The 2011 AAO American Academy of Ophthalmology Meeting had over 26,000 in attendance and 1800 attended the Refractive Surgery Sub-specialty Day. Alan N. Carlson, M.D. addressed the audience, speaking about how “eye rubbing” accelerates keratoconus. More specifically, eye rubbing in the keratoconus patient is distinct from “allergic” eye rubbing and Alan N. Carlson, M.D. addressed 15 differences between allergic eye rubbing and eye rubbing associated with keratoconus.