Chatter: Be cautious with eye rubbing or eyelid massages and intraocular pressure
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12 weeks ago
david 4.1k

Eyelid massage and meibomian gland expression can be helpful for dry eyes. However, it is very easy to do the technique incorrectly and to put pressure on your eye globe when doing these massages. Some of the eyelid massage videos on YouTube give incorrect instructions that could lead to elevated IOP.

This post is an attempt to raise awareness and to encourage people to practice eyelid massage or meibomian gland expression in a way that accomplishes the desired result without putting pressure on your eye globe.

Many eye massage techniques include the instruction similar to "don't push too hard." But the following paragraphs describe why that advice may not be sufficient.

How high can eye pressure (IOP) go when we rub our eyes? I have seen IOP go as high as 70 mmHg with only moderate finger pressure on the eye. However, the study below suggests it can go even higher than that:

The Magnitude of Intraocular Pressure Elevation Associated with Eye Rubbing - PubMed

Results:: IOP increased as much as 310 mmHg due to eye rubbing. The largest IOP elevations were associated with rubbing the eye and orbit with the back of the hand or wrist, rather than the fingers or knuckle. Eye rubs elicited mean IOP elevations of ~80–150 mmHg above baseline for 3–4 seconds, with peak IOP elevations reaching 205–310 mmHg depending on the individual NHP and eye.

Conclusions:: Rubbing the eyes causes momentary IOP elevations that average 109 mmHg above baseline IOP and can exceed 300 mmHg above baseline IOP in NHP eyes.

Those are momentary IOP elevations, but there are case histories of long term damage to eyesight as a consequence of habitual eye rubbing.

Hypotony maculopathy after eyelid massage for overcorrected blepharoptosis - PubMed

Ocular hypotony may result from digital eyelid massage in patients with filtering blebs.

In patients without filtering blebs, ocular hypertension may result from eyelid massage.

There are multiple case reports in the literature of eye rubbing leading to serious eye damage. In one case, it induced progressive optic neuropathy and severe visual field damage similar to the pathology of advanced glaucoma. Another case is described here:

Eye-rubbing optic neuropathy - PubMed

a patient whose "normal tension glaucoma" appears to have been produced by a long-standing habit of repetitive, bilateral eye rubbing.

I'd like to hear your comments. If you do eye massages, are you able to adapt your technique so that you can do it without putting pressure on the globe?

iop:intraocular-pressure eye-massage eye-rubbing • 122 views

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