Why rub your eye?
Above video comes from: Defeat Keratoconus @defeatkeratoconus4856 and illustrates what happens to your eye when you rub it - much as you might see with Superman’s (or Superwoman’s) “X-Ray vision.”
Rubbing your eyes can feel good - and generally doesn’t have any immediate negative consequences - so it must be good for us - Right? Well, generally speaking, it’s more wrong than right. Watching the above video gives a unique perspective on what is going on when you do rub your eyes, but let’s consider the good and the bad.
Good news first. When you rub your eye, it is possible to help your eyes make tears. Pressure on the lids can force some oil out of the oil-producing (Meibomian) Glands and oil is an important (and often lacking) part of a tear. I’ve covered much of the benefits of oil in our tears - as well as the function and support of these glands - in many prior posts, so won’t dwell on it here. This pressure can also slightly irritate - and therefore stimulate - the “firehose” glands that create the gush of salty water useful for washing dust, pollen or other irritants out of the eyes. Like a cough, rubbing eyes can trigger the vagus nerve that can slow our heart rate. Mild slowing can help relieve a sense of stress, though major slowing can risk dizziness or even fainting - so this can be a good or bad side effect depending on how slow you go. I tend to separate the act of gentle wiping (generally good for spreading eyelash cleansing products around the lashes, removing loose lashes and excess tears from the lids) from the act of rubbing (exerting force against the eye by firmly pressing on the lids, as in this video - and the subject of this posting).
Bad news can be many - and magnified by underlying eye issues. When you rub your eye, it is possible to damage the cells making and repairing the collagen fibers that create the fabric of the cornea. Collagen is “woven” throughout the clear front part of the eye that we call the cornea, in a distinct pattern that “cross links” these fibers tightly together. With equal woven patterns across the entire tissue, any force inside or outside the eye is “shared” equally across the entire “fabric.” Rubbing can unlink and stretch out these fibers and appears to damage the cells that normally repair this “fabric.” Triggering the defense system from excessive rubbing can also lead to the release of histamine (responsible for itching) that may lead to a vicious cycle of rubbing (similar to scratching an itch that then itches all the more). As we pour our inflammatory chemicals into the tears bathing our eyes, these can ultimately work against good tear production (and aggravate the corneal cells and fibers further). As the fibers become loose in areas most affected, the resulting weakness in the cornea will result in an outward “bowing” of the cornea - called a “cone.” Instead of the perfect spherical, desired “roundness” of the cornea, any bowing will distort the cornea leading to misshapen images (astigmatism) requiring stronger glasses or contact lenses to reshape the images necessary to good vision. At the extreme, this “cone” shape is called “Keratoconus” and can so distort the images that surgery to replace the cornea (a corneal transplant) or special procedures (to restore corneal cross linking) may be required.
More bad news is that too much pressure applied for too long may permanently damage the optic nerve (connecting the eye with the brain). This type of damage is commonly called glaucoma and if unchecked, can ultimately result in irreversible blindness. How much is “too much” will depend on many factors, including genetic tendencies for this nerve damage, or any pre-existing damage (from glaucoma or other injuries to the nerve). Also, if you watch the video carefully, you may see the outward bulging of the sclera (or white part of the eye) behind the cornea. Inside that area exists the thinnest and most delicate part of the retina. In patients with an already thin retina (often referred to as lattice degeneration), stretching the retina - especially in these already thinned areas - may lead to tears or holes that can progress to a retinal detachment - and require delicate surgeries to repair (or result in blindness if unchecked).
Lastly, I’ll point out that putting fingers or other objects in close proximity to the eyeball elevates the risk of transferring germs, toxins, allergy-producing materials or dirt into contact with the eye itself. A common cause for “pink eye” is the spread of germs or other materials from such contact. Obviously any time we touch our lids with our fingers, we are taking such risks unless we’ve carefully washed and otherwise disinfected them first. Ironically, one of the causes of acutely irritated and red eyes in the wake of the pandemic, is the inadvertent transfer of hand sanitizers from freshly “cleaned” fingers that then gets into the eye from alcohol or other germ-killing residue in the sanitizer (ANYTHING GREAT AT KILLING ANY AND ALL GERMS IS ALSO PRETTY GOOD AT KILLING OFF CELLS ON THE SURFACE OF THE EYES, TOO!).
My personal. experience is that I am also guilty of occasionally “rubbing” my eyes - and although I am generally cautious about hand cleaning and not rubbing excessively, I may have caused myself a case of pink eye in the past. When my eyes itch, my preference is to use antihistamine (anti-allergy) eye drops, a clean, cool compress and only mild wiping when applying lid cleaning products (Zocuwipes and Avenova being my favorites), since common lid germs can also aggravate eyes and lead to dryness and irritation. Hot compresses are also useful when dealing with non-itchy, dry or otherwise irritated eyes and when applying the (Bruder or other) heat mask, I use only the pressure required to keep the heat in contact with the lids (and not forcibly press on the eyes). Strong blinking and forced eye closure (short of grimacing) are likewise useful at expressing the Meibomian oil glands (and doesn’t require firm finger-pressure, as in the above eye rubbing video) - so there are ways to relieve an otherwise tired, itchy or irritable eye without resorting to “the rub!”
To schedule an appointment with Dr. Jaccoma, call Excellent Vision at either of these two dry eye offices:
(1) 155 Griffin Rd, Portsmouth, NH 03801 (603) 574-2020
(2) 3 Woodland Rd, STE 112 Stoneham, MA 02180 (near Boston) (781) 321-6463