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Abstract

Chronic abnormal eye rubbing, and external compressive forces has a long-established association with the incidence and progression of keratoconus (KC). Rubbing-related risk of ocular trauma can be induced by both active and passive, compressive mechanisms the effects of which are not fully understood. Demonstrating to patients that rubbing causes ocular trauma may be a useful approach to help motivate them to break abnormal rubbing and ocular compression habits, such as face-down pillow pressure. Ocular itch is a well-known powerful rubbing provocation, so too are other factors such as rubbing induced stimulus of a pleasure centre, psychological and psychological influences for reducing stress and anxiety, as well as relief of ocular surface dryness and other peri-orbital irritating stimuli. In the past, clinicians resorted to methods of detecting, measuring, and demonstrating corneal responses to eye rubbing, with instruments such as keratometers and early generation corneal topographic systems. Advances in the development of corneal topography, corneal tomography, corneal densitometry, corneal pachymetry, methods for measuring biomechanical properties, detection of tear film inflammatory markers, cellular responses, and technological advances in corneal artificial intelligence modelling, have revolutionized the potential for more sensitive methods in to detect corneal and other ocular responses to rubbing.

This study will evaluate changes in corneal epithelial thickness, corneal densitometry, corneal topography, and anterior chamber volume changes in normals and keratoconic subjects before and after ocular rubbing. A questionnaire has been developed to estimate and quantify the degree of abnormality of eye rubbing and to examine its association with ocular changes. The questionnaire results were presented at a poster session in October 2022 at the American Academy of Optometry meeting and will help determine an association with keratoconic disease severity.

Biography

A graduate with honours from the University of NSW class of 1994, Dr. Ared is an optometric clinician in private practice and researching the effects of eye rubbing in keratoconic participants. He has completed a graduate certificate in ocular therapeutics and one of only a select few of Australian optometrists to be inducted as a fellow of the highly distinguished American academy of optometry (FAAO). He is a member of the cornea and contact lens society of Australia, the orthokeratology society of Oceania, the optometrist’s association of Australia and for over twenty years host of "All About Eyes" a weekly talk back eye program on Sydney's Radio 2GB. He is also a credentialed vision examiner for CASA, the civil aviation safety authority of Australia and a manuscript reviewer for the highly esteemed Journal, Clinical & Experimental Optometry (Anterior segment section). His clinical practice is highly regarded in the fitting and prescribing of specialty contact lenses for orthokeratology and complex corneal diseases. His thesis is representative of the rigorous academic process which governs the faculty overseeing his degree and is on track for submission in 2025.

B. Optom(Hons.), PhD(Candidate), CASA (CO), GradCertOcularTher(UNSW), FAAO