OCT study shows effect of eye rubbing in children’s corneas
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An anterior segment OCT study showed that the corneas of children who frequently rub their eyes have abnormal epithelial thickness distribution, with thinning in the inferotemporal area on the dominant-hand side.
“This thinning could represent one of the earliest stages of keratoconus,” Tomás Loureiro, MD, said at the European Society of Cataract and Refractive Surgeons meeting.
Eye rubbing is recognized as the strongest nongenetic risk factor for keratoconus, but this association is based on retrospective clinical reports. This study prospectively evaluated in vivo the effects of frequent eye rubbing on the corneal epithelium and the differences between the two sides of the dominant and nondominant hand. Thirty right-handed boys aged between 8 and 12 years with a history of eye rubbing with the knuckles were included. AS-OCT was performed in all eyes. Corneal epithelial thickness (ET) and corneal thickness were measured and compared in the octants of the corresponding corneal regions of the right and left eyes.
“Comparing the two eyes, we found that in the inferotemporal area, epithelial thickness was lower in the right eyes. While in the normative databases the thinnest epithelial points are in the superior areas, in these children the thinnest point was in the inferotemporal region. That is also the region where most of the cones are found,” Loureiro said.
This study was able to show the damaging effect of eye rubbing and highlighted the potential role of hand dominance in keratoconus.
“Keratoconus is a bilateral but very asymmetric disease in most cases. Previous reports aimed to evaluate hand dominance in very asymmetrical cases of keratoconus and found a positive association. Other studies did not, and there is no consensus. But our results showed that ET was lower on the dominant hand side, and we come back again with the possible influence of hand dominance in the asymmetric nature of the disease,” Loureiro said.
The main message of this study, he said, is that eye rubbing is a dangerous habit, and physicians should strongly recommend to their patients to not rub their eyes.
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Loureiro T, et al. The effect of eye rubbing in corneal epithelium of children with atopy. Presented at: European Society of Cataract and Refractive Surgeons meeting; Oct. 8-11, 2021; Amsterdam.
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