Eye Rubbing in Chinese Patients With Keratoconus: A Multicenter Analysis
XingHan Guo, Jiang Bian, Kaili Yang, Xiaoxue Liu, Yu Sun, Mingna Liu, Xiaolin Qi, Shengwei Ren, Yanling Dong, Hua Gao
Abstract
Purpose: To investigate the eye rubbing habits of Chinese patients with keratoconus. Methods: This study was carried out from 2018 to June 2022 at Shandong Eye Hospital, Qingdao Eye Hospital, and Henan Eye Hospital. The study compared the number of patients who rubbed their eyes between medical records and second time questionnaires, eye rubbing of patients with myopia and patients with keratoconus, and disease severity between patients with keratoconus. A questionnaire survey of ophthalmologists was conducted to determine their degree of awareness that eye rubbing is a risk factor for keratoconus. Results: The study assessed 799 patients with keratoconus and 798 control patients, and 97 ophthalmologists. The average proportion of patients with keratoconus who rubbed their eyes was 31.0% in the medical records with an increasing trend related to the increase in ophthalmologists' awareness, 66.6% after the second follow-up, and 25.4% among patients with myopia. After multivariate analysis, the following variables showed significant results: eye rubbing frequency more than 10 times/day (odds ratio [OR], 9.168; P < .001); rubbing with knuckles (OR, 9.804; P = .001); and prone sleep position (OR, 12.427; P < .001). The proportion of patients who rubbed their eyes with stage IV keratoconus was 71.9%, 18.9% higher than those with stage I, 4.8% higher than stage II, and 17.8% higher than stage III. Conclusions: The proportion of Chinese patients with keratoconus who rubbed their eyes was relatively high. The main reasons for the low proportions reported were lack of attention. Clinical attention should be paid to eye rubbing in patients with keratoconus who should be educated to avoid it. [ J Refract Surg . 2023;39(10):712–718.]