Our eyes often itch in response to environmental factors like allergens and pollutants and medical conditions like dry eye (when your eyes don’t produce enough tears or the tears don’t work correctly). While occasional eye rubbing is natural and harmless, for individuals with ADHD, the behavior can become habitual and excessive.

Excessive eye rubbing places mechanical stress on the cornea, weakening its structure and causing it to thin. As the cornea weakens, internal eye pressure can push it into a cone-like shape, resulting in Keratoconus. This cycle underscores the importance of addressing habitual eye rubbing early and underscores the

Evidence Linking ADHD and Keratoconus

Dozens of clinical studies have documented the connection between ADHD and Keratoconus. Individuals with ADHD often experience heightened sensory stimulation, which can lead to habitual behaviors such as eye rubbing for comfort or stimulation. Additionally, dry eye, allergies, or fatigue — conditions common in individuals with ADHD — can further encourage eye rubbing.

A large-scale study summarized in the Review of Optometry highlights this correlation between ADHD and Keratoconus:

Therefore, to see if an association exists, researchers recently examined the prevalence of Keratoconus among patients with psychiatric disorders, including anxiety, obsessive-compulsive disorder (OCD), autism and attention-deficit/hyperactivity disorder (ADHD). They found only the latter was associated with Keratoconus and only in males.

The researchers found that compared with the general population, patients with Keratoconus were more likely to be diagnosed with ADHD (odds ratio: 1.58), even after adjusting for possible cofounders. When they stratified the cohort based on age, it revealed an association between Keratoconus and ADHD for males (OR: 1.62) but not for females (OR: 1.29).

In other words, ADHD and Keratoconus are directly linked where excessive eye rubbing is present. Not all individuals with ADHD who habitually rub their eyes develop Keratoconus, but young males with ADHD are more likely to develop it than other groups.

Implications for Patients and Caregivers

If you or someone you care for has ADHD, monitoring habitual eye rubbing is critical to reducing the risk or severity of Keratoconus. Here are some essential steps to take:

• Observe behavior: Watch for frequent eye rubbing and note when it occurs.
• Consult professionals: Work with primary care providers, allergists, or Optometrists to identify underlying causes of dry eyes or allergies.
• Address vision problems: Look for signs like frequent squinting, headaches, or constantly changing glasses or contact prescriptions. These may indicate Keratoconus.

If you notice eye rubbing and some of the symptoms of Keratoconus, schedule an eye exam with an optometry practice with expertise in Keratoconus.

Treating Keratoconus in Individuals with ADHD

Primary methods for reducing eye rubbing (with the goal of also reducing the onset or progression of Keratoconus) can be as basic as managing seasonal and chronic allergies (if present) or using lubricating eye drops to reduce the itching. In cases where your appointment with an Optometrist shows the disease has already begun, a wide range of treatment options, including scleral lenses and corneal cross-linking, are available through a qualified Keratoconus specialist.