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How to stop rubbing eyes?

How to stop rubbing eyes?

August 24, 2019

When people rub their eyes they are doing damage to the most important sensory organ in their body. The skin of the eyelids is the thinnest skin in the body.

This skin does not do well with constant trauma. "Pigmentary changes (darkening of skin) and loss of retro-orbital fat can lead to an unwanted facial appearance."

Rubbing the eyes fractures mast cells, which resemble tiny raspberries, with each saccule containing the chemicals histamine, heparin, and serotonin. Histamine makes eyes itch, heparin makes the eyes red, and serotonin keeps the inflammation going.

"The actual rubbing puts pressure on the eye sometimes up to 60mm Hg, which results in an immediate decrease of the itch response." "But minutes later it returns, often more intensely."

Additionally, eye rubbing inflames the ocular surface, which can make any inflammatory ocular surface disease, such as dry eye, worse.

Although the exact mechanism by which eye rubbing impacts keratoconus specifically is unknown (although increased inflammation may be a component), it is known that eye rubbing is highly associated with keratoconus.

"In some patients it may cause keratoconus, while in others it appears to exacerbate the keratoconus."

"The basic increased elasticity or decreased scleral rigidity of keratoconus is adversely affected by eye rubbing."

Also associated with keratoconus is increased allergies and atopic dermatitis.

"Both of these lead to vigorous eye rubbing,"  "The result is increased severity of keratoconus in these patients."

The incidence of floppy eyelid syndrome (FES) is approximately 59% of patients in the 45-60 age group. The presence of this condition has several negative effects on the ocular surface including papillary conjunctivitis, dry eye, severe meibomian gland disease, and exposure keratitis.

FES affects the quality of the lid closure and therefore the wetting of the ocular surface. In more severe case, the eyelids may actually open at night time, which leaves the corneal surface very exposed. Other severe case occur from an override of the upper lid over the lower lid (lid imbrication syndrome), which damages the underside of the upper lid and the corneal surface.

Identifying clinically significant eye rubbing can also entail observation, including darkening of skin around the eyes, increased erythema, and signs of mucus fishing syndrome, Dr. Perry said.

How to stop rubbing

Effective approaches to arresting eye rubbing are linked to the cause of the behavior.

Sometimes the behaviour is caused by allergies, so treatment of the allergies is key. Effective treatments include the use of topical and systemic anti-allergy medications, allergen avoidance, frequent showering and washing of clothes, and cool or cold compresses.

"Often it’s from habit, which is a lot harder to treat."

Suggests wearing glasses and taking preservative-free tears, mast cell stabilizers, or occasional topical steroids to break up the cycle of itching. Additionally, patients may consider desensitization therapy by an allergist.

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