Eye Rubbing: When and Why

Reasons for Eye Rubbing

WHY DO WE RUB OUR EYES ?

Many of us rub our eyes when they are itchy, when we are tired, or simply because we like the sensation of well-being and calm that comes with this habitual massaging of the eyes and eyelids. Eye rubbing can be pleasurable

Why does eye rubbing feel good ?

Rubbing evokes pleasurable sensations in several ways. Firstly, reflex tearing from rubbing lubricates the ocular surface and can relieve discomfort and itch from dry eye. Secondly, pressure on the eyeball stimulates the vagus nerve which then slows the heart rate, relieving stress and inducing a sense of calm.

Now we know why it feels good, but when patients commonly rub their eyes and what should they do to avoid it ?
WHEN DO WE RUB OUR EYES ?

There is multiple reasons and moments for rubbing their eyes. Triggers for eye rubbing include ocular discomfort, irritation, fatigue and itch. These symptoms are commonly associated with the following conditions :

Allergy / atopic conjunctivitis

Allergic / atopic conjunctivitis is triggered by the presence of allergens in the environment or food. It may be exacerbated during seasonal variations in the weather, or triggered by unknown factors.

Itch can be severe, and rubbing triggers a non-stop « itch-rub-itch » cycle. Rubbing stimulates the release of histamine, which in turn causes redness, itch and the desire to rub. 

Individuals who sleep on their stomachs or with their eyes buried in the pillow (« pillow hugging »), are often exposed throughout the night to allergens in the bed, pillow or linen, resulting in an allergic conjunctivitis and the need to rub the eyes excessively upon awakening in the morning.

Exposure to irritants

Common irritants include cosmetics, personal care products, dust, chlorine in pool water, dust particles in the atmosphere and expired eye drops.

Rubbing eyes with dirty hands transmits a host of irritants into the eye, including bacteria, fungus, viruses and allergens.

We also find that patients rub their eyes in the shower (eyes irritated by limestone) or after the pool (eyes irritated by chlorine).

Dry eye

Dry eye induces discomfort, irritation, visual fatigue and itch, and eye rubbing can stimulate a reflex tearing which temporarily soothes the ocular surface. As opposed to some of the other causes of itchy eyes, dry eye is a chronic condition and needs to be treated. In severe cases, it can cause keratitis which make the feeling of foreign object and the need to rub. Eye rubbing, make lubrication from tears can relieve feelings of dryness

Blepharitis

Blepharitis refers to inflammation of the eyelid margin due to abnormal activity of the oil glands (meibomian glands). In blepharitis, the eyelids and ocular surface are itchy, red, teary, swollen and dry, and these trigger an urgent need to rub the eyes.

Digital eye strain

In this digital age where the computer, mobile phone and tablet are very much a part of our daily lives, eye strain from the overuse of these gadgets can cause ocular fatigue, headaches and difficulty focusing, which may potentially impact our vision over the long-term. Eye rubbing or compression of the globe (eyeball) is often used to relieve the visual fatigue by inducing a reflex tearing that moisturises the eyes. It also helps relieve stress by stimulating the vagal reflex that slows the heart.

Contact lens use

Contact lens wear over long hours induces discomfort and irritation, and long term contact lens wear (especially with soft lenses) can induce an allergic condition called giant papillary conjunctivitis (GPC) which results in severely itchy eyes. The urge to rub is often most intense immediately after removal of the contact lenses at the end of the day.

Eye rubbing with a rigid gas permeable (RGP) contact lens in place is an unsafe practice and can lead to corneal thinning and scarring when the hard lens is rubbed against the fragile surface of the cornea.

Enjoyed rubbing & Pleasurable sensation

Some patients have pleasure to rub their eyes, because it relax them

Others reasons

These include sleep apnea, behavioura disorders and mentally retardation ( in Autism, Down syndrome, cerebral palsy etc. )