title: Keratoconus caused by eye rubbing in patients with Tourette Syndrome.
abstract: OBJECTIVE
  To report the association between keratoconus and Tourette Syndrome (TS) and to reinforce that eye rubbing may be a causative factor for keratoconus.
  
  
  METHODS
  Observational case series.
  
  
  METHODS
  Three patients with TS who presented with clinical and topographic findings suggestive of asymmetric or unilateral keratoconus.
  
  
  METHODS
  Evaluation of patients in a single clinical practice.
  
  
  RESULTS
  Patients' histories revealed asymmetric or unilateral rubbing of the affected eye as a result of a TS tic. Other organic causes associated with keratoconus were absent in these patients.
  
  
  CONCLUSIONS
  A possible association between TS and keratoconus exists with chronic eye rubbing being the suggested mechanism. Eye rubbing seems to be an important causative factor for keratoconus.
authors.affiliation: Toronto Western Hospital, University of Toronto, Toronto, Ont, Canada. Raneen_sh_mash@hotmail.com
authors.forename: Raneen Shehadeh
authors.initials: RS
authors.lastname: Mashor
authors.forename: Nikhil L
authors.initials: NL
authors.lastname: Kumar
authors.forename: Rusty J
authors.initials: RJ
authors.lastname: Ritenour
authors.forename: David S
authors.initials: DS
authors.lastname: Rootman
mesh_terms: D019781:Corneal Topography; D006801:Humans; D007640:Keratoconus / Q000175:diagnosis / Q000209:etiology*; D008405:Massage / Q000009:adverse effects*; D005879:Tourette Syndrome / Q000150:complications*