There is no definitive evidence that keratoconus and autism are causally linked, but some studies have suggested a possible association between them.
One study explored a case report of a child with autism spectrum disorder (ASD) who developed progressive keratoconus after standard corneal cross-linking (CXL) due to abnormal eye rubbing, which is a repetitive motor stereotypy associated with ASD symptoms. The authors suggested that eye rubbing may be a risk factor for keratoconus in patients with ASD, and that behavioral modification intervention may help prevent further keratoconus progression.
Another study reported that a gene called PPIP5K2, which is involved in eye and cornea development, is associated with both keratoconus and autism. The authors speculated that PPIP5K2 may play a role in the pathogenesis of both conditions, and that further research is needed to elucidate the molecular mechanisms.
However, these studies are limited by their small sample size, lack of control group, and observational nature. Therefore, they cannot establish a causal relationship between keratoconus and autism, nor can they rule out other confounding factors. More large-scale and rigorous studies are required to confirm or refute the hypothesis of a link between keratoconus and autism.