To the Editor: We report on a patient with a provisional diagnosis of schizophreniform disorder and keratoconus, an eye disease associated with abnormal personality characteristics (1–3). Keratoconus is a bilateral degenerative disease of the cornea beginning in adolescence, with a prevalence of 1 in 2,000 (1). Ophthalmologists have long speculated about the existence of a "keratoconic personality," described as paranoid, anxious, compulsive, and somatically oriented (1).

Several studies have documented differences in personality characteristics when keratoconic patients are compared to healthy subjects, including higher scores on the schizophrenic subscale of the MMPI (3). It is unclear, however, whether this is independent of the psychological stress caused by chronic eye disease (1).

Although the association in our patient may have been coincidental, we believe that the co-occurrence of psychosis and other syndromes is of value and may lead to the further elucidation of genetic correlates and pathophysiological processes, as in velocardiofacial syndrome and schizophrenia (4). Keratoconus is a genetic disease with familial clustering; like schizophrenia, it is thought to be a final common pathway stemming from multiple etiologies (5). Linkage studies have identified possible genetic loci, including loci mapped to chromosome 21. Although there is no evidence of linkage between keratoconus and schizophrenia, observations of the co-occurrence of these two syndromes might prompt further investigation.