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Eye rubbing anxiety in a man with Keratoconus

Eye rubbing anxiety

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Eye rubbing anxiety - images of man with Keratoconus and how he rubs his eyes. Suffers from anxiety. Map shows where he rubs his eyes.
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Eye rubbing anxiety

Eye rubbing anxiety

This is a very interesting presentation of keratoconus in a young man diagnosed with ADHD who is very anxious.

Blurry vision noted incidentally in the left eye and had been told to have cross linking.

It was a very intense consultation, and I noted he was very enophthalmic….look at his side view.

Front and side view of man with Keratoconus suffering with ADHD and anxiety.

So how do you rub an eye that is sunk so deep in an eye socket?

Very aggressively, with the palm of the hand, on the left side, which he states he does to relieve “pressure”.

Take a look at the eye rubbing photo: he could only manage to contact the temporal aspect of the eye, the exact location of temporal cone.

Eye rubbing anxiety using the palm of the hand to aggressively rub the eye and only contact the temporal aspect of the eye.

I now call all such rubbing, EYE RUBBING ANXIETY, and I believe this is the first use of such a diagnosis in the world.

When you look and ask, you will find a considerable portion of your patients do it.

Funny how we miss seeing things that are so familiar (in our professional and personal lives!).

Topography map of the cornea showing how the eye rubbing anxiety effects the cornea in someone with Keratoconus.

By the way, consider this article on eye rubbing damaging the optic nerve published 20 years ago:

Pecora L, Sibony P, Fourman S. Eye-rubbing optic neuropathy. Am J Ophthalmol. 2002 Sep;134(3):460-1. doi: 10.1016/s0002-9394(02)01498-8. Erratum in: Am J Ophthalmol. 2003 Aug;136(2):following 403. PMID: 12208269.

Dr Anthony Maloof

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