Unilateral keratoconus in a child with chronic and persistent eye rubbing.

PURPOSE: To report a case of unilateral keratoconus in a 7- year-old female, secondary to chronic persistent eye-rubbing in the absence of any systemic condition. DESIGN: Observational case report. METHODS: In the case of this child, no organic cause was found to explain the onset of keratoconus other than persistent eye-rubbing in the affected eye. RESULTS: Nocturnal eye padding was instigated and the condition stabilized. She was reviewed over a 2-year period of follow-up. CONCLUSIONS: Eye-rubbing has been implicated in the pathogenesis of keratoconus. Eye-rubbing is also often a feature of a number of conditions linked to keratoconus such as Down syndrome, atopic keratoconjunctivitis, mental retardation, and Lebers' congenital amaurosis. There are a number of reports linking eye-rubbing and keratoconus in children, typically in relation to these conditions. However, in this case the keratoconus was secondary to chronic and persistent eye-rubbing in a healthy child.