Keratoconus from corneal degeneration to systemic disease: implications for treatment

Keratoconus has been traditionally considered an ocular disaese, and, specifically, a non‐inflammatory corneal degeneration. However, systemic comorbidities are associated with keratoconus in up to 50% of cases, and recent evidence is emerging that nutritional/metabolic inbalances are associated, and perhaps indispensable, co‐factors in disease pathogenesis. Here, we will provide a review of current evidence, and our recent data, supporting a provocative hypothesis: keratoconus is the ocular manifestation of a systemic disease.