Rubbing the eyes weakens the cornea, and a strong link between frequent eye rubbing and the progression of keratoconus has been known for years. This rubbing can become a habit, like when contact lens wearers remove their lenses in the evening and rub their eyes extensively.
In some cases, allergies—such as hay fever or dust allergies—cause itchy, red eyelids, leading to eye rubbing. To reduce this urge, we work with allergists to manage these symptoms effectively.
Do you rub your eyes? Often, it’s helpful to ask family, friends, or a partner, as people may not realize how frequently they rub their eyes.
Eye-rubbing techniques vary: some people rub with their fingertips, others use the heel of their hand, and some (in the most risky way) use their knuckles.
There’s a clear link between eye rubbing and keratoconus, but while some suggest that eye rubbing is the sole cause, no concrete evidence has yet been published to support this claim.
Eye rubbing can weaken the cornea, potentially worsening keratoconus. However, whether it actually causes keratoconus is still debated. To explore this question, the first step is understanding how much force eye rubbing places on the eye—a measurement that was previously unknown.
Scientific research on the relationship between eye rubbing and corneal strength is limited. Our ELZA team of surgeons, researchers, and colleagues took on this investigation, measuring the mechanical forces applied to the eyelids during eye rubbing. Our findings were published in the journal BMC Ophthalmology (1) and revealed the following insights:
People tend to rub their eyes in three ways: with their fingertips, knuckles, or fingernails. Among the 57 patients we studied, 51% used their fingertips, 44% used their knuckles, and 6% used their fingernails. When we measured the force exerted during each type of rubbing, we found that knuckle rubbing applied significantly more force to the eyelids—an average of 9.6 N—compared to fingertip rubbing (4.3 N) and fingernail rubbing (2.6 N). This means knuckle rubbing exerts 2.2 and 3.7 times more force on the eyelid (and the underlying cornea) than fingertip and fingernail rubbing, respectively.
Rubbing eyes with fingertips
Rubbing eyes with knuckles
We built an eye-rubbing machine and it took us 2 years. Our goal was to study how repeated eye rubbing affects corneal strength and whether there’s a connection between repetitive rubbing and weakening of the cornea. This research was an important step toward answering the question of whether eye rubbing is directly linked to the development—beyond just the progression—of keratoconus.
To read the paper, click on the image:
In simple terms, this means that repeatedly rubbing a (dead) animal eye 11,500 times didn’t impact the cornea’s strength. However, at the ELZA Institute, we still strongly advise against eye rubbing. We believe that the harm comes not from the rubbing itself, but from the inflammation it causes in a living eye. When your eye turns red from excessive rubbing, your body releases an enzyme called LOX (lysyl oxidase), which weakens the corneal collagen.
In short: avoid eye rubbing—it doesn’t cause keratoconus directly, but the inflammation it triggers can weaken the cornea and make keratoconus progress.
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