ADHD and Eye Disease

Carter Coleman - Department of Ophthalmology

Link: https://pubmed.ncbi.nlm.nih.gov/37943540/

Keratoconus is described as a condition where the cornea becomes slowly thinner and bulges into the shape of a cone. This cone shape can often lead to eye disturbances, like myopia (near-sightedness), as well as astigmatism, which results in decreased visual acuity. In a recent study, a large cohort of children and adults were examined for the presence of keratoconus as well as several psychiatric comorbidities, like OCD and ADHD. After adjusting for confounding variables like age or intellectual status, statistical analysis showed an association between ADHD and a diagnosis of keratoconus in male patients. 

Risk factors for keratoconus include both genetic and environmental factors. It is commonly seen with a family history and approximately 1 out of 10 people with keratoconus will also have a parent with the same diagnosis. A primary environmental factor seen with keratoconus is persistent, vigorous eye rubbing. The authors of the study believe it was due to this factor that patients with ADHD were also associated with a diagnosis of keratoconus. ADHD can cause individuals to be hyperactive and potentially be constantly rubbing their eyes, putting them at increased risk for developing keratoconus. 

Although statistically, no causative effect could be placed between ADHD and keratoconus, their association reflects an important message about educating patients about risky comorbidities with their particular conditions. If individuals with ADHD are made aware of the link between eye rubbing and keratoconus, they can be more vigilant about reducing this activity, therefore, lowering the potential risk they have of developing the condition. Striving for better outcomes for every patient, physicians and healthcare workers should educate their patients more holistically about their conditions, as the knowledge to reduce risk factors can save the patient from developing debilitating comorbidities and improve their quality of life. 

References:

Safir M, Hecht I, Heller D, Pras E, Lifshitz M, Einan-Lifshitz A. Psychiatric Comorbidities Associated With Keratoconus [published online ahead of print, 2023 Nov 9]. JAMA Ophthalmol. 2023;10.1001/jamaophthalmol.2023.5176. doi:10.1001/jamaophthalmol.2023.5176