Management of chronic habits of abnormal eye rubbing.

A review of the provocations and the consequences of chronic habits of abnormal rubbing indicates a range of possible adverse responses. Gentle rubbing may double intraocular pressure. However, the combination of tight eye closure and forceful rubbing may raise intraocular pressure to more than 10 times normal levels. The possibility that, in susceptible individuals, chronic habits of abnormal rubbing may lead to the development or progression of keratoconus has been extended to the possibility of rubbing related adverse responses in other diseases and conditions. The adverse consequences of rubbing appear to be active processes, in contrast to the apparent passive nature of any recovery from those responses. Avoidance of the possibility of permanent adverse changes is clearly preferable. However, advice to avoid rubbing may not be successfully followed. Education and counseling appear to be the foundations for helping patients to control chronic habits of abnormal rubbing. An instrument has been developed as the basis for patient education and counseling for this purpose. It is intended as a take-home document which might have relevance to other family members. The widening of the application of this form of patient education to all members of a family, and a wider range of conditions, may produce beneficial synergy with advantage to patients who may have the most to gain from controlling chronic habits of abnormal rubbing.