The occasional “knuckle rub” to an itching eye can feel so relieving, especially as allergy season starts. But according to Dr. Mark Mifflin, professor of ophthalmology, chronic eye itching can lead to serious, irreparable damage to your eyes. On this episode of “The Specialists” we investigate what can cause constant eye irritation–and the risks you take by rubbing your eyes too often or too hard.
Dr. Miller: Rubbing your eyes might feel good, but it is really bad. Is that true? We’re going to talk about that next on Scope Radio.
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Dr. Miller: Hi, I’m here with Dr. Mark Mifflin. He’s a professor of ophthalmology at the University of Utah. Mark, is rubbing your eyes too much a problem? Can that lead to some bad outcomes?
Dr. Mifflin: Yes, actually, it wouldn’t be necessarily intuitive that rubbing one’s eyes could result in actual damage to the eye, but it’s fairly common.
Dr. Miller: Now everybody at some time has got to be rubbing their eyes. So are we talking about a small number of people?
Dr. Mifflin: Well, we actually see a category of disease, perhaps two, that are related to chronic eye rubbing. Certainly, short term eye rubbing is probably not going to cause a problem except for maybe a very few patients who may have some kind of severe problem underlying their eye condition. But chronic eye rubbing can result in the weakening of the cornea and distortion of the cornea called keratoconus.
And it’s often associated with people with very bad allergic conjunctivitis or itchy eyes and, unfortunately, some of these people are so itchy that they nothing feels better that . . . I call it the knuckle rub to the eye. Unfortunately, over time, that can actually weaken and distort the eye.
Another thing that can be associated with chronic eye rubbing is actually laxity of the eyelid. The eyelid can, over time, lose its elasticity and that’s a less serious problem, but still not something that we want to happen.
Dr. Miller: So if somebody was rubbing their eyes because they have severe allergies in the spring or even year-round, how do they end up at your doorstep? Is it that their vision is blurred at some point?
Dr. Mifflin: Yes, typically, most of the patients who we feel that actually there is an association between chronic eye rubbing and disease fall into the diagnosis of the condition called keratoconus, which is a structural abnormality of the cornea causing poor vision due to an abnormal shape to the surface of the eye. The shape causes irregular astigmatism, which often cannot be corrected by glasses or even contact lenses in its severe stages.
One really important is that this disease may run in families and, typically, may start even in childhood. So certainly, parents should be advised to try to seek treatment for their young children who may have severe allergic disease and in the case of eyes, typically allergy eye drops are very effective in eliminating itch. And behavior modification just through teaching can help children not rub their eyes.
Dr. Miller: Now, how do you know if you’re rubbing your eyes too hard?
Dr. Mifflin: I tell my patients that the amount of pressure needed to wash one’s face with a washcloth gently or dry with a towel is the appropriate amount of pressure to put on one’s eye. Anything more than that is probably unhealthy for the eye.
Dr. Miller: So if you’re rubbing to the point where you’re seeing stars, then it’s a bad thing?
Dr. Mifflin: It is possible to induce the sensation of light or the perception of light without actually seeing light. And this can occur with the eyelid closed and these little sparks of light are called photopsia and certainly, when one rubs their eye hard enough to induce photopsia, that is not a good thing.
Dr. Miller: And if you do that repetitively, you might end up in the ophthalmologist’s office.
Dr. Mifflin: I would say that there is a good chance that if you do it over a period of years, you could end up with even worse than that.
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