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  • Cornea/External Disease

    Review of: The association between keratoconus and allergic eye diseases: A systematic review and meta-analysis

    Seth I, Bulloch G, Vine M, et al. Clinical & Experimental Ophthalmology, April 2022

    Finding modifiable predisposing factors of keratoconus could help mitigate its prevalence. This study examined the potential association of eye allergies, eye rubbing, and atopy with the development of keratoconus. By scouring multiple research databases for case-control, cohort, and cross-sectional studies that enrolled patients with keratoconus, the researchers collected data for analysis.

    Study design

    A meta-analysis of published articles was performed using Pubmed, Web of Science, Scopus, and Cochrane databases from their inception to April 2021. Case-control, cohort, and cross-sectional studies addressing atopy, allergies, and eye rubbing as potential risk factors for keratoconus were included.


    Out of 573 articles, 21 studies were included for qualitative analysis and 15 for the quantitative analysis. No significant association was found between keratoconus and allergic eye disease, eye rubbing, or atopy.


    One potential limitation of the study that could have affected the results is the heterogeneity of sample sizes and resulting outcomes of the included studies, some of which were of relatively low quality.

    Clinical significance

    More prospective studies are needed to fully understand the relationship between atopy, eye rubbing, and keratoconus. For now, using clinical judgement is imperative in keratoconus patients, with common practice including control of allergic eye diseases and cessation of eye rubbing.