Environmental factors, which have been recognized, are: eye rubbing, atopy and UV exposure, although the relative contribution of all these factors is currently unknown [12].The theory goes that environmental factors are causing oxidative stress to KC corneas and, because of the inability of KC corneas to process reactive oxygen species (ROS), a degradation process is initiated that leads to corneal thinning and loss of vision [13] due to a lack of corneal enzymes such as aldehyde dehydrogenase class 3 (ALDH3), catalase, or superoxide dismutase to remove or neutralize the ROS [14]. Here, ALDH3A1 is linked to keratoconus.