Assessment of Awareness of Keratoconus and its Relation to Eye Rubbing Among Saudi Arabia Population Supervisor/Primary Investigator

Nuwayyir Abdullah Alqasimi ¹ Lujain Hatim Aljohani ^1* Renato Ambrósio Jr. ^2,3,4,5,6 Bader AlQahtani ^7,8* Fatemah Saleh Alsalem ^9* Nasser Saleh N Al Haydar ¹⁰ Bdour Raja Alanazi ¹¹ Lina Sami Hussain Saber ^12* Danah Tariq AlFurayhan ^13* Nawaf Abdullah Alqahtani ^14* Jose Manuel Vargas ^15*

• ¹ College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
• ² Department of Ophthalmology, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Paraná, Brazil
• ³ Department of Ophthalmology, Federal University of São Paulo, São Paulo, São Paulo, Brazil
• ⁴ Ambrosio Vision Academy, Rio de Janeiro, Brazil, Rio de Janeiro, Brazil
• ⁵ Rio Vision Hospital, Rio de Janeiro, Brazil, Rio de Janeiro, Brazil
• ⁶ Brazilian Artificial Intelligence Networking in Medicine - BrAIN, Rio de Janeiro & Maceio, Brazil, Rio de Janeiro & Maceio, Brazil
• ⁷ Cornea, Cataract and Refractive Surgery Consultant, Riyadh, Saudi Arabia
• ⁸ Assistant Professor at College of Medicine, Alfaisal University in Riyadh, Saudi Arabia, Riyadh, Saudi Arabia
• ⁹ MBBS, General physician, Al-Ahsa, Saudi Arabia, Al-Ahsa, Saudi Arabia
• ¹⁰ MBBS, General physician, Najran, Saudi Arabia, Najran, Saudi Arabia
• ¹¹ College of Medicine, Al-jouf University, Al-Jouf, Saudi Arabia, Al-Jouf, Saudi Arabia
• ¹² Faculty of Medicine, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia
• ¹³ College of Medicine, University of Hail, Hail, Saudi Arabia
• ¹⁴ College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, Riyadh, Saudi Arabia
• ¹⁵ Ophthalmology Head Section, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia, Riyadh, Saudi Arabia

Keratoconus (KC) is a bilateral, asymmetric, progressive thinning of the cornea that causes a decrease in optical quality due to induced myopia, irregular astigmatism, and higher-order aberrations.Keratoconus affects 1.38 per 1,000 individuals globally, with a higher prevalence in Asian and Middle Eastern populations.Eye rubbing has been recognized as one of the leading risk factors for KC.This study aimed to assess the knowledge and awareness about keratoconus and its relation to eye rubbing among the population of the Kingdom of Saudi Arabia.A cross-sectional study was conducted in 2024 among people residing in different regions of Saudi Arabia. Data collection was carried out using an online questionnaire consisting of 21 questions, which were divided into two sections. Prior to administering the questionnaire, informed consent was obtained, and the confidentiality of the collected data was ensured.This survey had a total of 2,059 respondents. The majority of the participants in the study were female, and their ages ranged from 18 to 30 years. Most of the participants held a university degree or higher. In total, 44% of respondents reported having allergic disorders, while 57.6% demonstrated a lack of knowledge regarding KC. The level of KC awareness was poor among Saudi residents, with 74.8% showing insufficient awareness. The group with acceptable awareness of KC was predominantly aged between 18 and 30 years and female, with a percentage of 30.4%.The study revealed that Saudi citizens are not knowledgeable about KC and the risks associated with eye rubbing. Additionally, the study identified several KC risk factors, including but not limited to eye rubbing, allergies, and family history. To alleviate the burden of KC in Saudi Arabia, it is imperative to enhance public health awareness and discourage the habit of eye rubbing.