Purpose: Mechanical irritation can contribute to the pathogenesis of various eye diseases. The release of inflammatory mediators due to eye rubbing may alter the corneal collagen leading to corneal ectasis. Eye rubbing may never cause eye pressure spikes, but lowering intraocular pressure. In this study, we aimed to uncover the eye rubbing effects on retina by retinal imaging analyses using optical coherence tomography (OCT).

Study Design: Case-control Study.

Methods: This comparative case series enrolled 131 patients (262 eyes, age: 65.4±18.9 years) who confessed to compulsive and frequent eye rubbing, and showed inner retinal layer abrasion on OCT. Comparative studies were conducted using 116 patients (232 eyes, age: 67.0 ± 13.3 years) with primary glaucoma (PG) meeting the diagnostic criteria as positive controls; and 94 healthy subjects (118 eyes, age: 56.4 ± 18.8 years) as negative controls. OCT observations and statistical analysis included 128-256 sequential macular images followed by 3D images, and significance maps of the retinal ganglion cell layer (RGCL), and the retinal nerve fiber layer (RNFL). Mann–Whitney U-test, and χ2 test were performed.

Results: OCT images showed partial abrasion of inner retinal layers extending from the internal limiting membrane to the RNFL, or to the RGCL due to eye rubbing. RGCL and RNFL were significantly thin in frequent eye rubbing and PG patients compared to healthy controls.

Conclusion: Mechanical irritation such as frequent eye rubbing can cause to shake the vitreous,lead inner retinal layer abrasions, and thinning of the RGCL and RNFL.