Keratoconus is a progressive eye condition where the cornea—the transparent front part of the eye—gradually becomes thinner and bulges into a cone-like shape. This distortion causes blurred vision, irregular astigmatism, glare, and even significant visual impairment in advanced stages.
Over the years, eye rubbing has gained attention as one of the strongest risk factors linked to keratoconus. But does eye rubbing cause the condition, or does it only make it worse? This article explores the science, the debate, and the practical steps you can take to protect your vision.
Does Eye Rubbing Cause Keratoconus?
The relationship between keratoconus and eye rubbing is one of the most discussed topics in ophthalmology. Experts widely agree that mechanical trauma from vigorous rubbing can worsen the disease. The question of whether it is the root etiology of keratoconus, however, is more complex.
Some researchers propose the phrase “No rub, no cone”—emphasizing that rubbing may be a crucial trigger in genetically predisposed individuals. Others caution that rubbing alone cannot explain all cases, since keratoconus is influenced by both genetic and environmental factors.
What’s clear is that eye rubbing is a modifiable behavior. While you cannot change your genes, you can stop rubbing your eyes—and that may slow down or even prevent the disease progression of keratoconus.

How Eye Rubbing Damages the Cornea
When you rub your eyes, you’re applying repeated shearing forces and mechanical trauma directly onto the cornea. Here’s what happens beneath the surface:
- Collagen weakening: The cornea is supported by collagen fibers. Vigorous rubbing causes these fibers to stretch and weaken, reducing the cornea’s structural strength.
- Keratocyte apoptosis: Trauma from rubbing can kill corneal cells, disrupting the repair process.
- Inflammatory mediators and enzyme release: Rubbing triggers the release of proteinases and other enzymes that break down corneal tissue.
- Corneal thinning: Over time, this leads to the hallmark feature of keratoconus—progressive thinning and bulging.
- Intraocular pressure (IOP) spikes: Each rub briefly raises the pressure inside the eye, amplifying the stress on the cornea.
This chain reaction explains why frequent or forceful rubbing is so harmful, especially for those with a genetic predisposition or existing corneal weakness.

Why Stopping Eye Rubbing Matters
Even if rubbing isn’t the sole cause of keratoconus, it clearly worsens the condition. Several studies show that patients who adopted rubbing cessation saw their keratoconus stabilize over time. In some cases, the disease stopped progressing altogether.
That’s why eye care specialists strongly encourage breaking the habit. By doing so, you can reduce stress on your corneas and improve the effectiveness of treatments like corneal cross-linking (CXL), which strengthens and stabilizes the cornea.
How to Stop Rubbing Your Eyes
Quitting the habit may be difficult, but it’s one of the most important steps you can take. Here are strategies that help:
Medical Solutions
- Anti-itch eye drops: Antihistamine or mast-cell stabilizer drops reduce allergic itchiness.
- Lubricating eye drops/artificial tears: Relieve dryness and soothe irritation.
- Allergy management: Treat underlying causes with oral medications or lifestyle changes.
Lifestyle & Habit Hacks
- Keep tissues or cold compresses nearby as safer alternatives.
- Adjust your sleep position to avoid pressing on your eyes.
- Use reminders or apps to train yourself to avoid rubbing.
- Practice gentle lid hygiene to reduce irritants.
Frequently Asked Questions about Eye Rubbing and Keratoconus
Eye rubbing is a strong risk factor, but keratoconus also involves genetics. It is safest to assume rubbing increases your risk and should be avoided.
Rubbing causes IOP spikes, collagen weakening, and inflammatory mediator release, which together lead to corneal thinning.
Allergic conjunctivitis leads to chronic itchiness. This causes frequent rubbing, accelerating progressive deformation of the cornea.
Stopping won’t reverse existing damage, but it greatly improves chances of corneal stabilization with treatments like CXL.
Yes, many people press their eyes against pillows during sleep, leading to nocturnal rubbing and worsening keratoconus.
Conclusion
Eye rubbing may not be the sole cause of keratoconus, but it is undeniably one of the most important risk factors for disease progression. The damage from mechanical trauma, collagen weakening, and inflammatory mediator release makes the cornea thinner and weaker, increasing the risk of severe vision loss.
The good news is that this is preventable. With the right combination of rubbing cessation, allergy management, and advanced treatments like corneal cross-linking, patients can achieve long-term corneal stabilization.

At Shinagawa Lasik & Aesthetics, we combine expertise in corneal biomechanics with cutting-edge diagnostic tools and treatments to help protect your vision. Whether you’re experiencing ocular irritation, dry eyes, or early signs of keratoconus, our specialists are here to provide safe, effective, and personalized care.
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Citations and Resources
Shinagawa LASIK & Aesthetics strives to provide accurate and reliable information regarding LASIK procedures and eye health. We utilize primary sources to support our content, including peer-reviewed scientific studies, data from reputable medical organizations, and expert opinions. We also reference established publications and research where appropriate.
Our commitment to evidence-based information ensures that you receive trustworthy and up-to-date details to make informed decisions about your eye care.
Resources Used in This Article
- Pubmed. “Eye rubbing in the aetiology of keratoconus: a systematic review and meta-analysis, https://pubmed.ncbi.nlm.nih.gov/33484296/“
- Frontiers. “Independent and interactive effects of eye rubbing and atopy on keratoconus, https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.999435/full“
- ScienceDirect. “Management of chronic habits of abnormal eye rubbing, https://www.sciencedirect.com/science/article/abs/pii/S1367048407000835“
- PubMed. “Effect of eye rubbing on corneal biomechanical properties in myopia and emmetropia, https://pmc.ncbi.nlm.nih.gov/articles/PMC10279860/“
- PubMed. “Medium to long term follow up study of the efficacy of cessation of eye-rubbing to halt progression of keratoconus, https://pubmed.ncbi.nlm.nih.gov/37293301/“