Take care when rubbing your eyes Take care when rubbing your eyes

It sounds like scolding when people tell you not to rub your eyes, but the consequences of this apparently inoffensive action can be serious.

Advisors: Juan Carlos Abad, Ophthalmic Surgeon
Diego Aristizábal, Ophthalmic Surgeon
Practitioners at Coomeva Private Healthcare

Rubbing your eyes is a common impulse: sometimes we do it because of tiredness, to remove a foreign object, or to relieve the irritation experienced by those who suffer allergic reactions. However, it’s important to know how to do it in the right way in order to avoid damaging the eyes, a highly sensitive organ. “You can rub your eyes by using a finger to apply pressure on the tear duct down towards the nasal bone, but you shouldn’t touch your eye because the cornea is like a millefeuille, which has layers of pastry; if you rub too hard you can break the layers and alter the shape of the eye, leading to keratoconus”, explains the ophthalmic surgeon Juan Carlos Abad.

Keratoconus is a deformation of the cornea, which changes in shape from a semi-circle or oval to a cone, hence the name of the condition. “This means that the image can no longer be focused where it should be, which is in the retina, and instead it becomes diffused, irregular or lacking in sharpness”, says the ophthalmic surgeon Diego Aristizábal. Most cases of keratoconus emerge in childhood, when allergies begin to appear and children rub their eyes uncontrollably, and for this reason ophthalmologists across the world want to raise awareness of the consequences of this seemingly insignificant action.

Necessary procedures

When keratoconus occurs, it needs to be stopped from progressing through surgery called corneal collagen cross-linking, which consists of applying a vitamin to the cornea and using ultraviolet light of a specific wavelength so that the cornea acquires resistance, Aristizábal explains. Following this, glasses and soft or rigid contact lenses can be used to improve eyesight, but the damage is often too severe and further surgery is required. This involves intrastromal ring implants, which are tiny pieces of semi-circle shaped plastic that restore the normal shape of the cornea and enable the patient to focus better again. In the most serious cases a cornea transplant may be necessary.

Needless to say, rubbing your eyes again is off-limits after this condition is diagnosed, as it is progressive and the more you rub them, the greater the damage to your eyesight. Keratoconus can reappear following surgical intervention, warns Abad, and it doesn’t only occur in childhood. Patients who have undergone other surgical procedures on their eyes are more likely to suffer from it, as are those who develop allergies later in life. It can also occur solely due to the habit of rubbing your eyes, something that can be caused by psychological factors.

The specialist physicians Abad and Correo worked on a study at the University of Antioquia that demonstrates that the simple act of giving up the habit of rubbing your eyes slows the progression of keratoconus, and means that surgery may not be necessary. “The prevalence of this condition will probably decrease due to coronavirus, because everyone has been recommended not to touch their face. It’s going to be interesting, because people have stopped rubbing their eyes as a result of the guidelines; when doctors go back to evaluating patients, they are likely to find that keratoconus has quietened down”, Abad concludes.

Other consequences

Rubbing your eyes can also cause foreign objects to become embedded in the cornea, and a visit to the ophthalmologist may be required to extract them and prevent them from scratching the eye. When you feel like you have something in your eye and it doesn’t go away with blinking or the tears that the eye produces to defend itself, medical attention is necessary. “This often happens to motorcyclists who ride with their helmet visor up, and animal hairs can potentially cause allergic conjunctivitis. If they don’t disappear through blinking or artificial tears, it could be a problem”, Aristizábal advises.

It’s also important to bear in mind that the eyes are a point of entrance to the body. When viruses and bacteria enter into contact with them, not only can it lead to diseases like conjunctivitis but also generalized infections such as that caused by coronavirus. This gives rise to the recommendation to avoid touching your face with dirty hands. Ophthalmologists don’t consider the use of goggles or face shields to be necessary among those who don’t go out much or who observe social distancing, although they are a requirement for employees who have to be in direct contact with the public.

Kick the habit

Breaking the habit of rubbing your eyes can be a challenge — particularly for allergy sufferers — and for this reason ophthalmologists recommend visiting an allergist so that you can begin treatment and relieve yourself of the sensation. Using protective goggles can also help small children by stopping them from touching their eyes. It’s even possible to turn to psychological counseling when no other medical strategy seems to solve the problem; the important thing is to prevent your eyesight from being affected and avoid the development of conditions that may necessitate the use of prescription glasses, or even surgical intervention.

As hard as it might be rubbing your eyes should be avoided and even more so if it’s become a habit, as this repetitive action can cause retinal problems and exposes you to infections.