches a lot the eyes, they are red. That's the reason it rarely puts lenses.
    For some time, he sees less and less well and scratches his eyes a lot.
    I would like to know what actions to avoid to minimize the risk of increasingly serious visual deficits?
    If there is medication or treatment to clean your eyes or avoid scratching them?
    What to do and what not to do or there are no solutions because of the severity of his eyes. (I encourage that we see very durable the white lines on his eyes after operations the two eyes)
    Is this disease transmissible to its children?
    is what it should avoid or not force on bodybuilding because it makes a lot

    Thank you for your answer

  6. Dr. Damien Gatinel says:

    It is very important that your son is more rubbing eyes, otherwise induce a recurrence of Keratoconus. If rubbing are related to an allergy, then attempt a desensitization and treat the symptoms of the allergy by some eye drops (anti histamine) or per os treatment. Rather than rub when your eyes are irritated, it is best to rinse them with saline. The practice of strength training is possible. Concerning the transmission of Keratoconus, it is typical to consider this disease such as genetics, because there sometimes the presence of a Keratoconus in several members of a family, in one of the biological parents, etc. However, the mode of transmission is not clear and there is no specifically identified for Keratoconus gene. However, it is likely that some genetic traits predispose to have atopic land, more or less thick and resistant corneas... and that the practice of eye rubbing faster mislead a Keratoconus in some subjects than others. From my point of view, the absence of eye rubbing (or repeated application of mechanical stresses on the cornea) should alone be enough to eradicate the Keratoconus. Even if one is entitled to doubt this assertion as the Treaties define classically Keratoconus as corneal dystrophy whose origin is unknown, it is admitted that repeated eye rubbing accentuate the corneal deformation and speed up the evolution of the disease (from my point of view, the frottenents are the cause of what we called Keratoconus and their intensity and frequency to determine the evolution)

  7. Alex says:

    Hello I have Keratoconus since 6 years. I was offered a crosslinking but since I read your site very well done I rub more eyes what I was doing since childhood (I'm 29). My Keratoconus evolves more according to an another Opthalmo who gave rigid lenses. I see better in glasses but is that wear hard lenses is bad if for the cornea Keratoconus? Thank you

  8. ZIANI says:

    Hello doctor,
    I am expatriate, my visual acuity has deteriorated in some time. I went to do some tests, I was diagnosed with a keratoconus. For the moment only my right eye is reached, I was told of a frustrated keratoconus left. I dread the worst, I always have a good view, former sportsman of high level, healthy life. I am not sure how to go about it.
    Am I doomed to see less?

  9. Dr. Damien Gatinel says:

    As a first step to confirm the diagnosis of Keratoconus. This can sometimes be worn by excess, based on the topographic map made, and of the criteria used for diagnosis. If it is a Keratoconus, it comes from my point of view of the consequences of trauma repeated COS horny, that should be more frequent and pronounced the most affected side; repeated eye rubbing are of course often found mechanism. More Keratoconus appears later during the existence, and more its evolution is considered slow. It is certainly a bias of appreciation; When the Keratoconus appears later (ex: after 30 years), is that it is a process even to slow evolution, and who leads so more late in the outbreak of the disease. You have therefore not necessarily fear the worst. Do more rub the eyes, and make another corneal topography in a few months.

  10. Dr. Damien Gatinel says:

    Wear rigid lenses well suited is absolutely not a risk about the evolution of your Keratoconus. The pressure exerted by the eyelids and cornea via the rigid lens is several orders of magnitude lower than that of the fingers or knuckles during eye rubbing. The significant improvement in your vision through the lens is related to the fact that their geometry allows to make a smoother curve on the surface of the eye, which allows to significantly reduce optical aberrations that inflicts, alone, Keratoconus.

  11. David says:


    I am 26 years old and we just diagnose me a Keratoconus DPM scalable according to the expert.
    An astigmatism that has evolved in the last months/years.
    I currently wear glasses as well as soft lenses for sport 4 times weeks.
    I rub my eyes regularly. (Fatigue, lentils, dust, alarm clock)
    The surgeon offers me a very fast operation via the crosslinking.. I am quite suspicious about this technique and especially the urgent aspect of the operation.
    What do you recommend?
    Thank you

  12. Dr. Damien Gatinel says:

    If you read the pages conacrées to Keratoconus and the crosslinking of this site, you can guess my answer to your questions. First, Keratoconus has been caused in your case and in (in my opinion) all other cases by the eye friction. Its development, which is to be decided on the achievement of topographies spaced in time, and whose differences must be significant, is also related to continued these frictions.
    From this assertion follows a clear conclusion: if you stop rubbing your eyes strictly, your keratoconus will no longer have any reason to evolve. From my point of view (nourished by the practice and observation and followed by dozens of case of keratoconus), Keratoconus is not a corneal dystrophy whose appearance stems from a favorable genetic terrain and some factors Environmental. Its origin is much simpler: it is the result of a biomechanical weakening of the cornea acquired and directly caused by the repeated eye rubbing, which cause a gradual stretching and disorganization of the collagen lamellae of the Cornea.

    There is never urgent to achieve a CXL because even if one believes in the effectiveness of this technique (not proven by the meta serious analyses), must achieve at least two topography in few weeks showing a progression of the condition to ask the indication of CXL. If the KC does not change, why make a technique to achieve intense oxidative stress to induce hypothetical Covalent within the corneal tissue? The CXL changes are modest and related to the healing of the corneal surface, not to a real solidification of it.

  13. Chender Djamel says:

    Is that you can practice strength training when you're on stage 3 of Keratoconus?

  14. Dr. Damien Gatinel says:

    There is no contraindication for weight training, or any other sporting activity as long as it does not lead you to make you rub your eyes. Stations so to dust, or sweat that would flow into the eyes.

  15. marion Liu says:

    I've been grafted from the cornea for 16 years for the right eye and 15 years for the left eye, actually as long as I remember I was rubbing my eyes very often, my eyesight tumbled in a year and a half and went from 10/10 to 1 and 2/10th In a year and a half, I was 17 years old, I have been inquiring since Qqs time about scleral lenses and it seems that the lenses on grafts reduce their life span. (Currently I wear glasses but am not at 10, a test of scleral lenses has given me a taste to see much better), what do you think? Have you ever done any studies on this issue?
    Moreover I am in contact with Keratoconiens on FB, which have their source from ophthalmologists and for the CXL (Crosslinkin) actually efficiency is far from proven.
    Thanking you.

  16. Dr. Damien Gatinel says:

    The port of sclerale lens is possible in case of cornea transplant, without reducing the life expectancy of the grafts, and improvement expected for your vision is looks substantial.

  17. Laurent says:


    I have Keratoconus on the left eye for over 20 years (I'm 34 currently), it is true that I much rubbed their eyes in my life being allergic to pollen and dust mites so the assumption that you advance seems not absurd to me.
    On the right eye I have only a myopia (although he too was entitled to his dose of friction) and I was thinking of having laser surgery but I'm not sure it's a good idea, would it not risk weakening the cornea of my right eye?

    Thanking you in advance for your return.

    Kind regards


  18. Dr. Damien Gatinel says:

    Thank you for your question and do not find absurd the idea that corneal deformation observed during the Keratoconus is the direct consequence of eye rubbing. Actually, it is in my view absurd to claim that the cornea can deform without the action of an external mechanical force (friction), while one never highlighted to biochemical mechanism of mutation responsible for protein abnormality or other. This is important, because in your case, if the right eye is free of Keratoconus (absence of deformation or minimal deformation), and you stop rubbing your eyes, then it is not inappropriate in my view to propose a technique for correcting nearsightedness, rather in PKR. If you rubbed your eyes in the past, you may be weakened the cornea on the right side, so it seems to me preferable to opt for a technique of laser surface (PKR), if however this is possible - and a topographical record with your correction to issue measure will maybe confirm this.

  19. Michèle says:

    The cornea which is a tissue can regenerate if the deformation is not too important, and I rub more eyes?

  20. Dr. Damien Gatinel says:

    Friction stop interrupts the mechanism of corneal deformation originally, but unfortunately it is final. Sometimes, however, a small improvement a few weeks after stopping of frictions, probably thanks to a light epithelial remodeling.

  21. Jessie says:

    Hello doctor Gatinel, I need your answers. Votra assistant doctor Saad diagnosed me a Keratoconus two months early and prescribed an adaptation to the rigid lenses with doctor VAYR. As Rouen, I did it yesterday in Rouen. But then I am told that my eyes do not support them after 3 different models and they let me leave without telling me. I then let my eyes drop like that without being able to do to relieve myself? I had the impression to support how can you see my eyes them not? I thought that there was necessarily a model of lenses we corresponding? I thought I'd go see the VAYR doctor for a second opinion, but I'm afraid to have the same answer. What must I do to relieve my blurry sight knowing that my glasses me almost more correct? Thanks in advance
    Kind regards
    Jessie is 25 years old.

  22. Jérôme prieto says:

    Hello and thanks for this forum
    I am 42 years old and have undergone a pose of rings on the right eye in 2001 allowing me to find a correct view 7/10th.
    Today my eye seems to make a rejection, requiring a withdrawal.
    What solutions are offered to me to find a correct view. Can I consider new lenses. The last tests in 2000, had not been conclusive causing me strong irritations.
    Have there been any developments on this?
    Thank you in advance for your answer

  23. Dr. Damien Gatinel says:

    If the rings are poorly tolerated locally, it is actually stated to remove them. It is appropriate to reassess the interest of a new contactologique adaptation, because some progress has been made in the area of lenses for the Visual rehabilitation of patients with Keratoconus.

  24. Louis says:

    My ophthalmologist told me about a keratoconus. It is not about him and was late in these appointments and therefore no longer explained. He made a letter for a specialist stating that there was no opacity of the cornea and the eye backgrounds are normal but an aspect of KC and my visual acuity is corrected to 6/10 to the max for both eyes.
    He still prescribed glasses for me.
    OG-3.50 (-4.50 to10 °)
    OD-4.75 (-5.00 to 163 °)
    This is the first time I've changed my glasses in three years.
    I am 31 years old and I am afraid in view of the messages and remoignages that I could read.
    Is this really a keratoconus?? Can it evolved rapidemnet at my age??
    Thank you for your answer

  25. Dr. Damien Gatinel says:

    Diagnosis of Keratoconus is based on the realization of a corneal topography. This review allows to appreciate the shape of the cornea, the thickness, and its regularity. Keratoconus is characterized by a deformation of the cornea, which can give (or increase) the short-sightedness and astigmatism. Without topography, it is difficult to say that there is a Keratoconus, even if the clinical context can be evocative. From my point of view, the mechanism of the deformation of the cornea is directly related to the eye rubbing. The first thing to do is to stop rubbing the eyes and do inspections at regular intervals. Patients who don't rub more eyes progress more. see here: https://www.gatinel.com/2016/12/faire-devant-Decouverte-DUN-keratoconus/

  26. N says:

    Hello, doctor. I came across your site looking for information about the keratoconus. I read your article and it's really interesting. I did a corneal topography and is mentioned "clinical appearance of a gDo keratoconus with average astigmatism 8,89 OD and-10,11 OG.
    OD: Simk at 60.81 astigmatism 8.89
    OG: Simk to 60.48 astigmatism-10.11»
    I will only see the doctor next week and I would like to know the type of keratoconus I have (if it is at a serious stage or not) and the best treatment to be adopted in your opinion. namely that I have a very strong myopia that could not be corrected according to several ophthalmologists. Thanks in advance

  27. Dr. Damien Gatinel says:

    The numbers you report are actually very evocative of Keratoconus. In this configuration, please stop rubbing your eyes (definitely) and try an adaptation of rigid contact lenses. See this link: https://www.gatinel.com/2016/12/faire-devant-Decouverte-DUN-keratoconus/

  28. Rachid says:

    Hello doctor, already thank you for this article concerning the keratoconus and also for the time you devote to answer to our questions.je am currently reaching a bilateral keratoconus, and at Stages 3 (OG/OD), and I was prescribed LCS hybrid lenses, because I can't stand the rigid menicon. Can you tell me more about the hybrids, especially the disadvantages, it seems that there may be an abscess of the cornea, because of the material of it (not enough oxygenated)? Thanks, good luck, in the medical field and even private.

  29. Dr. Damien Gatinel says:

    The risk of abscesses is low with hybrid lenses if you respect the maintenance and wearing rules. The comfort of the hybrid lenses is superior to that provided by the rigid lenses a priori.

  30. Kprathap says:

    Hello Dr,
    Thank you for this very interesting article.
    Indeed I am reached by a keratocones a can enhancing, and I have a few questions:
    1-Being a computer engineer (software developer) working in Saudi Arabia in Riyadh or the climate is very dry, can this disease?
    2 – I made two corneennes topographies (difference 6 months):
    – The first a 29/06/2016: OD Simk-6.4 D Max 47.6 D thinnest 421 um/OS Simk-7.4 d Max 52.4 D thinnest 383 um.
    – The second 05/02/2017: OD Simk Max 52.1 D thinnest 431 um/OS Simk max 53.9 D thinnest 423 um.
    May I ask what stage I am in?
    Will the rings be a good solution in my case?
    I've heard that the rings are very unpleasant at night especially with the lights of cars, is this true?
    Thank you very much

  31. Dr. Damien Gatinel says:

    It is not possible to define a stage of keratoconus from this information. The term of the stadium is however arbitrary. It is more interesting to classify the keratoconus according to the functional discomfort generated. If you are adaptable in rigid lenses, it is an essential data because it allows you in principle to live relatively "normally". The corneal rings allow, when the improvement is effective, to reduce corneal astigmatism, but they cannot solve all the optical problems posed by the deformation of the cornea. They can actually occaseionner unwanted visual symptoms when the pupil expands, i.e. in low light situations (twilight, night driving, etc.). At the risk of repeating myself, the most important in the first time is to no longer rub your eyes, and try to make you fit into rigid contact lenses. With regard to the potential evolution of keratoconus, it would be interesting to carry out differential maps between examinations carried out on these different dates.

  32. Kprathap Linda says:

    Thank you very much Dr,
    This question is important to me: being a computer engineer (software developer) working in Saudi Arabia in Riyadh or the climate is very dry, can this disease?

    Thank you

  33. Dr. Damien Gatinel says:

    Repeat that the keratoconus is in my opinion a secondary distortion to excessive friction (whose energy ends up defeating the resistance or limit of elasticity of the cornea), only frictions are able to evolve this distortion, and thus so-called "keratoconus". Dry air is a source of eye irritation, and in this sense can lead to the desire to rub your eyes. It is absolutely necessary to stop this and simply instill wet eye drops regularly.

  34. Vincent says:

    Hello doctor,

    I allow myself to contact you because diagnosed with a keratoconus I see halos around light sources making driving difficult especially at night, I was given special contact lenses that make my eyesight very good however the halos are only slightly altered, what do I do to improve this problem?

    I stopped the friction that could be the cause of the keratoconus. (Pruritus in the morning in the eye)

    Thank you in advance.

  35. Dr. Damien Gatinel says:

    First of all Bravo for stopping the frictions that explain the occurrence of the deformation corneal. No more rubbing will allow your cornea to be stable. In the case of halos, these should in principle be reduced with the lenses (if these are rigid), in particular the asymmetric luminous deformations (light streaks, spicules, star rays starting down, etc.). However, the total disappearance of halos is difficult for several reasons; The fact that some aberrations are not completely reduced by the lenses (in particular the spherical aberration which is sometimes even increased paradoxically, due to an imperfect asphéricité of the lens). Moreover, the joint deformation of the posterior face of the lens induces aberrations (which are oriented "upside down the aberrations of the front face of the cornea and tend to reduce a little the overall rate of optical aberrations of corneal origin"). When you wear the lenses, the front side is "corrected", but this unmasks the distortion of the back side of the cornea. If you observe that the direction in which the light "drools" without lens (usually rather downward) is inverted with the lens (slight upward shift), then this latter hypothesis could be accredited.

  36. Abbott says:

    Is this disease due to one on meningitis, with elevated temperature?

  37. Dr. Damien Gatinel says:

    No, keratoconus is not an infectious disease or meningitis-related. It is a multi-factor disease, mainly related to the realization of repeated and vigorous eye rubbing (therefore more common in allergic patients, or prone to chronic fatigue, to long-screen work, etc.).

  38. Jessie says:

    I wanted to know why Kératocone is rare in farsighted people? is kératocone as scalable as it is for those with myopia? Thanks in advance. Kind regards. Jessie.

  39. Hanson says:

    Hello Dr,

    I would like to know if the fact that I'm not wearing my SPOT lenses aggravates my kératocone?

    I hate lenses and support them poorly, nevertheless I can manage without lenses with a life about normal (even if it's complicated sometimes), I got used to it.

    I think my keratoconus has been relatively stable since I stopped rubbing my eyes.

    I have another question: Is it true that the kératocone stops evolving after 30 years?

    Thank you for your answer.

    Kind regards.

  40. Hanson says:

    I have another question doctor, when my eyes scratch me or I have a dust I do not rub my eyes but I have a technique that involves "pulling" my eyelashes which relieves me a bit. I'm careful not to put high pressure on the cornea.

    Do you think I should stop?

  41. Dz says:

    Can the keratoconus make it blind?

  42. Dr. Damien Gatinel says:

    In practice, the enlightened management of keratoconus helps to avoid severe complications and to become blind. The only fully effective treatment to stop the evolution of keratoconus is the cessation of eye rubbing. It is both simple and complicated (it is sometimes difficult to resist the temptation to rub irritated eyes).

  43. Dr. Damien Gatinel says:

    This kind of technique, which helps avoid rubbing the eye and pressing the cornea, is much better than the one that would be to "press" and rub vigorously.

  44. Dr. Damien Gatinel says:

    My extensive experience allows me to tell you that the cessation of the eye rubbing alone allows to stop the evolution of the deformation corneal. You will be offered here and there techniques such as cross linking, but an unbiased study of the results of the literature and a mind that is not so scientific (and without commercial ulterior motives) is enough to reconsider this technique, which has always Not well evidence of its first effectiveness, what it is designed for, i.e. stiffen the cornea. It seems curious, even disturbing, to think that we can propose to patients a technique so weakly effective (and not without complications), but it is like this ... Again, and as you have noticed, stopping the frictions stabilizes the keratoconus at any age. Be careful at times of the day like waking up, or showering, during which patients sometimes rub their eyes without their knowledge.

  45. Kprathap Linda says:

    Hello Dr,
    I just equip myself with rigid lenses in piggy-back (with soft lenses),
    My question is how to choose soft lenses? What power? What kind of guy?
    Thank you

  46. Ivan says:

    I am 30 years old and have a kératocone already well advanced. When I am 90 years old if I reach this age I would most certainly be blind to the most deteriorated eye, even if I stabilize it?

  47. Delphine says:

    Hello doctor,
    I've read everything you've been able to write on the keratoconus for a while. I was diagnosed four years ago, following a test for a myopia surgery. The first ophthalmologist who detected it wanted to operate me and to carry out a cross-linking at the same temps...et proposed to do this quickly. Anxious about this news, I was consulted in a university clinic at a specialist where I have been followed since then. It does not advocate the operation of myopia on a "sick" eye. On the other hand, she confirmed to me during my last consultation that my keratoconus was still slightly evolving, even though I stopped the frictions to the eye as she had told me, from the first consultation, about +-4 years ago. I have a little astigmatism now in addition to myopia. She told me that it would take "one day to consider the operation of cross-linking" before it deteriorated further. I admit to being scalded by all these diagnoses and developing the fear that I am being operated/touched in my eyes. Having stopped the scratches, I therefore think that it is my position of sleep that promotes a compression of the eye. I try as much as possible to sleep on my back but I regularly sleep on the left side (eye actually most affected) on an ergonomic firm pillow. If this pressure promotes the development of keratoconus, what can I do, what type of pillow to choose? I also specify that I am prone to seasonal allergies and that I had a pregnancy (influence of hormones?) Thanking you,

  48. Dr. Damien Gatinel says:

    The correlation between the most affected eye and the sleep position is indeed striking, and it is a heavy argument in favor of the mechanical origin of the keratoconus. I am not sure that the pressure of the eye against the mattress or the pillow is the direct cause of the deformation. On the other hand, it promotes the emergence of many factors of risk of friction: local irritation, heat, contamination by bedding mites, various germs etc. We studied the position of sleep in subjects not affected by keratoconus (declaring or not rubbing the eyes), and we have inferred rather that in the absence of associated friction, there is no keratoconus the subjects that sleep "on the eye" but do Don't rub their eyes. However, it is preferable to correct this factor in your case, as it is possible that reflexive frictions are performed during sleep or rapid awakening phases. You can also wear a protective shell for a night or two, this test is quite informative, because patients who rub their eyes in a reflex way then become aware (the shell is interposed between the eyelids and the fingers). Regarding the evolution of your keratoconus, it should not be a simple "impression" but documented as accurately as possible with differential topographical maps. There are fluctuations in measurement between various exams, and in fact it is important not to put the diagnosis of progression by excess. We have never observed progression of a deformation when patients actually stop rubbing (I invite you to visit the site Http://www.defeatkeratoconus.com To get acquainted with this if it is not already done. Finally, from my point of view, the correction of a slight myopia by the technique of PKR (surface laser) is quite possible for the little evolved and non-evolutionary forms (i.e. when the problem of friction is definitively solved).

  49. Robert L says:

    Good evening, Doctor Gattinel,
    First I want to thank you for your site.
    I am 30 years old, I suffer from a high myopia since my young age and I was diagnosed with a bilateral keratoconus in 2013 at CHU d'antibes, keratoconus which evolved quickly and at the end of 2015 I was offered a CXL in an external firm (for 800 Euros). That's when I discovered your site. I've tried not to rub my eyes ever since, and miracle! The keratoconus has hardly evolved. If I ever had this recommendation before, it would have saved me the degradation.
    Today I still arrive with the glasses to have 10/10 because the distortion is biased on my left eye, by cons my right eye with the correction reaches 5/10 maximum because the distortion is centered.
    I wanted to take your opinion on two phenomena that annoy me and which I think are related to the disease:
    – I see glowing halos while driving at night and I am often dazzled by the headlights of other cars
    – I see floating bodies, especially on my left eye when I focus on a white background.
    My question is: Are there any means/treatments that can reduce or even eliminate these phenomena?
    Thank you in advance for your reply.
    Very cordially.

  50. Dr. Damien Gatinel says:

    Thank you for your testimony. Stopping the progression of your keratoconus does not hold the miracle;-)
    Keratoconus is induced by repeated and particularly sustained rubbing of the eyes; In the absence of friction (or stopping of these), there is no progression. This discovery, which we illustrated by the example (see the case gathered here: https://defeatkeratoconus.com/portfolio-filtersearch/ (and that are not sorted), does not do the trick of the followers of the CXL. Nevertheless, any patient discovered with a keratoconus should receive a substantiated information on friction, be invited to become aware of eye rubbing, and followed with differential topographical maps ... that reveal to Each time the stop of the progression when the friction stops.
    About your questions about visual symptoms:
    1) Visual halos are largely the result of corneal deformation. This deformation is responsible for a reduction of the optical quality of the eye: The perception of an echo around bright lights (e.g. several crescent moons in the night sky), halos, doubling of constrastées images (ex; subtitles) stems Of the asymmetry of the cornea (which is the most important optical lens of the eye). The best way to fix it is by adapting rigid lenses. Many progress has been made in the realization of lenses for the equipment of horns with keratoconus (hybrid lenses in particular, which combine the comfort of soft lenses and the quality of correction of rigid lenses). This page is a bit technical but tries to explain the effect of optical aberrations involved in the visual distortion of patients with keratoconus; https://defeatkeratoconus.com/vision-disturbances-of-keratoconus/
    2) There is, however, no treatment for the usual floating bodies, which are related to myopia, and can be more easily perceived when looking at a plain pattern like a white wall, the sky, etc.

  51. Lauren Theresa says:

    Hello doctor and thank you for what you are doing.
    I have two questions to ask you.
    The first, is it possible to cure the keratoconus?
    The second, is there an evolution for the assumption of social security?
    What are the latest developments regarding this disease?

    Thanks in advance!
    Signed, a patient who does not support his rigid lenses...

  52. Dr. Damien Gatinel says:

    It is not possible to cure the keratoconus, but it is quite possible to stabilize its evolution by permanently stopping to rub vigorously the eyes. The keratoconus is not a hereditary disease, but the consequences of a terrain conducive to friction, ie generally atopic (allergies), with fatigue, stress (the eyes are tired and give desire to rub them, etc.). Sleep position is an important element; Patients who sleep on one side (the head supported in the pillow) are often keratoconus on this side (or more marked on the side most "supported" at night.) If, before the occurrence of repeated and prolonged friction in time, the cornea is fine, the keratoconus (the permanent deformation of the cornea) will occur more quickly.
    Social Security Refunds Eye drops (anti-allergic, moisturizing) and certain keratoconus-related operations. The lenses are generally supported in this context, and are the most effective means of visual correction.
    The latest advances in this disease are from my point of view the fact that it can be prevented and stabilized if one accepts the hypothesis of an origin directly related to friction (no friction, no keratoconus, "no rub, no cone"). Many logical elements, and numerous well-conducted clinical observations support this hypothesis. It is unfortunately not the object of much interest on the part of those who prefer to prescribe costly techniques (and ineffective when the first goal sought, harden the cornea), like cross linking (CXL). It is not so important to (attempt to) harden a cornea softened by years of repeated friction as to stop these frictions! A site is dedicated to Keratoconus (in English): https://defeatkeratoconus.com/ It brings together all the case seen since last year and followed for several years by my care for some. All are stable: as all patients have stopped rubbing their eyes, and avoid sleeping on the belly or side (which is highly correlated with keratoconus).

  53. Alexander LANNE says:

    Hello, doctor.

    Alexander 24 years old.

    Subject to severe ocular dryness (Blepharite + dermatologist chronic atopic conjunctivitis) and to a well evolved Kerato OG, I had surgery to this eye in October 2016. This keratoconjunctivitis would not have evolved much since (I do my best not to rub my eyes..)

    I would like to write to you because it is now 7 years that I am prone to pain, especially at the level of the left eye, where the keratoconus is the most evolved.

    These pains are unbearable, I went to see Opthtalmos centers and even climbed to the 15-20 in Paris.. No one gives me the slightest answer.

    These pains translate into general pain at the globe, and quickly get big headaches. A huge migraine sensation "in" the eye, and then on the whole forehead.. And it's like I felt the cornea, following the movements of the eyes (feel the tip of the eye touching the eyelid.. not obvious to explain by message!)

    I'm on tramadol LP 50 see 100 because my personal and professional life is greatly affected by all this.

    I have drops, vitamin A, and I'm trying to try my first rigid lenses, for the moment I can't stand them at all.

    I was wondering if you could advise me on these disabling pains, which make me feel like a madman to the so-called specialists..

    I did an MRI, I even saw a neurologist... But these pains are very present, not created by my nervous system.. No doubt about it.

    After years of research if I may say, my only explanation would be a very important visual fatigue, and an allergic terrain that would make it all worse.. But this is just my patient opinion.

    I'm out of the solution.

    Thank you for your site, from your point of view rational, descriptive and very helpful regarding the Kerato.

    Thank you for a possible response.



  54. Daniel says:

    Hello I have 66 years I underwent 2 keratoplasties of 2 Eyes in 1975 and 1995. I rub my eyes a lot and I can't help myself. We tried in 1995 to equip myself with toroidal lenses but the off-center graft rubbed on the lens. Progress has been made that would allow me to improve my vision which is much less good with glasses
    I wore hard lenses and then scleraux lenses before the first operation
    If you could tell me a possibility of equipment with a new technology it would be amazing
    Thank you for all your information

  55. Dr. Damien Gatinel says:

    Significant progress has been made in contactology, with the development of new generations of scleral and hybrid lenses (rigid in the center, soft on the periphery). It is important to consult a contactologue specializing in the adaptation of Keratoconus and grafts. And, last but not least, it would be much better if you would stop rubbing your eyes. This can have a certain impact on the corneas and grafts.

  56. Dr. Damien Gatinel says:

    It would be useful to know the type of intervention done on your left eye. You may be suffering from corneal hypersensitivity, but this remains to be confirmed. The fact that you "feel" the cornea during eye movements (rubbing against the eyelid) accredits this hypothesis.

  57. L. Caillaud says:

    Hello doctor,
    My 17-year-old son was diagnosed with a keratoconus Stage 2 on the right eye and stage 1 on the left eye on February 7. The ophthalmologist prescribed glasses to correct astigmatism of the right eye but it is magré all embarrassed, especially at night and when driving (accompanied conduct): trails, duplication, etc... A monitoring visit is planned in June to assess the evolution, after stopping friction (our ophthalmologist is sensitized). These are proven, very common, especially on the right side, in the form of kneading of the eyes with the base of the wrist (itchy eyes, allergic context). If there is a change in June (PENTACAM), a cross-linking will be proposed. We are very disturbed by the announcement of this keratoconus, which intervenes at an age where the future is built. We are ready to take several opinions and in particular to come and consult you on Paris because interested in your approach (we consult today on valves). What would be your recommendations in order to handle this problem in the best way it is.
    Thanking you.

  58. Mulliez says:

    I would be able to contact you because I have a bilateral keratoconus. Detected in the 1990s, I underwent a corneal transplant in St Etienne in 2002 on the left eye.
    I have eczema since I was little and rub my eyes very regularly. I have a certain ocular drought. However, when I instill artificial tears, I still want to rub my eyes.
    Currently equipped with SPOT lenses.
    I have in addition to my lenses since September 2017 a pair of extra bezel to be said to work. However, I can no longer do without.
    To this day, I work more than 39h/week on a computer screen. I have more and more pains behind the eye globe and headaches.
    I am thinking of reducing my working time (to reduce the time on screen).
    Do you know if patients with this disease are entitled to any care for a reduction in working time related to this pathology?
    Thank you for your information.
    Kind regards

  59. Dr. Damien Gatinel says:

    A priori, there is no specific support for screen work in patients with keratoconus. Prolonged screen work is certainly difficult for patients with reduced vision, and we have also observed that it is a risk factor for eye rubbing. It is important to resist the urge to rub, and to arrange the ergonomics of your workstation if possible.

  60. Dr. Damien Gatinel says:

    Regarding the keratoconus of your son, it is crucial that the frictions stop permanently. As explained on these pages, friction is the necessary ingredient for the appearance of a keratoconus, and those you describe are most frequently implicated in patients with KC (because they are vigorous and performed with the "hard" part Fingers and hands). From my point of view, CXL has no interest in patients with KC (unless it induces locally caused inflammation of the patient's inability to continue rubbing). Indeed, contrairemnt to the assumption that the KC is the result of spontaneous tissue softening, this disease is in fact the result of repeated local trauma. The deletion of this trauma is enough to stabilize all the KC that I am, and these case, anonymised, are searchable here. I consult regularly for the KC, especially his screening and early management at the Rothschild Foundation in Paris.

  61. Domenico says:

    Hello doctor,

    Thanks for this writing allowing (I find) to respond effectively to keratoconus.
    Diagnosed in 2013 (22 years old), a keratoconus with the right eye, I am offered an operation the next day...
    I decide to wait for a counter-notice, which will be the same, KC on right eye, so I am offered in the immediate a Cross linking.
    I am diagnosed some time after the KC on the left eye.
    I have since stopped any rubbing on the eyes, this can happen to me, but it is very rare, and only on edge and delicately.
    I am so far with a more than minimal evolution on both my eyes. While only the right eye was operated.
    For my part, I own an allergic ground with essentially allergic rhinitis in early spring.
    I confirm your writing, friction is most likely the CAUSE of keratoconus.
    No doctor met could explain to me clearly the keratoconus...

    Apart from that, I wanted to know given my astigmatism and low myopia, is it possible to consider a visual correction operation on a patient with a light KC with a satisfactory corneal thickness?

    Well yours,

    And good continuation for this article and your research

  62. Dr. Damien Gatinel says:

    Your testimony is unfortunately a reflection of medical practices that can be judged negatively. There is never an urgent need to carry out a CXL, and the interest of this technique (for the enlightened patient who is able to control his friction) is not justified when the friction ceases. This is what your left eye (like those of all the patients I am for KC) testifies to. The KC is caused by friction (without friction, no keratoconus), and it is also (through the frotteements) very related to a particular sleep position as the deep support of the head in the pillow (side position or on the belly). As you mention, the OPHs who refute the direct responsibility for trauma in the KC Genesis are well in trouble to find another explanation. Friction is not a default explanation of the keratoconus, as there is a direct link between the most rubbed side and the most affected eye, and the frictions precede the installation of the KC for a few years in general. They act as a "vulnérant" agent. One can make an analogy with the cause of sunburn (solar erythema). They are related to exposure too strong to UV, as the cornea is to friction in some patients. No UV, no burn, no friction, no traumatic injury.
    If you are absolutely certain not to rub any more, an operation by PKR is quite possible on the weakly distorted eye (surface laser). I have experience in your field.

  63. Domenico says:

    Thank you for your clarifications.
    Regarding the PKR, I would come back to you by mail at first.
    I have annual (or almost) topographies concerning the evolution of my cornea.
    So if it's something to consider, I'd be a taker.
    Today, I still have an allergic terrain, so I regularly do cravings to rub, and inevitably I do not yield. So I am convinced of that.

  64. Karim says:

    BJR doctor,
    I am 27 years old and they diagnosed me with a KC stage 2 from APRs my doctor and stage 1 according to my ophthalmologist...
    My ophthalmologist my advised of rigid lenses but the prob is that my eyes produce a tear can is that gene and fause the result of the Correction.. I'm a lost can
    PS: Ma vu currently ODG 7/10.. Mnt I hesitate to prédre these lenses
    My qustion esque I can stay without lenses? And live normally, I stopped rubbing my eyes, I happen to rub on the borders
    Thank you PR your DR rep

  65. Emilie says:

    Hello doctor,
    My left eye Keratoconus was diagnosed 1 year and a half ago (I am 32 years old). Rigid lenses were prescribed to me but the adaptation was made certainly too quickly and I never supported them. Today I changed ophthalmologist, and it turns out that my keratoconus left eye has evolved in Stage 4 (I have less than 1/10), and that the right has evolved also (I have less than 5/10). I have an appointment with a specialist in June to discuss a possible transplant for the left eye. In the meantime, I took over a rigid lens adaptation on the right eye.
    Teacher, I am forced to exercise at 120 km from my home and my administration, not knowing the disease like many people, do not take it seriously and refuses to transfer me for this reason. The MDPH of my department also refuses to grant me the status of disabled worker, in support of my request for transfer.
    So I asked for new medical certificates, but
    Is there a brochure, or any other medium, to the doctors of the administrations, in order to make them aware of the disease and especially its consequences on our daily life and thus, to enable them to take the measure of what it implies and "Compel" them to adapt our workstations?

  66. Sam Leuk says:

    Hello doctor,
    I have a bilateral keratoconus diagnosed at the age of 27, I currently have 39. I have been operated with several years of intra-corneal ring intervals on both my eyes. I recently made a control topography and it turns out that there is a recovery of the disease on my right eye but no loss of visual acuity. I'm not hiding that I'm worried. Will it be necessary to consider removing my implant? Think of a transplant?

  67. Dr. Damien Gatinel says:

    In many cases, topographic controls carried out in this context are not "reliable" (there is a great variability between examinations that can lead to a progression, whereas in reality it is a measurement bias). If there is no loss of acuity, it means in all case that the situation is not alarming; Remake one (see several) topographic controls, if possible with the same macbine as initially. It is of course important to check that you have stopped rubbing your eyes (without your knowledge?).

  68. Dr. Damien Gatinel says:

    I advise you to consult the website of the French Association of Keratoconus, which should, I hope to steer you: http://www.keratoconus.net/presentation.html

  69. Dr. Damien Gatinel says:

    It is not necessary to wear rigid lenses if you are relaitvement at ease without correction. You can wear glasses occasionally (e.g. driving, shows, etc.). The most important thing, as you have understood and realized, is not to rub your eyes anymore: your deformation will no longer progress if you permanently stop kneading your corneas!

  70. Joris says:

    Hello, I'm here because I was diagnosed with a keratoconus mid-April. I have been seeing vision impairments for quite a few years, and they have been growing rapidly over the last few months. I'm 34 years old.
    The ophthalmologist therefore diagnosed a keratoconus and strongly advised me never to rub my eyes again and prescribed a pair of glasses (I had never worn glasses or lenses until then).
    Since then, I have tried to stop rubbing my eyes, and have found that I rub my eyes often, without realizing it. My eyes often sting and I have a hard time preventing myself from rubbing them: so I do it now gently, without pressing, and using only the "pulp" of the fingers (where the fingerprints are) rather than the phalanges: is that enough? In the opposite case, how can I stop this incessant desire to rub my eyes?

    Another question: Before this diagnosis, I knew that my vision was to be corrected, but I did not imagine a case like that. But since this diagnosis, I have the impression that the discomfort has suddenly increased, without finding whether this is real, or psychological. I will have my glasses on the weekend, I already know that this correction will not be optimal but I fear that it is not even effective. And I find it hard to understand what correction is to be preferred for a case like mine: I read that the glasses were often not enough, that the lenses did not fix anything, that cross linking was ineffective and that the surgery was to Book to the most serious case...
    In fact, my question is simple: when I read a text, I see the lines in duplicate: Can it correct (and if so: how) or is it irreparable (and the case appropriate: what should I do to make my vision the least bad possible)?

    Thank you very much.

  71. Durand says:

    Hello. I also have a keracotone.
    I'm being made to wear lenses now. But I would like to know if it would be possible to gain visual acuity when I am not wearing my lenses.
    My work could fire me if my eyesight drops...

  72. Lopes ana says:

    Hello, doctor Gatinel,.

    I was detected an evolutionary keratoconus in 2010 on both eyes. I had a cross linking of the left eye in 2011 and the right eye in 2012. In 2013 I was team in rigid lenses that I have very poorly supported, so the adapter put me hybrid lenses. My keratoconus continued to evolve, and in December 2017 I had a keratitis amoebic to the left eye and suddenly my eye is more sensitive. At the Rothschild Foundation I was made topography that shows that my cornea is too fine to the left of the shot impossible to lay intra-corneal rings, but to the right it is still possible.
    What are the advantages of an intra-corneal ring installation?
    What would be the solution for my left eye very affected?
    What's the solution for my case?
    I am talking about corneal graft but I am very afraid because I am very young I have only 29ans?
    I'm afraid of this intervention

    Thank you for any R

  73. Dr. Damien Gatinel says:

    As far as your left eye is concerned, it is likely that the solution resides in a corneal graft, if it has opacity and can no longer receive a lens. For the right eye, the laying of rings can actually be considered, but the results are often inconsistent: if your eye is myopic, you will have to wear glasses or a lens despite the laying of rings. However, the rings sometimes complicate the secondary adaptation of a Contact lens...

  74. Dr. Damien Gatinel says:

    It is sometimes possible to improve at least partially the vision with glasses. The most important thing, to prevent the keratoconus from progressing, is to stop rubbing your eyes.

  75. Dr. Damien Gatinel says:

    It is indeed very important not to rub your eyes anymore. Doing it with the pulp is certainly less deleterious than with the phalanges. This page provides many recommendations to no longer rub your eyes: https://defeatkeratoconus.com/eye-rubbing-tips/
    The duplication of letters and printed texts is related to astigmatism, one component of which is regular (correctable in glasses), and the other known as "irregular" (not correctable in glasses). Wearing rigid lenses often helps to alleviate these symptoms.
    More on the vision of patients with keratoconus:

  76. Manual says:


    I am 49 years old and I have a bi lateral keratoconus, diagnosed since the age of 20 years. I have been wearing rigid lenses since and the keratoconus has no evolved, and the vision remains stable with the lenses. My uestion is as follows: Is there a correlation between vision and topography? In other words, if my vision moves, that is to say that the cornea also moved, so we have to redo a topography. I had not asked myself the question because my vision does not move...

  77. Ivan says:

    For my part stop rubbing my eyes became possible when I could drastically decrease the mold in my apartment.
    I have a question for Dr. Ganeshan, how is it possible that superficial eye irritation can have an impact on the stroma?
    In sum a friction of the eyes should not have an impact on the fate of the Kératocone, since it is indeed the deep layer that comes into play.

    This is an issue that I think is important because I was told that my kératocone had worsened, and then another opinion "a little" aggravated, in essence I did not feel that it was so aggravated in the end.
    Especially since to make a cross linking, one scratches the epithelium completely removed, if really superficial irritation would aggravate the kératocone we would not do cross linking.

  78. Amine says:

    Hello, doctor Gatinel,.

    I am 30 years old and I suffer from a non-evolutionary keratoconus in the second stage on the right eye. So the glasses are not enough for me. So I'll consider wearing lenses. But I have a question, is what the fact of posing and removing lenses will not cause any problem in the long run? Since it is a direct contact with the eye.

    Thanks in advance.

  79. Dr. Damien Gatinel says:

    The lenses are nothing deleterious to the keratoconus. On the contrary, rigid (or hybrid) lenses are, by far, the best means of correction for keratoconus. The intra corneal rings are far from bringing the same visual benefit. Cross linking is sometimes a source of worsening vision in the first postoperative weeks, and, as explained on this site, does not serve much if not to give the illusion of therapeutic management. On the other hand, it is crucial not to rub your eyes during the removal of the lenses, or during the wearing of these.

  80. Dr. Damien Gatinel says:

    The corneal deformation, which is actually the real entity of the keratoconus, is that of the stroma. The epithelium is a fairly fine layer (10 pcs of the total corneal thickness about). The keratoconus is caused by repeated mechanical stress (friction) which is transmitted to the entire corneal wall. It is not unusual that divergences exist to judge the evolution of a KC, as topographic maps are less repeatable in the KC context than in normal subjects. What is certain is that if you no longer rub your eyes, the chances of progression are zero. The KC is not a genetic disease that evolves for its own account, but a primitively mechanical deformation.

  81. Dr. Damien Gatinel says:

    There is indeed a close correlation between vision and topography: the visual symptoms experienced by patients with keratoconus are induced by the deformation of the cornea (irregular astigmatism which is not correctable in glasses). However, patients with keratoconus may experience fluctuations in their vision, depending on the ambient lighting, the state of the ocular surface, etc.

  82. The Sadrati says:

    Hello doctor,
    I just learned that my 4 year old daughter has a keratoconus. His doctor my wondered to do the topo every 3mos, and have glasses. Is there any other solution to stop it!!!

  83. Dr. Damien Gatinel says:

    It should be verified that this is a keratoconus because the realization of a corneal topography is sometimes difficult in infants, and that it is a very early age to develop this condition. If your daughter has rubbed her eyes in a fierce way since she is old to do so, this could corroborrer this diagonstic. However, this is probably an excess diagnosis. Remake the topography, and above all, make sure that your daughter does not rub her eyes, especially with fists and phalanges.

  84. Gonzalez Myriam says:

    Hello, doctor.

    I hope you will take the time to read Me....

    I have a moderate keratoconus, my ophthalmologist does not want to equip me in lenses because it is "moderate" even if this term does not mean anything to me because my galleys are not.....
    When I change my glasses I can't stand them (discomfort, headaches etc...) I only support my old pair of glasses or so I have to buy always the same type of glasses (breakthroughs, small same brand lenses) and again.....
    I find it astonishing, I'm guessing the keratoconus is the cause.
    I specify that it was discovered by chance 3 years ago, because of the weary war with these glasses problems, I wanted to have surgery.
    I have been wearing glasses since I was 16 years old, I have 43, I began to be myopic then astigmatism arrived around 30 years.... and the galleys of glasses then started....
    I tried to wear other kinds of glasses, larger acetate lenses, closer to the eyes too...
    It is as if my eyes (my brain) in deforming day after day, "recorded" The characteristics of the glasses, their geometry, and then when changing glasses (even at equal Correctionsmeme) did not want others.
    I read a lot of articles on the keratoconus, very few talk about discomfort but rather a bad vision.
    I specify that the killer whale I was younger I changed glasses very easily more CA has deteriorated with the years...
    Have to stop the glasses, m equip in lenses I'm lost (NB J have done lots of sessions of orthoptics that have not changed anything)
    Thanks in advance
    Kind regards
    Myriam Gonzalez

  85. Dr. Damien Gatinel says:

    Keratoconus-induced optical anomalies (aberrations) are not correctable in full with eyeglass glasses. In addition, the correction of astigmatism (often pronounced) of patients with keratoconus causes disorders related to aberrations or distortions that can be induced by glasses of spectacles that carry a strong correction of astigmatism. It is plausible that your brain adapts to a type of correction, finding a compromise, and that subsequent correction changes destabilise this adaptation. In any case, it is certainly useful that you try an adaptation in contact lenses. Lentils are the best way to correct optical aberrations caused by keratoconus. More information on the visual anomalies observed in the keratoconus (in English): https://defeatkeratoconus.com/vision-disturbances-of-keratoconus/

  86. Gonzalez Myriam says:

    Thank you very much doctor for your answer
    Well cordially

  87. Lari says:

    I am 33 years old and I have a kératocone detected October 2017 but the specialist told me that there was nothing to do because I had a good visual left eye:-0.5 (-0.75), right eye 0.75 (-0.50)... and I have redone a test so far August 2018: Left Eye:-0.75 (-0.50) , right eye 0.50 (0.50)... is this possible that I could improve my vision slightly? and is the loss of the left eye disturbing to you? I see slightly more blurry a little discomfort (knowing that I am very anxious I only think about this eye...) and when it itches, I lightly touch the sides of the eye and the eyelashes (is it good or bad?)... and the glasses are necessary knowing that I spend 8:00 am dev Computer and laptop and it must be tired of the eye? Thank you for your reply and your attention...

  88. Dr. Damien Gatinel says:

    In view of your correction, the deformation corneal must be quite minor, because otherwise you would have a much more pronounced astigmatism. Stop rubbing your eyes vigorously, and things should not be much évouluer. This may be a diagnosis of keratoconus posed by excess; Take another opinion.

  89. Jeremiah says:

    Hello doctor,

    I am 34 years old and I suffer from a keratoconus Bl evolutionary lateral Stage 3, 4. I wore Eyebride-type rigid lenses from LCS to piggyback. Vision 10/10 and no bezel possible.
    For 6 months, I have a Gigapapilaire conjunctivitis, it gives me eye pain with and without lentils, pain that goes back in the temples.
    I was advised to change lens materials. I am in adaptation with as soon scleral always from LCS. Difficult Adaptation, it gives me dizziness and headaches.. + Port time can fit around 7am. When do you think? How do you treat this Giga papillary conjunctivitis by continuing to wear lentils?

    Thank you

  90. Dr. Damien Gatinel says:

    This is a tricky point in the adaptation and wearing of rigid lenses: the occurrence of Giganto papillary conjunctivitis needs to revise the modalities of the Contactologique adaptation (type of lens, product, etc.). It is necessary to discuss this with your contactologue who controls these parameters and has databases of specific examinations such as the position and the behavior of the lens on the cornea, etc.

  91. LEGHEDA says:

    Hello doctor,

    I suffer from a keratoconus. I have undergone two operations to date: a Crossliking first and then an implantation of the Intra-cornea rings. Following the last operation, the surgeon after two controls prescribed flexible contact lenses identical to each eye in terms of parameters.

    These lenses allow me to see as it should be, ie the correction of the blur, but I notice for already a few weeks that they are not too adapted because currently I have as a blur on the images I fix or even the scriptures.

    Therefore, I would like to know please, if it is possible to redo (in another ophthalmologist specialized in soft contact lenses) in-depth exams and controls in order to properly check what is wrong but also that to get out of there prescribe me good lenses of Flexible contact Please, that is, it can adapt me or prescribe flexible contact lenses adapted to the desired correction according to the results of analyses found?

    Thank you in advance for your return of reply and the attention you will bring to my request.

  92. Dr. Damien Gatinel says:

    The flexible lenses do not allow the completeness of the optical defects induced by the corneal deformation to be corrected during the keratoconus. It is best to adapt rigid (or semi-rigid, or hybrid) lenses to significantly reduce these defects. The adaptation of rigid lenses is the first thing to consider when a keratoconus induces a visual discomfort that it is not possible to correct in glasses.

  93. Dr. Damien Gatinel says:

    It is difficult if not impossible to correct all the optical defects caused by the keratoconus with soft lenses. It might be more appropriate to try to adapt rigid or hybrid lenses in your case.

  94. Pauline says:

    Hello, Dr. Ganeshan,

    – I'm 26 years old and my eyesight has started to drop steadily since I was 19-20 years Old. As a student, I studied whole days and therefore exercised a close view in a prolonged way. In the evening when I came out of my home I saw extremely blurry, but it was temporary and after a night of sleep everything was better.
    – But over time my eyesight has continued to fall, and this even by being less immersed in my books. I then Consulted. But I could not find an answer to my questions: I did not understand (did not admit) that my eyesight could degrade at this point and so quickly, without any Explanation. After a medical tourism, I met my current ophthalmologist, which she took the time to perform a real history and explained to me that I had perhaps a keratoconus: it was for me the cold shower (i already knew what it meant following research on Internet). I soon see my ophthalmologist in December for a confirmation/reversal of the Diagnosis.
    – My current view: right eye (-1.75 to 165 °) and left eye-1 (-1.75 to 30 °).
    – My ophthalmologist advised me not to continue my investigations on the internet, but curiosity being stronger, I fell fast enough on your website and its many resources (thanks!)
    – I started to think about the friction that you evoke as the cause of the keratoconus: so I do not know, maybe it makes me better to have this answer as to the origin of my difficulties, but it is true in all 468799587679879009494/ 516312260 that the eye rubbing are part of my past: always I rub my eyes in the morning when waking up, in the evening during bedtime and in case of fatigue during the day (only when I am not wearing makeup , that is, rarely, phew). These frictions are quite innocuous and practiced by many people without a problem of sight, but as you explain very well, basic we do not all have the same quality corneal. Since adolescence I have the impression that the "overall" quality of my eye has diminished: the sclera of my eye is more easily irritated, Red (i have a past of persistent conjunctivitis...) and I have the impression that it is fine (we see small vessels, it was not the case when I was a child) my iris rose from Brown to green/hazelnut growing (?). And since I was very little, very curious about nature, I have experienced some things with my eyes and especially long and intense supports on my eyeballs (it's absurd but I was amazed at all the colors/glittering effects that this provoked, It was for me a real spectacle:D) growing up I stopped this joke and was always limited to intense support, repeated but in order to relax (because of anxiety and insomnia...).
    -i have a question: being flirtatious in nature I only wear my glasses very little, my ophthalmologist then offered me rigid lenses. Clearly I do not support them and I confess not to persevere either... I'm afraid this will accentuate the deterioration of my corneas, I feel like I offer them bits of glass... What do you think of the rigid lenses on a cornea with keratoconus?

    doctor, Thank you for having the courage to read Me so far.

    I am open to any information (i still have to go through more detail on your website, but if you have additional and recent literature on the subject), or even any clinical trial/experimentation, in short I am available.

    Thank you in advance.

  95. Dr. Damien Gatinel says:

    Thank you for your very enlightening testimony. There is no doubt that the eye rubbing are originally (I.E. an indispensable ingredient for the genesis) of the Keratoconus. This theory will one day be admitted, even if for various reasons it is not yet shared by all Ophthalmologists. And yet it is necessary, as in your case, to have rubbed often and vigorously the eyes to trigger the onset of a permanent corneal deformation. Rigid lenses are the best way to visually correct the keratoconus, as they can correct optical defects that soft lenses (and eyeglasses) cannot compensate for.

  96. Pauline says:

    Hello doctor,

    Thank you for your reply.

    But are you certain that the repeated friction caused by the movement of the rigid lens on the cornea is safe for this one, does it not accentuate the long-term keratoconus?

    Or maybe you don't have enough long-term setbacks to be able to say it? For certainly, the wearing of rigid lenses gives the illusion of an almost perfect sight found, but I do not want to pay the price in X years...:-/

    Thank you in Advance. :-)

  97. Dr. Damien Gatinel says:

    The force applied by the contact of the lens (support on the horn) is minimal vis-à-vis the one exerted by the eye rubbing. Epithelial remodeling can be caused by prolonged wearing of a rigid lens but this is Transient. There is no risk directly related to the lens – unless the local irritation that can cause the lenses triggers the urge to rub the eyes.

  98. Neetesh says:

    Hello doctor
    Can the keratoconus make it blind?

  99. Dr. Damien Gatinel says:

    The keratoconus does not make blind, but can alter the vision sufficiently to handicap patients, especially when the adaptation of a rigid lens is no longer possible, and a corneal graft is necessary. This occurs only in patients who rub their eyes in a incoercible way. Any patient with keratoconus who no longer rubs his eyes, and who modifies his sleep position so as not to "press" on the eye (or both) during sleep will not see the deformation corneal progress. Our experience today allows us to establish this point which is excellent news for patients with keratoconus.

  100. Hello Dr Ganeshan
    A keratoconus "frustrated" that has not evolved for 17 years can it evolve again? A big stress can have an impact on vision and result in many visual disturbances (near and far Diplop, photophobia, flying flies, ghost pictures, discomfort with headlights, lights and sun ect..) or is this an evolution of the KC.. Knowing that they have not evolved according to the ophthalmologist and that he does not understand these visual disorders..
    With all my thanks

  101. Dr. Damien Gatinel says:

    A frustrated keratoconus evolves into a more proven form than if repeated local physical trauma (friction) is exercised and this trauma exceeds the corneal resistance. Beyond a certain threshold, the reduction of the elasticity of the cornea can have a permanent deformation. In our experience, this deformation is fairly well correlated with the intensity of friction exerted (although it is not easy to quantify these, and patients often rub their eyes unconsciously). The sleep position is important and patients who present a "frustrated keratoconus" (according to us a moderate deformation of the cornea, and which is precisely moderate because the cumulative mechanical stress is also moderate) often sleep on the belly or side ( Eye support on the pillow, etc.). The other visual disorders that you report are not related to the keratoconus a priori except the Phantom images which are the optical translation of the distortion of the cornea.

  102. Emmanuel says:

    Hello Dr. Damien Ganeshan, my 20 year old son has more pronounced vision problems of the left eye that makes me think but without certainties to a keratoconus . Whatever the friction of the eyes proves harmful.
    He is careful in the day, the problem is the position when he sleeps. He sleeps on his back with his right hand placed directly on the left eye. Is there a way to remedy that?
    Thanking you, very cordially

  103. Dr. Damien Gatinel says:

    We have actually discovered a strong link between sleep position and keratoconus. If the hand is placed on the left eye at night, it is very likely that prolonged support, increased local heat and friction induce a perennial deformation of the cornea (i.e. a keratoconus). It may be interesting to have your son wear an eye protection shell so that he becomes aware of friction and changes his position. More here: https://defeatkeratoconus.com/eye-rubbing-tips/

  104. Akim says:

    Hello doctor I've been following you for five years.
    On our last appointment you told me that my keratoconus no longer evolves because I do not
    Don't rub your eyes.
    On the other hand my astigmatism has risen sharply and my eyesight has suddenly dropped.
    Do you think the rings could help me.

  105. Brian Guyffroi says:

    Hello doctor,

    First of all, thank you. Thanks because of reading your site, so I stopped (without really believing too much at first) to rub my eyes (I did not do much, but it was probably already too much for my corneas). And verdict the day before yesterday at my ophthalmologist: no aggravation corneal, no decrease in acuity in the space of 6 months whereas before it was the perpetual tumble.... And then I blame you because I would have loved to have access to this information much earlier. I am-1.75 of astigmatism with every eye, it goes again, but I live this as a handicap, I am almost dependent on a pair of glasses or rigid lenses... (Good OK there are worse in life:-)) I imagine you do not have the full powers to share this information on a large scale, but still.. Hold such information that can save the sight to many patients (although people with a predisposition to the dvlpt of Keratoconus are few, they still exist...) and then if it is necessary to wait for science to prove the clinical observations of Practitioners, I think we have not finished waiting! For my part, I inform all the children I meet in my practice (I am a speech therapist) and I shout at the scandal when I see one rubbing his eyes! Let's see the positive: About me, the stability of my view is already a first victory.... But so I do not intend to stop in such a good way: I now want to recover a perfect view or almost, in a non invasive way. The mere fact of observing the temporary remodelling of my cornea following a prolonged port of the lenses leads me to think that the distortions cannot be completely definitive... I know that an eye is not a brain, but still: among my Alzheimer patients with whom I work, I found to my amazement that many of them progress slightly, provided that cognitive stimulations are sufficiently targeted, Intensive and experienced positively by the patient, even at an already advanced stage of the disease! Therefore, evolutionary/degenerative disease does not necessarily mean inevitable deterioration or simple stability. It's brain plasticity that works OK, but it can perhaps be transposed to the cells of the cornea...? I still do not know much about the operation of the eye, even almost nothing at the moment... but I intend to learn and try certain things..... Doctor, if you have any clinical intuition, information (even surprising) I'm willing to try. I may be playing sorcerer's apprentices, but I wonder, instinctively, if extremely light massages, with eyelids, or repeated muscle exercises every day would not promote the reorganization of the cells of the cornea?

    Thank you in advance.

  106. Dr. Damien Gatinel says:

    I thank you for your testimony that has attached my comments. I do not quite understand, however, your reproaches regarding the "retention" of useful information. This site, as well as the site Http://www.defeatkeratoconus.com That I have created are specifically dedicated to bringing this information to the public. I have also published several articles (linked from these sites) on the subject and the conjecture "no rub, no cone" (Http://beta.jaypeejournals.com/eJournals/ShowText.aspx?ID=14217&Type=FREE&TYP=TOP&IN=&IID=1108&isPDF=YES), which stipulates that the keratoconus is directly caused by friction, and that the halting of the latter prevents its evolution. Feel free to share the pages of these sites. The ophthalmologic community remains divided on this point, but an increasing number of practitioners realize the relevance of this theory, and check the positive consequences by noting that in patients who no longer rub their eyes (and modify their Sleep position), the Keratoconus no longer evolves. Néanmmoins, as always, a certain conservatism is faced with the diffusion of these concepts, which also come into conflict with financial interests (CXL industry, fees related to these surgeries, etc.). We continue to collect data and have published a scientific paper based on a detailed study of the risk factors of keratoconus, which reveals the major influence of friction and certain sleep position.

  107. Michael says:

    Hello doctor
    How to sleep otherwise than on the side I no longer rub my eyes but it hardly possible for me to sleep otherwise I put glasses at night to be sure not to rub my eyes during sleep del

  108. Dr. Damien Gatinel says:

    This is actually a very good question and it is crucial not to rub your eyes at night. Wearing glasses or night protection shells is a possible way to do this. But it's not always very practical unfortunately...

  109. Jul87 says:

    Hello doctor,

    You are talking about submitting to publish a new article on eye rubbing . What will we be able to consult with him?
    Do you have absolute certainty that stopping friction is enough to stabilize the cone? It is very comforting for the sick, but there is always a doubt when we see that some keratoconus occur very quickly without any apparent cause. Do you believe that this also works for the "hereditary" KC (uncles, grandmothers afflicted in the family)? In all case , this is very valuable to us because the evolution of the disease is a torment for most people afflicted.

  110. Akim says:

    Hello doctor I've been following you for five years.
    On our last appointment you told me that my keratoconus no longer evolves because I do not
    Don't rub your eyes.
    On the other hand my astigmatism has risen sharply and my eyesight has suddenly dropped.
    Do you think the rings could help me.
    Thank you

  111. Dr. Damien Gatinel says:

    Publications concerning our results in the study of the causal link between friction and keratoconus have been submitted for publication, they are in critical proofreading. When our patients stop rubbing their eyes (and sleep with extended support on one eye or both, so by lifting the possibility of compression and night friction), there is no evolution of deformation, which is quite logical if one considers the primitively mechanical etiology of affection. You can view case Practical and informative on the site defeatkeratoconus.com. There is no hereditary KC: What is hereditary is the presence of risk factors for accelerated deformation (fine cornea) and friction (especially allergic terrain, eye irritation medium, etc.).

  112. Jul87 says:

    Thank you for your answer, doctor. We look forward to your upcoming publications! It appears that your solid theory is a tremendous comfort to people with KC. This pathology that drastically diminishes the quality of life, completely unknown to the general public, is a torment. Indeed, you are explained to the announcement of the diagnosis often a disease that comes inexorably make you lose the optical quality of the eyes. I have had many ophthalmologists who speak only in "tenths". I have a "Stage 3 Krumeich" on the Left eye (54 diopters in Keratometry Max), I have 3 tenths with glasses. With lentils, 9 tenths. The ophthalmologist tells me that this is satisfying, except that I find it hard to recognize people (visual distortions), an extreme photophobia compared to a healthy eye, the vision is painful see untenable. The handicap of the keratoconus is not due to the distortion of the anterior face, because it can be regulated by the wearing of lenses, but it is the deformation of the posterior side of the cornea that is incorrigible and the aberrations are unmasked by the port of Lenses. Although the amount of optical aberrations is less on the posterior side, it is often completely underestimated by the ophthalmologists, even specialists in this pathology. The OPD Scan 3 with optical quality simulations (convoluées images) are a first step towards the recognition of this handicap (thanks to you) real and formidable. My question is this: can you conceive in the future a software with a prediction of the images of the daily that can see a "Kératocônien", from the wavefront and the PSF? This would be even more speaking than a reading board, even if it's already great! and secondly, you possess information of vital importance for the fate of thousands of people to become visual, that is to say the strict shutdown of eye rubbing Stop the deformation of the KC. Is it possible, in addition to your numerous publications and explanatory sites, to ask the French Channel 5 to redo a program on the KC with your explanations on the KC? This would allow an even wider dissemination of this crucial information? We are still facing a major health problem, the KC, is from my point of view, not a rare disease! Thank you very much.

  113. Akim says:

    Hello doctor I've been following you for five years.
    On our last appointment you told me that my keratoconus no longer evolves because I do not
    Don't rub your eyes.
    On the other hand my astigmatism has risen sharply and my eyesight has suddenly dropped.
    Do you think the rings could help me.
    Thank you

  114. Dr. Damien Gatinel says:

    Thank you for your comment; I strongly agree with your remarks on the optical aberrations of the posterior side of the cornea, "unmasked" by the wearing of a rigid lens. We had studied them in the past: http://m1.wyanokecdn.com/ac3f8e3418e778d6b3d582c679483b93.pdf
    The OPD scan III allows to perform simulations of vision from an image representing a street at night, I will soon post examples on the site. I actually conceive that the paradigm shift towards the keratoconus that we are trying to carry should be much more attracting attention. Maleureusement, it opposes the "business model" in force which is supported by certain actors in the medical industry (companies that sell material and consumable for cross linking), and does not propose a therapeutic alternative "paid", since it does not cost/report anything to change his eye hygiene by stopping to rub excessively his eyes. The vast majority of the ophthalmologic world refuses-or remains sceptical of – my theory, which can be understandable after all, because skepticism is a rather useful virtue in science and medicine, and disruptive ideas take time to Take the membership. What is less understandable is that there is not really a critical review of the conjecture "no rub no cone", which, after all, could lead to its rebuttal in due form if it proved to be érronnée. It is a little heartbreaking to note that conservatism, various interests, or even some intellecturelle laziness, are combined to continue to advocate concepts that are contradicted by the facts, i.e. to attribute to the keratoconus the label of "pathology Of unknown origin, probably multifactorial including genetics, which can evolve spontaneously and cannot be the subject of prevention. I proposed to France 5 to deal with the keratoconus in the light of our discoveries, but it seems that this theme has been dealt with recently... hope it will come soon in the spotlight! I will continue waiting to communicate via this site and defeatkeratoconus.com, in addition to the symposia, seminars and congresses to which I participate regularly. Readers who are concerned by the keratoconus and would like to bring these concepts to the knowledge of the greatest number are invited to do so through shares on other sites and social networks.

  115. Khalid Montréal says:

    Hello Dr. Gattinel,
    I would like to begin by thanking you for your site and for the work you are doing.
    I am 34 years old and I have the keratoconus It's been 8 years on both eyes but much more advanced on the left eye than the right, 3 years ago I had an appointment for cross-linking (CXL) in Montreal that I cancelled (fortunately) following your suggestions on this site 《 I definitely stop rubbing the 》 eyes and subsequently I made the decision to try the hybrid lenses but just on my left eye (the most advanced) but very difficult adaptation (I do not arrive at the meter alone) correction with lenses almost 9/10 but the problem saw that I just put u NE lens I see blurry with both eyes and if I close the right eye I see clear (Straight eye without lens acuity 8.5/10 which has a keratoconus That has not evolved since I do not rub my eyes)
    My question for this phenomenon of seeing blurred is what if you just put a lens it's normal to see blurry? The fact of putting just a lens is it dangerous for the health of both eyes?
    I made the decision to just put a lens to not touch the only eye I have left that thanks to it I can live without lens.
    Please is what if I put lenses on both eyes I will not see blurry?
    MERC a lot for the time you give for us ITA and answer.

  116. Dr. Damien Gatinel says:

    You were right to stop the eye rubbing , this simple decision is sufficient to curb the evolution of the keratoconus. Supporters of a cross linking are often careful to explain this to their patients, and do not understand the mechanical nature of the affection. If your KC was more advanced on the left eye, it may also be because you are sleeping in a position that preferentially exposes this eye to an overpressure on the mattress, pillow or forearm (eg: sleeping on the belly with the head rotating towards the right). It is important to pay attention to this: again, this aspect is always neglected in patients while the sleep position plays a crucial role in the genesis of the Keratoconus (the correlation between the most reached eye and the sleep position is glaring : Weakening by compression, heat, and irritation probably generating a greater urge to rub on this side). I understand your fear vis-à-vis the right eye: If you are uncomfortable in unilateral correction, it is that this eye sees slightly blurry (effect of moderate keratoconus on this side). It is certain (or roughly) that you will not see blurring after a bilateral correction. However, a unilateral correction is not dangerous to the eyes. What would be dangerous, repeat it, is to pursue the eye rubbing Without your knowledge.

  117. Khalid says:

    Hello doctor
    I want to thank you for your quick rethink,
    Indeed I tried to make the correlation between the most reached eye and the sleep position, but I often sleep on the right side so normally it is the right eye that had to undergo more friction er pressure for my case Perhaps it is not the sleep position but rather a correlation between the most reached eye and the dryness of the eye. I have dry eyes and the left eye drier than the right eye.
    A small precision for blurred vision without unilateral correction I do not see earned blur with the unilateral correction that I see blurred with both eyes and if I close my right eye I see clear with the unilateral correction on the left eye

  118. AMESSOU says:

    Hello doctor,

    I just consulted the 30/01, and I was diagnosed with a keratoconus with a stage 3 at the OG, and a stage 4 at the OD. The doctor told me that I had to undergo corneal grafting at OD, and first programmed me to set up intra-corneal rings at the OG for the 18/02.
    Knowing that I see almost nothing with the OD unlike the OG that I mainly use, and that I will start a CDI in computer science on 05/03.

    Do you think that following the ring pose I could start my CDI on that date?

    Thank you in advance for your answer,

  119. Dr. Damien Gatinel says:

    In principle, when discovering a keratoconus, one begins by trying to adapt a pair of contact lenses. If the lenses correct the vision, then it is not useful to put a ring. Indeed, even with a ring (which aims to reduce astigmatism), it is very likely that the improvement of the vision will not be sufficiently marked so that you no longer need glasses. To the right, if it is not possible to adapt a lens, then a graft may be the only therapeutic solution to recover from vision. In all case , it is crucial that you stop rubbing your eyes + + +

  120. Mary says:

    Hello doctor,

    Can people with keratoconus benefit from Orthokeratology?

    I wear rigid lenses during the day that I support quite well, except when a dust comes in the eye, that is to say at least 10 to 15 times a day... In these moments wearing the lenses becomes a torture, I am forced to remove them in emergency, which is not always possible and sometimes dangerous (driving by car e.g.) ...

    Thank you in advance.

  121. Myriam says:

    Hello doctor, thank you for your valuable advice. My 17-year-old son is hyperopic since he was little and wears glasses. Yesterday the ophthalmologist had a doubt about the kératocone, he prescribed it resumed a new correction and a topographer in 6 months, and told us about rigid lenses. My question: Can we wait six months without risk that it evolves? What do you think? Following your advice I told him not to rub his eyes. Thank you for your reply.

  122. Hanaa says:

    Hello M, I have a sister trisomic reaching the keratoconus in both eyes! Unfortunately we could not detect her illness until the day she lost one of her eyes and she needs a cornea transplant, for the second eye we were told that we must curb evolution but it is not too urgent, I want to know your opinion : Do we have to start by operating the eye that needs a cornea transplant, or we start with the one who still sees to brake the keratoconus... We are very inquirets in the context of a Down syndrome...
    Thank you Doctor

  123. Dr. Damien Gatinel says:

    It is necessary to consider a graft for the eye which has lost its useful vision because of a very evolved keratoconus. Making a graft with the other eye (which still sees enough) is not indicated. To curb evolution, it is crucial to stop the eye rubbing . This is often difficult to obtain in trisomics, and that is why these patients often have serious – because evolved – forms of disease. They rub their eyes very vigorously and frequently, and a vicious circle settles because the local irritation only increases. Nocturnal friction is also common. Sometimes wearing an eye protection shell at night can avoid rubbing on the eye. Of course, it will also be necessary to ensure that the friction stops on the eye that will be grafted.

  124. Dr. Damien Gatinel says:

    It is indeed crucial to stop the eye rubbing (typically made with finger phalanges in patients with keratoconus). In our experience, this is necessary but also sufficient to stop the evolution of the keratoconus, which is logical since it is these same frictions, exercised generally for some years in a vigorous and repeated way (several times Day, even hour, etc.) That precede and cause permanent corneal deformation. In addition, care should also be taken to change a sleep position that would be "on the belly" or "sideways", as this type of position promotes chronic eye irritation and stimulates the need for rubbing (local warming, contamination by mites, etc.)

  125. Dr. Damien Gatinel says:

    The orthokeratology may be a solution to consider, provided it is effective in your case (It all depends on the degree of myopia, astigmatism, etc.). For small deformities and low to medium myopias, this type of correction must be possible. Of course, it is important not to rub your eyes when waking up after removing the orthokeratology lenses.

  126. Mymie says:

    Good evening doctor and thank you for your reply. My son was ordered new glasses with a more pronounced correction. And a topography in six months. Can we wait that long without risk? The ophthalmologist has a doubt keratoconus . Thank you very much.

  127. Danièle says:

    Hello doctor,
    I was able to understand from your article how much the eye rubbing played a prominent role in the coming of Keratoconus and could aggravate it. After reading this article, I wondered if the technical gesture to put and remove the lenses could cause a worsening of the corneal deformation in case of Keratoconus. In fact, when one puts lenses for the first time one is often confronted with a multitude of unsuccessful tests before arriving to correctly place the lens on the eye. The finger thus comes in contact with the cornea very often even unintentionally. This contact with the cornea intensifies when attempting to remove the lens. Finding myself confronted with this situation I would have liked to know if this type of friction were likely to aggravate the Keratoconus or not. In this case , would it be preferable in the ideal that I only wear glasses?
    Thank you, Mr.

  128. Dr. Damien Gatinel says:

    Your question about the friction caused by the installation manoeuvres and the removal of contact lenses is legitimate. A priori, these are not particularly dangerous, because the intensity of the force exerted against the corneal tissue is much less than that induced by vigorous friction. Lens carriers often tend to rub their eyes after removing lenses; Sometimes they rub during the wearing of these, to "moisten" the eye (induce a lacrymal reflex secretion). This is of course harmful, more than gestures rather gentle and "tangential" (without prolonged impact, and without the shear forces generated by the lateral or circular movements that the patients perform when they rub their eyes).

  129. Dr. Damien Gatinel says:

    It is indeed useful to control the evolution, case of doubt, by making a topography at a more close time (one to three months). Keratoconus (and intermediate forms) does not progress/more once the eviction of eye rubbing Obtained. If this is the case , then the topographical controls will objectide the stability of the corneal deformation. Ideally, it is necessary to carry out checks with the same instrument, which allows to achieve a " map differential ". This map is an objective element to affirm the stability of Keratoconus (or, in the case otherwise, its progression).

  130. Lucas says:

    Hello Doctor Ganeshan and thank you for your precious articles and explanations, which deserve to be seen by more people still.

    I write to you because I have been in a few months of anxiety. Last September I was in a ophthalmologist center for a simple checkup, where I was diagnosed with a bilateral keratoconus, more advanced to the OD and almost derisory to the OG (I specify that I do not wear glasses or lenses). The surgeon told me that it was urgent to operate and that I did not really have a choice, first by carrying out an intra-corneal ring, and then supplementing it with the Excimer + cross linking laser. I let myself be persuaded because I realized that day that actually, looking only with the OD, I saw blurry, something I had never realized because the two eyes open I have no difficulty.

    So I received the ring-laying operation on the OD in November. Since the operation until today, I see a little blurry whereas before the operation I had no problem both eyes open, and above all, huge glowing halos now appear in my daily field of view. I stopped all the procedures because I didn't feel confident anymore. I exposed these genes to my surgeon, who replies that all my vision problems + light halos should be solved by continuing the planned operations (laser Excimer + cross linking).

    In reading several articles, I have the feeling that this operation was precipitated (especially that the surgeon decided to operate me without having any visibility on the evolution of my keratoconus, since he met me only once before the operation).

    Today I find myself with blurred vision and halos that disturb me until I get depressed. If these rings concern only the vision and not the slowdown or the shutdown of the keratoconus, then I am strongly thinking of getting them removed, but I am afraid that my keratoconus evolves and that in a few years having to remove these rings would prove to be a Error.

    Do you think I can give myself serenity by removing these rings, without putting my vision in danger for the future?

  131. Dr. Damien Gatinel says:

    You have actually been operated too hatively. The evolution of Keratoconus is not a fatality: it is necessary to stop the friction and change your sleep position (no longer exert pressure against the right eye during sleep while sleeping on the belly or the right side). Wearing a protective eye shell at night often helps protect the eye and the patient from being aware of nighttime chafing or waking up. The installation of a ring does not have a stabilizing effect on the KC. The effects on astigmatism are sometimes a little unpredictable. Also, surgeons often propose the laying of a ring, then an excimer laser correction (PKR) associated with a cross linking. The PKR alone is largely sufficient (when it is possible, i.e. when the correction is not too large) with two conditions; 1) that the cornea is not too thin by repeated friction (2) that the eye rubbing be stopped in full. So you can have the ring removed if it bothers you, you will find a priori the vision you had before. The halos are probably related to the inner edge of the ring which is "too close" to the edge of the pupil . A topographical monitoring will be necessary then, and if you do not rub any more, the deformation of your cornea will not progress.

  132. Paola says:


    I am 32 years old and I have been diagnosed with a keratoconus in January. OG is at stage 3 and I was told about keratocone frustrates for the right eye.
    A corneal topography was carried out today and my keratoconus has not evolved since the month of January.
    Indeed, I have traveled a lot your site. And I completely stopped rubbing my eyes and I sleep now on my back.
    I took the time to analyze what you say at the level of friction, and actually I rub my eyes a lot:
    I used to live in the West Indies and I had no allergy problems. And I have been living in France for eight years and I have started to become very allergic to pollen for about 4 years.
    Last year I underwent allergies during pregnancy and not being able to treat me with antihistamines, I got a lot of rubbing my eyes. And it was towards my sixth month of pregnancy that I found that my eyesight had declined.
    Afterwards, it seemed to accelerate even after the pregnancy and prompted me to consult last November.

    I definitely stopped rubbing my eyes but this is very difficult to manage because I realized that I often had like micro-cysts inside the eyelid. It appears and disappears but represents a gene that pushes me to rub my eyes.
    Also, I found that I often had eyelashes that fall and end up in the eyes and that besides, these tend sometimes to push the wrong way, coming to touch the eye (I take them off the tweezers when it's too Genant).
    All these factors pushed me to rub my eyes more than reasons...

    Moreover, the specialist offered me cross-linking + rigite lens or cross-linking + instracorneens rings.
    I let him know that I did not want the CXL but he seems to say that for I must first do the cross-linking and then have the lenses or rings. like-so basically I didn't have much choice.
    He made me understand that my left eye was really reached and that suddenly it was necessary to preserve the right eye.
    So we have to meet again in three months for a topography and to let myself be refflted to all this.

    I would just like a follow up of the evolution of my keratocone and why not try the lenses if my eyesight came down, because at the moment this does not represent a handicap for everyday life, except possibly for night driving.

    I have the impression that we are obliged to go through the CXL as part of the follow-up of keratocone, regardless almost of our will. I would like to find a specialist who respects my choice without putting pressure on me explaining that my situation is so serious that I could not do without this operation.

    Moreover, I still noticed that it strongly recommended me not to rub my eyes and no longer sleep on the side.

    In all case Thank you for this site that has informed me a lot and allowed to stop rubbing.

  133. Keratoconus says:

    Hello doctor,

    I present a slightly/moderately evolved Keratoconus (at least-1.75 astig. to each eye) and since I have stopped rubbing (digital) on the eyes, my eyesight has stabilized. But then I started wearing rigid lenses and it seems to me that my eyesight has fallen again... My next ophthalmo control is scheduled for July but I perceive that my astigmatism has increased again... Personally I stop using rigid lenses because it is all the same about incessant rubbing directly touching the eye.. I do not have dry eye or pain but I still feel the friction associated with moving the lens over the cornea. Also, small dusts (normally innocuous and slightly annoying on a naked eye) are a real torture when they pass under the rigid lens: O (rigid lens holders will recognize each other). In short I have glasses that I do not like to wear, I only put them to drive, for safety. My ophthalmo tells me that only rigid lenses or glasses are possible in my case .

    Is there another solution that you think is possible? I also do not have the right to Orthokeratology because I have a slight myopia and that "the difference between myopia and astigmatism is too important to me (I did not understand what it implies)"
    Where is the research concerning the healing of the eyes (without going through surgery) how to regain the eye health of my childhood? I dream (I hope) that one day it suffises a medicine, a eyedrops, rehabilitation exercises to heal the eyes... Regarding Keratoconus, it's still a shame to see completely blurred just because of a tiny capricious cornea (I curse her every day..) and I don't really feel like I have a "sick" eye.. and yet the impact on everyday life is enormous.
    Is there a food to be preferred, food to be banned? I stopped eating meat and fish a little before the onset of Keratoconus, maybe it's related...?
    I even came to consider this: "the ancient Chinese put small bags of sand on their eyelids, at night, to diminish their nearsightedness and to see better during the day. It is a classic notion that is undoubtedly one of the first attempts at corneal remodeling. » http://www.snof.org/encyclopedie/orthok%C3%A9ratologie-et-crt
    I will avoid the sand but I would like to try the night to place on the eyes a blindfold, tightening it lightly so that there is a very slight support on the corneas...? This may sound crazy but it's probably less aggressive/invasive than some surgeries not? And then if the Chinese did it:-)
    And then the impact of stress/fatigue/lack of light: it is a fact I see much better when I am in the Sun, at the other end of the world and that I am relaxed... (I live for now in a very little sunny area, I really feel that it aggravates the difficulties..)

    Thank you doctor for your understanding

  134. Dr. Damien Gatinel says:

    It is not recommended to exert pressure on the cornea by case of Keratoconus; The eye rubbing with the fingers are responsible for a embrittlement with biomechanical decompensation and alteration of the natural braid of the cornea. This causes the initial astigmatism. The deformation caused by chronic support is quite unpredictable and could contribute, through local modifications (enzymatic activations, temperature rise), to aggravate the situation. Hybrid lenses could be a solution in your case (rigid in the central but flexible portion of the periphery).

  135. Dr. Damien Gatinel says:

    It is absolutely not necessary to make a CXL to benefit from a lens adaptation in case Keratoconus, or the laying of rings. The attitude of systematically proposing a cross linking to a patient with Keratoconus is abusive. As explained on this site, the CXL has not really demonstrated its effectiveness to curb Keratoconus (studies are generally statistically low, without a control group, without evaluating the impact of stopping friction etc.). In vivo, the cornea is not hardened by the CXL and even if it is, it would not be enough to counteract the effect of eye rubbing which exert a force potentially well above the threshold of resistance of a biological tissue. As you understand, friction is the trigger and aggravating element of Keratoconus. Their stopping is necessary and sufficient to stop the evolution of the deformation. Of course, this "remedy" is more economical (for the patient), and meêm if it is not always easy to implement, it is of crucial importance. Treating local irritation factors is very important (ectopic lashes, dryness – the latter often increases during pregnancy with increased friction).

  136. Marion says:

    Hello doctor,

    My Keratoconus was detected at the age of 16 but did not require the wearing of lentils. I could see and do everything without glasses. It was when my eyesight began to fall and no longer be corrected by the glasses that I resolved to wear lenses at the age of 30 (I am currently 34 years old).
    I first tried the small rigid lenses, but I could not put them or lost them in the eye. I then tried semi soft-mid rigid lenses, then rigid scleral lenses for which my opthalmologist and I opted.
    Actually my view was much better than with the glasses (almost 10/10) on the other hand my big problem is that without the lenses I see nothing. It happened from the beginning so I don't think my eye got used to it so fast. I who could do everything without glasses I became completely dependent. I'd like to know why? Does this happen frequently? My opthalmologist thinks it's normal and I see so much better with the lenses that I have the impression that there is a huge difference. This is absolutely not the case . For example: before the lenses I saw without problem the meter of my ATV sitting on the bike, now I do not even discern the colors. I can no longer drive, I can not do anything....

    Thanks in advance for your help.

  137. Dr. Damien Gatinel says:

    It is likely that your Keratoconus has evolved a little. In our experience, evolution is contingent on the realization of eye rubbing repetitive and particularly vigorous; It is crucial to avoid rubbing the eyes to stabilize the corneal deformation. If you sleep on the belly or the side, you must also change this to avoid any compression/heat/eye irritation, which usually also triggers the urge to rub. It only takes a little astigmatism to induce a Visual discomfort preventing to see NET from near and far. Scleral lenses are an excellent means of optical correction, but they require some constraints.

  138. Melody says:

    I wonder if your hypothesis is plausible in the case of my companion (29 years) who was diagnosed late in the keratoconus . (2013) he carried out in urgency all the procedures which were futile to the fifteen twenty. The most curious is the illness shared by his twin brother. (True twins)
    How can you explain this phenomenon?

  139. Ryadh says:

    Hello M, I have a Keratoconus evolved in the left eye I did a cross licking on this eye. is what the screen (TV, PC, phone) can influence on the evolution of this disease especially at the level of the eye operated?

  140. Fabienne says:

    Hello doctor,

    My spouse has a bilateral keratocone, diagnosed with about 35 years ago (about ten years), associated with a pigment dispersion (diagnostic in 2015).

    It has undergone Crosslinking with each eye a year apart. He had been told that with Crosslinking, the keratoconus would stabilize. But this is not the case .

    For the pigmented dispersion, he underwent a laser intervention on one eye. He does not want to be operated on the second, because since the operation he sees a "hole" and no other improvement...

    He tried the rigid lenses, which he could not stand: difficulties in laying and withdrawing, loss in the eye, and once the lenses were asked, his eyes "injected" with blood.

    He consulted in the University Hospital and private practice, the balance sheet to date: we can not do anything for you if you do not support the lenses!

    Today, he wears glasses, which help him to improve the vision but it is not a correction to 100%. We are talking about an improvement of 25-30%...

    In addition, it has the impression that the disease evolves with every allergic crisis.

    What can you advise me?

    I thank you in advance for your answer.

  141. Djamel says:

    Good evening, doctor.
    Six years ago, my wife was diagnosed with a 39-year-old keratoconus bilateral since it has not been controlled until yesterday, advanced stage and severe right eye 0.5/10 and e left 6/10 with right side bezel 4/10. What is the conduct to hold? What should be avoided? Knowing that she is a doctor and uses the ultrasound daily.
    Thank you

  142. Bouguerra med Yacine says:

    Hello doctor
    In March 2018, the doctors diagnosed a keratoconus at my daughter, it was in stage 1, the solution advocated was the semi-regional lenses because my daughter could not tolerate regides lenses after a year her keratoconus has been evolving in stage 2, now the doctors advocate a cross linkikg, my question is do I first have to insert a ring intra crows then a cross linking or it matters little and you can make the ring afterwards, because according to his doctor dealing with the urgency is to stop the disease
    Thank you
    Kind regards

  143. Dr. Damien Gatinel says:

    To stop the evolution of Keratoconus, it is sufficient to obtain the eye rubbing , and in some case , to change the sleep position to avoid prolonged night support on the eye. If a cross linking is carried out and the rubs continue, it will be useless. After the CXL, pain and scarring cause patients to stop touching their eyes, and this is how the corneal deformation ceases to evolve. Just do not rub your eyes, without CXL, and there is no more evolution. The ring fitting is indicated to reduce corneal astigmatism, and can be made when friction is stopped.

  144. Dr. Damien Gatinel says:

    A corneal topography should be carried out to serve as a reference. On this site, as well as this one: http://www.defeatkerartoconus.com, you will find a lot of information about the KC. In short, it should be eye rubbing permanently cease (they are the cause of the deformation) and the sleep position, if it induces a support on the orbit (on the belly or the side with head against the pillow), must be changed. If these two prescriptions are fulfilled, there will be no progression, and a correction in (rigid) lenses can be carried out.

  145. Dr. Damien Gatinel says:

    If Keratoconus evolves, it is that your spouse has not stopped rubbing his eyes, which is actually difficult in case of allergic thrust. There are special lenses, such as "scleral glass", which are often more comfortable once the adaptation is achieved (these lenses are designed to be filled with physiological serum to promote better vision and eye hydration).

  146. Dr. Damien Gatinel says:

    The factor that triggers and maintains the evolution of Keratoconus is the realization of eye rubbing Repeated. When looking at a screen in a prolonged manner, there may be eye fatigue, dewatering (less blinking), and all this can induce the urge to rub. We must stop this if you want to be certain that there will be no pejorative evolution.

  147. Dr. Damien Gatinel says:

    There are case of concordances between twins, comms in the case you report. This does not prove much, except that there is probably an identical terrain (fine cornea and/or atopia), and an identical environment if the twins were bred together. Thus, two twins with a little fine corneas and rubbing their eyes will have to develop each a Keratoconus. If you expose two twins to the same dose of UV radiation, it will develop a sunburn, and this of course does not mean that sunburn is a primitive genetic disorder. If the twins have a clear phototype, they will be more likely to develop Erythema after exposure. There are also many observations of the case discrepancies between monozygotic twins for Keratoconus; one twin reached, not the other. Only one case of unconformity (and there are many) in monozygous twins would prove that KC is not a primitive genetic disorder! Let us finish that only 10% of KC's are family, the rest being made up of case "sporadic" in a sibling or only one element has a KC, it is generally noted that this is the child who was allergic, rubbed his eyes, etc.

  148. Fabienne says:

    Hello doctor,

    Thank you for your items.

    For rubbing, my spouse is well-done and does not rub his eyes. Moreover, as soon as he sees someone rubbing his eyes, he informs him of the wrongdoing...

    So if I understand your answer, you propose to change the sleep position by sleeping on the back and testing scleral glass lenses?

    Thank you in advance.

  149. Keratoconus says:

    Hello doctor,

    I am 27 years old and a Keratoconus having started to evolve around 19-20 years. I currently have a mild to moderate astigmatism with each eye (-1.75 or-2..). I don't wear glasses or lenses, by choice. Goggles only by car safety. In the long term, is it harmful for the brain to receive Visual stimuli of poor quality, i.e. without Visual correction? I begin to accept gradually the decline of my vision, to mourn my view from before (I followed your advice on friction and hopes to keep a corneal stability) but I am afraid that over the years the poor quality of my eyesight has an influence Su r the Visual brain areas and more broadly on the brain in General... I am thinking in particular of the dementias. In my daily life I am embarrassed every day by my Visual difficulties (loss of contrasts + +) but manage to compensate them fairly effectively because of my age and a fairly routine lifestyle.
    Thank you doctor for the accuracy of your answers as well as sharing your knowledge for the good of the patients.

  150. Mohamed says:

    Good evening, Dr. is what bodybuilding is against indicated in case due keratoconus 2/3 stage?

  151. Dr. Damien Gatinel says:

    Bodybuilding is not contraindicated. What is eye rubbing . in case perspiration of the face, be careful not to rub your eyes and gently spin your face.

  152. Abdelhakim says:

    Hello, Dr. Damien,
    Thank you for the information you have put in your site!
    I just made intra-corneal rings at the left eye level. According to my doctor, my keratoconus is biased. It fait15 days of the intervention but still no visual enhancement, also I start to feel a pain in the contour of the eye and also fatigue. My question is what I can wear glasses or lenses knowing my doctor told me it's impossible to correct the vision with the glasses.
    formal way of ending a letter

  153. Dr. Damien Gatinel says:

    The purpose of ring-laying surgery is to reduce astigmatism and allow for a correction of glasses or lenses. If the fitting of intra corneal rings does not allow you to see better, nor to be corrected in lens or glasses, then they are useless or not much. Hopefully the adaptation of a Contact lens can give you a better view; However, be aware that the fitting of the ring can complicate the adaptation of a rigid lens. In principle, any Keratoconus must first undergo a lens test, as the lenses are the devices that best correct the vision of patients with Keratoconus. Unfortunately, some practitioners are very interventionist and orient patients with Keratoconus towards surgical operations not always useful...

  154. Derrien Dominique says:

    Hello doctor
    I was transplanted in 1975 and 1976 by Professor Pouliquen and then in 1995 and 1996 by Professor Colin for a recurrence.
    My eyesight has decreased since then.

    Mrs Mallet tried to equip me with toric lenses in 1996, she obtained 10 in both eyes but unfortunately if for one eye the comfort was perfect, for the other, the graft being slightly off-centre the wear became unbearable after one hour
    Do you think the new scleral glasses could provide a solution for me, Doctor?
    In the 1970s, Doctor Cochet equipped me with scleral glasses (old model) when I could no longer support rigid lenses due to the evolution of Kératocone.
    But wearing these glasses was not very pleasant.
    Thank you for your attention to keratoconus disease.

  155. Valentine's Day says:

    Hello doctor,

    I was diagnosed with a keratoconus in September 2016, after noticing a decrease in vision in my left eye. I underwent cross linking in each eye, even if the right eye did not present at the time of evolution.
    Following the discovery of the disease, I immediately stopped rubbing my eyes and I now sleep exclusively on my back. I am extremely attentive to this, especially after reading your site.
    However, despite all these precautions, I now notice a deterioration on the right eye. I am surprised because from all your answers you seem convinced that any evolution is linked toeye rubbing.
    How do you explain this? Do you think that the eyelids can have a role in the deformation of the cornea, with a minimal but continuous impact throughout the day. I notice in particular that my cornea is marked by my lower eyelid (red trace)

    Thank you in advance for your answer.
    Thank you also for all your work on behalf of patients with keratoconus.

  156. Dr. Damien Gatinel says:

    A sensation of visual decline does not necessarily reflect the evolution of the keratoconus. In certain situations, the ocular surface (tear film) may be altered, for reasons related to keratoconus, or associated pathologies (blepharitis), or even the consequences of the reduction in corneal sensitivity caused by cross linking. It is not the eyelids that are responsible for red traces on the "white of the eye". The pressure exerted by the eyelids is several orders of magnitude lower than that exerted by the fingers during friction. It is also essential that you have been able to stop the friction and change your sleeping position. If you follow these instructions, the KC will not evolve, because corneal deformation is not spontaneously initiated, at least in early to middle forms.

  157. Dr. Damien Gatinel says:

    It does seem desirable that you should be able to carry out a new test with the new generation of scleral lenses.

  158. Marie Fabre says:

    Hello Dr Ganeshan
    As a carrier of two stabilized keratocones, I will soon undergo laparoscopy for ovarian cyst. Can this intervention not have a negative impact (pressure) on the evolution of my kc...? And also, what about the consequences that MRI can have on the vision of patients with kc?
    With all my thanks.

  159. amy says:

    First of all a massive thank you Dr. Damien Gatenil . I am 23 years old I am suffering from a sever allergy in my eyes since i was a child so it has become abvious that rubbing my eyes causes me keratoconus . i am using rigid lenses for 3 years the vision becames clear as i did cross linking on my right eye and I supposed to do the left eye too, but I couldn't because it's been 1 year now and that eye still hurts and can't handle the lense anymore and it kinda became dry with a cloudy vision . i am wondering if the scelar lenses would be better for my eyes than the rigid? I am afraid to do the cross in the other eye!!! I am aware of rubbing envolve the cornea but honestly I can't stop myself... ALL the eye drop I've used don't soothe my eyes. what should I do Dr I really need your help because i am in a country where i went to the best professors but in vain

  160. Hedjar imane says:

    Hello doctor,
    I have one keratoconusand it keeps evolving especially during my pregnancies (2014-2017) my ophthalmologist finally opted for a CXL that I had on July 1. Being far from my ophthalmologist I had to follow the healing in another ophthalmologist while waiting for my control appointment of the 30th, the latter questioned the whole procedure of my CXL from where my following questions:
    -Is this normal that the cornea is still not healed?
    - how long does it take to adapt a new correction to the eye?
    - is calcicol administered in mycase?
    - the thickness of my left cornea is less than 400u so the CXL is not the right solution what is the alt?
    Thank you very much for all the details you have provided.

  161. Djebaili says:


    I have been suffering from keratocone on both eyes for 5 years now one of your colleagues offers me stick linking plus rings plus laser on rings if need be I follow you from lomgtemp and no longer rub my eyes but my eyes eyes decrease year after year what do you think...?
    Thank you for your time.

  162. Dr. Damien Gatinel says:

    There is a certain propensity among some surgeons to offer these surgical techniques. The (theoretical) goal of the CXL is to harden the cornea, but if you follow this site, you know that the problem with keratoconus is not to harden the cornea but to stop those eye rubbingthat cause permanent corneal deformation called "keratoconus". Even if the cornea hardened after the CXL, this would still not be enough to stop the KC in casefriction (the force carried by the hands is much greater than the resistance capacities of a biological tissue, even a modified one, subjected to repeated physical stress). The findings made after CXL in vivo (on patients and not in the laboratory on pieces of cornea) do not reveal any convincing hardening, even for some studies, rather a "softening" (!) The CXL is always proposed because it is difficult to return to a technique that generates income, and often requested by patients since it is presented to them as a solution to their problem and anxiety of progression. The purpose of the rings is to reduce corneal deformation in an attempt to reduce astigmatism and improve vision a little. However, they do not make it possible to do without glasses or lenses (the adaptation of the lenses can also be made more difficult by the presence of the rings). Finally, the laser is often used to improve vision beyond the effect of the rings... The expected (medical) gain is often perceived as a little disappointing by patients. The best way to improve the vision of an eye with keratoconus is to successfully adapt a lens (rigid, or scleral for pronounced deformities).

  163. Dr. Damien Gatinel says:

    The supposed purpose of CXL is to harden the cornea, as most ophthalmologists consider keratoconus to be a pathology related to a "spontaneous" biomechanical failure of the cornea. If you read the pages devoted to this subject on this site, another conception of the keratoconus, which is much more correlated to the clinical reality observed on a daily basis, makes this condition a pathology of mechanical origin: the eye rubbingexcessive ones cause the biomechanical failure of the cornea (all the faster as the friction is intense, repeated, prolonged and as the cornea is initially thin). Also, stabilization of the KC can be "simply" achieved by stopping friction (and possibly changing the sleeping position when it causes prolonged nocturnal ocular compression). During pregnancy, ocular dryness increases significantly, and this sometimes leads to the exacerbation ofeye rubbing, hence the observed progression. After the realization of a CXL, the cornea is sensitive and it is generally observed a stop of friction (which constitutes at least a benefit for this technique). For the rest, healing can be difficult, the complication rate (including scar delay) is estimated at 15% after CXL. The cornea, already mechanically traumatized, then undergoes photochemical trauma during the CXL... Epithelial healing can then slightly modify the curvature of the cornea. It takes a few months to judge the stability. Cacicol is supposed to accelerate epithelial healing. This treatment is a little expensive and prescribed in difficult wound healing conditionscase. Fine corneas are poor candidates for CXL because this technique puts the corneal endothelium at risk (UV is toxic to endothelial cells when they have been impregnated with riboflavin). But as you will have understood, it is not from my point of view a major concern, and almost a "chance" that it is not possible to perform a CXL in your country, because I consider that this technique, whose efficacy in biomechanics is questionable, is not in any case a good answer to the problem posed by the keratoconus.

  164. Dr. Damien Gatinel says:

    Scleral lenses are a good option for eyes with keratoconus which cannot be fitted with rigid CLs. Instead of trying CXL, which does not address the real cause of KC, you should truly focus and concentrate your efforts toward the cessation of eye rubbing. Rubbing exacerbate local irritation and trigger further corneal deformation. Scleral lenses sometimes help to relieve the itching and irritation because the ocular surface is immersed in saline solution.

  165. Marie FABRE says:

    Thank you for your answer... I will go to the keratocone center of Bordeaux or Toulouse...

  166. Aymeric F says:

    Hello doctor,

    I have keratocone (only visible on a topo), so I have irregular astigmatism that bothers me especially at night when I look at, for example, rear lights in cars (triple or double vision).

    Since my visit on your site I stop all eye rubbingof them. Indeed I scratched my eyes a lot because of my allergies. In addition, I work in an environment with a lot of dust (construction) that often makes me want to scratch my eyes. I also stopped sleeping on my stomach.
    I hope your theory is correct.

    However, I wanted to have some information. If I receive a grain of sand or thick dust in my eye, can it create an evolution of the KC if it is not removed quickly?

    Thank you for your interest.

  167. Dr. Damien Gatinel says:

    Don't worry, this theory is unfortunately correct ;-) However, the bright side of the coin is that the cessation of friction will ensure that there is no progression of corneal deformation (which is minor and will therefore remain so). Projection of a foreign body into the eye does not advance the keratoconus/deformation. The latter corresponds to a deformation that requires a lot of cumulative energy. The presence of a foreign body, if it is not a source of friction, may cause an isolated local inflammation which will normally disappear with its removal. In these circumstances, it is always better to rinse the eyes than to rub them.

  168. Houry says:

    Hello doctor
    My brother has a bilateral keratoconus (stage 2 OG and 4 OD), diagnosed at about 22 years of age, associated with irregular astigmatism

    He was cross-linked to each eye 3 days apart. He was told that with crosslinking, he keratoconuswould stabilize it.

    4 days after the operation white spots appeared on the cornea (2/3 of thepupil) with a blurred and incomplete image just after an intense eye inflammation that persisted for 24 hours

    I don't know exactly the cause of his stains and if they will disappear with usual antibiotics (if c an infection) or it requires another operation (Therapeutic photokeratectomy for example)?

    he now takes:
    - Thealose
    - Vigamox
    - Dexafree

  169. Dr. Damien Gatinel says:

    Unfortunately, the realization of CXL exposes to scarring, inflammatory or infectious complications (about 10 to 15% ofcase). If you read this site, you will understand that its author does not recommend this technique, which seems generally ineffective (the cornea is not hardened) and ultimately not justified when you realize that the cause of keratoconus is mechanical (eye rubbing excessive). Even if the cornea were slightly hardened by CXL, this hardening would be too weak compared to the force delivered by the corneas (it still eye rubbingtakes several years of friction, in general, for a keratoconus, i. e. a permanent deformation of the cornea, to appear). It is necessary to follow the healing of your brother's cornea in a rigorous way. Vision should decrease for a few weeks, before returning to its pre-CXL level (a small improvement is sometimes observed: it is not specific to the technique, because it is part of the scar regularization that is sometimes observed when the corneal epithelium regrowth is "stimulated" - it is removed at the beginning of the CXL procedure).

  170. Amine says:

    Hello doctor,
    At the end of 2015 (19 years old) I discovered that I had a Keratocone for both eyes, my doctor advised me to wear rigid lenses but I can't wear them, in 2017 I was oppressed by Operation Crosslinking and since I can't wear the lenses I made a scope that really doesn't help me. Now I work in a restaurant where the heat is strong and the steam too.
    My question is, do I have to avoid steam and heat?

  171. Thib says:

    Hello doctor,

    I just got out of my second appointment with the ophthalmologist three months apart. The corneal deformation of my right eye did not change during these few months but the thickness of my cornea decreased. I was at 520 microns and fell to 470. The practitioner's recommendation is therefore to practice cross linking without delay, indeed it would seem that she does not wish to operate on corneas finer than 450 microns. I'm a little confused. If the purpose of this procedure is to harden the cornea, why is it used for this thinning problem? I understand that in general cross linking is not your recommendation anyway. It should be noted that during these few months I reduced friction. I can't say I never do it again, but very rarely.

  172. Dr. Damien Gatinel says:

    Isolated corneal thinning without increased deformation is unlikely. It is probably a measurement artifact. It would be useful to verify the reality of this thinning by performing a new examination, using the same instrument if possible as in the previous measurement a few months ago if it was not thecase. It is crucial to understand and take into account the variability of the tests for the keratoconus; the repeatability is less than for normal corneas. A keratometry variation of less than 1D is not statistically significant for proven forms of keratoconus. Ironically, most studies concerning CXL report a late evolution of keratometry in the order of a half diopter reduction... Which is not significant. On the other hand, there is no point in trying to harden a cornea whose deformation is not initially caused by a loss of "spontaneous" rigidity. A "soft" but unrubbed cornea becomes thinner and flatter over time, as taught by the study of Marfan's syndrome. In the keratoconus, the cornea curves irregularly, as friction mainly affects the central region of the cornea. This focal loss of rigidity explains the particular character of corneal deformation: central thinning and permanent deformation with central camber and peripheral flattening. To stop the evolution of the keratoconus, it is necessary and sufficient to stop rubbing at all, and possibly modify your sleeping position.

  173. Dr. Damien Gatinel says:

    You just have to avoid all the factors that could lead you to rub your eyes excessively and vigorously. Steam or heat is not a problem in itself, if you don't rub your eyes anymore.

  174. Mohamed says:

    Hi Dr. Can we practice weight training when we are at stage 2 OD and 3 OG of the keratoconus??? THANK YOU FORWARD

  175. Dr. Damien Gatinel says:

    All sports activities can be performed in casekeratoconus: it is simply not advisable to rub your eyes vigorously with caseperspiration, projections, etc.

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