Why this website?

Our goal is to provide relevant information to anyone interested in or affected by keratoconus.
After years of reviewing and managing keratoconus patients, Damien Gatinel and Adrien Mazharian, the Main Authors of this website were convinced that repeated eye rubbing was the direct or root cause of the corneal deformation seen in keratoconus. This conclusion was based on scientific and clinical evidence obtained from examination, interrogation and investigative analysis of hundreds of  patients with the disease.

This website is dedicated to the better understanding and eradication of the disease called keratoconus.
Keratoconus has long been labelled “a dystrophy of unknown origin”, but the authors believe that it is primarily a mechanical disease, with eye rubbing being the root cause.

The aim of this website is to sensitize patients to the importance of eye rubbing in keratoconus causation and progression, by illustrations with real patients and testimonials, and by highlighting the most recent publications by experts in Ophthalmology.

The authors have no financial or proprietary interests in any of the methods, techniques or subject matter discussed in this website.


This conclusion relies on logical arguments, and offers an explanatory framework that alternative theories fail to provide. Ocular rubbing is the common denominator of allergy, ocular fatigue and dry eye. These conditions are currently considered as risk factors for keratoconus. Individual predisposing factors may co-exist with eye rubbing, such as a thin cornea or corneal stroma of reduced collagen quality. These factors make the cornea more vulnerable to the effects of ocular friction. The vast majority of patients with keratoconus recognized that they have rubbed their eyes long before the onset of the disease. Some patients deny rubbing at the first visit because they are unaware of this habit, but once sensitised to the deleterious effects of eye rubbing, they become more aware of their habits and routine, and eventually realize their actions.


The cases presented in this website were collected consecutively in a prospective manner, and have been followed-up for up to nine years from the time of diagnosis. Each of these cases provides compelling evidence of the responsibility of eye rubbing in the direct genesis of the corneal deformation seen in keratoconus. Despite the many facets of the disease, eye rubbing appears to be the common denominator in all these cases of keratoconus.

These clinical cases are monitored, and sharing their progress to document them prospectively constitutes an open online study.

Prevention is the key: stop rubbing your eyes!
Keratoconus is a disease whose intimate mechanism is mechanical: the deformation of the cornea is not caused by an innate biological mechanism. The action of an external mechanical force, which is responsible for the permanent deformation of the cornea, is necessary, and ​​this force is conveyed by ocular rubbing.

This means that regardless of any risk factor or genetic background, absence of eye rubbing would mean no keratoconus.

Eye rubbing being the root and indispensable cause of keratoconus matches much better the clinical reality of keratoconus. This concept is compatible with most of what is known and observed about the disease. The different forms of eye rubbing, with its varied duration, intensity, frequency and laterality, combined with the inherent heterogeneity of biological tissue such as the cornea (in which thickness may differ significantly within the population) accounts for the huge variability in expression of the keratoconus presentation. Fortunately, not everyone who rubs their eyes will develop keratoconus. The trauma has to be frequent, vigorous and repetitive, especially when occurring in predisposed eyes that have thin corneas or compromised corneal stromal collagen. Chronic night compression (sleeping on the stomach or the side) and/or local exposure to allergens in pillows and bed linen, may also be an important trigger for chronic eye rubbing of the affected eye(s).

Logically, cessation of eye rubbing will result in the arrest of progression of the corneal deformation.

These facts are well illustrated by the many clinical cases accessible in this website.

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