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The Role of Dynamic MRI Imaging in Understanding the Impact of Eye Rubbing on Ocular Health

by | Jan 1, 2025 | Manuscripts | 0 comments

Mahesh Mudi, B.Optom

Consultant Optometrist, Narayana Nethralaya, Bengaluru, India

 

Introduction

Without realising it, you might rub your eyes and overlook the potential harm it can cause. Although it may seem like a harmless action, recent magnetic resonance imaging (MRI) studies reveal the serious damage this habit can inflict.(1,2) This blog explores the effects of eye rubbing and how MRI studies have shed light on this issue.

What Happens When We Rub Our Eyes?

Eye rubbing exerts mechanical pressure on the cornea and sclera, leading to deformation and potential damage. This behaviour is often triggered by fatigue, allergies, or foreign particles. Excessive eye rubbing is a known risk factor for keratoconus, a condition characterised by thinning and bulging of the cornea. Repeated eye rubbing can further weaken the corneal structure, increasing the risk of ectatic corneal disease (ECD).(3)

Insights from MRI on Eye Rubbing

Dynamic MRI examinations have shown that rubbing the eyes creates immediate pressure and strain on the cornea and nearby orbital structures, leading to microtraumas. Over time, these small traumas can accumulate, causing structural damage to the eye and potentially contributing to keratoconus.(4) Additionally, frequent eye rubbing can worsen dry eye symptoms and other ocular surface abnormalities.

The Rothschild Foundation conducted an experiment using dynamic MRI imaging on a healthy volunteer to observe ocular changes during eye rubbing.(1,2) By employing dynamic MRI, the study captured real-time images of the eye during and after eye rubbing. Participants were subjected to controlled eye rubbing, and MRI scans were used to observe changes in corneal shape, intraocular pressure, and other ocular structures.

Unexpected Outcomes of Eye Rubbing

Preliminary findings reveal significant deformation of the cornea and sclera during eye rubbing. MRI images show increased corneal curvature and thinning, especially in individuals with a history of frequent eye rubbing. Transient increases in intraocular pressure were also observed, supporting the hypothesis that eye rubbing may aggravate conditions like glaucoma.(5)

  • Corneal Deformation: Dynamic MRI imaging shows that eye rubbing can significantly deform the cornea, potentially contributing to the development or progression of keratoconus by weakening the corneal structure.
  • Orbital Structure Changes: The study also identified alterations in the surrounding orbital structures beyond the cornea, which may affect the eye’s overall stability and function, potentially leading to further complications.
  • Increased Intraocular Pressure (IOP): Eye rubbing can temporarily elevate IOP.(6) Although typically transient, repeated increases may lead to long-term damage, especially in individuals with pre-existing conditions such as glaucoma.

MRI Findings Highlight the Need for Patient Education on Eye Rubbing Risks

Key points for clinicians include the following:

  1. Avoidance of Eye Rubbing: Patients with allergies or dry eyes should avoid rubbing their eyes and instead use lubricating eye drops for relief.
  2. Early Detection and Management: Regular eye exams are essential for the early detection of keratoconus, enabling timely intervention and reducing the need for invasive treatments.
  3. Patient Education: Informing patients about the risks of eye rubbing and teaching them to manage triggers can significantly reduce complications.

Figure 1: Eye rubbing: the piece that solves the puzzle
(The figure was prepared by the author)

Conclusion

When a patient rubs only one eye, it is often the eye they sleep on and is more likely to be severely affected by keratoconus.(7) Identifying these risks allows us to implement strategies to maintain vision and improve eye health. If you frequently feel the urge to rub your eyes, consult an eye care specialist to identify any underlying issues and prevent lasting damage.

 

References

  1. Gatinel, D. (2021, november 17 ). TwistedSifter. Retrieved from TwistedSifter: https://twistedsifter.com/videos/mri-shows-what-happens-when-you-rub-your-eyes/#google_vignette
  2. Sengupta, S., Smith, D. S., Smith, A. K., Welch, E. B., & Smith, S. A. (2017). Dynamic imaging of the eye, optic nerve, and extraocular muscles with golden angle radial MRI. Investigative Ophthalmology and Visual Science, 58(10), 4010–4018. https://doi.org/10.1167/iovs.17-21861
  3. Salomão, M., Lopes, B., Ambrósio, R., Faria-Correia, F., Silva-Lopes, Í., Azevedo-Wagner, A., & Tanos, F. W. (2018). Paradigms, Paradoxes, and Controversies on Keratoconus and Corneal Ectatic Diseases. International Journal of Keratoconus and Ectatic Corneal Diseases, 7(1), 35–49. https://doi.org/10.5005/jp-journals-10025-1158
  4. Jafri, B., Lichter, H., & Stulting, R. D. (2004). Asymmetric Keratoconus Attributed to Eye Rubbing. In Cornea • (Vol. 23, Issue 6). DOI: 1097/01.ico.0000121711.58571.8d
  5. Lorenzo Peco ra, M. P. (2002, march 5). Eye-rubbing Optic Neuropathy. AMERICAN JOURNAL OF OPHTHALMOLOGY, 134(3), 460–462. doi:https://doi.org/10.1016/S0002-9394(02)01498-8
  6. Turner, D. C., Girkin, C. A., & Downs, J. C. (2019). The Magnitude of Intraocular Pressure Elevation Associated with Eye Rubbing. Ophthalmology, 126(1), 171–172. https://doi.org/10.1016/j.ophtha.2018.08.025
  7. Mazharian, A., Panthier, C., Courtin, R., Jung, C., Rampat, R., Saad, A., & Gatinel, D. (2020). Incorrect sleeping position and eye rubbing in patients with unilateral or highly asymmetric keratoconus: a case-control study.
  8. Graefe’s Archive for Clinical and Experimental Ophthalmology, 258(11), 2431–2439. https://doi.org/10.1007/s00417-020-04771-z

 

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