Firstly, it is important to keep in mind that not every chronic eye rubber will develop keratoconus. It is a matter of intensity x duration x frequency of the rubbing on one side, and of the native corneal resistance on the other. However, patients who rub their eyes often and vigorously exhibit some minor corneal irregularities, which have been coined by some « forme fruste KC », as it was believed that there would be such condition as an abortive or non-evolutive form of KC. Corneal topography is mandatory to confirm the presence of such topographic irregularity. It is also mandatory to stop rubbing your eyes after corneal refractive surgery. Asian eyes are not susceptible to develop more symptoms or complications after refractive surgery, and they are eligible for having any technique, depending on the preoperative evaluation result.

Happy New Year and thanks for allowing me to repost it here, I hope this is a more relevant column .

I am 32y, East-Asian with myopia & astigmatism (-1.75 (-0.75),-1.75 (-1.25)). I am heavy computer screen user (>12h per day), and I haven’t been wearing glasses systematically(<1h per day) until very recently, after having experienced frequent eyestrain and possible eyesight drop.

Initially I went to your website to learn more about the laser surgery then I discovered about your article on the linkage between keratoconus and eye Rubbing.

I realized immediately that I'm guilty of having mentioned bad habit. I was systematically pressing my eyes when I was at 20s because I thought my eyes were "popping out". I also do not wear glasses or contact lenses.

I have a couple of questions :

How can we separate the keratoconus of an early stage from "normal" Astigamstim if topography exam is not systematicly proposed? (I had ophthalmologist appointment in 2018 but topography test was never even mentioned.)

Will high-risk-behavior population (like myself) be considered as sub-clinical KC automatically and by consequence non eligible for lasik ?

Asian eyes differs in shape to Europeans eyes with a thicker cornea. Will this increase the chance of mis-diagnosing KC (false negative. ex) ?
I was told that Asian eyes will experience more severe and long lasting post-surgery symptoms such as dry eyes and pains. is this true? Will the lasik/pkr/smile performed in Europe be suitable for Asian eyes?

Do you have any good colleague/hospital in Belgium that you can recommend for KC screening &lasik?

I wish I had read your article about eye rubbing 20 years earlier, I m very grateful for your effort of sharing this so valuable information. Thank you in advance for your patience and good vibes.

Many thanks