Assessment of the mechanical forces applied during eye rubbing

Hafezi, Farhad; Hafezi, Farhad; Pajic, Bojan; Gilardoni, Francesca; Randleman, J. Bradley; Gomes, José Álvaro Pereira; Kollros, Léonard; Hillen, Mark; Torres-Netto, Emílio A.

doi:10.1186/s12886-020-01551-5

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…Eye rubbing, as a well-known risk factor for keratoconus development, can induce distinct alterations in corneal biomechanics 25,88 . However, little is known about the impact of stretch on corneal ECM degeneration.…”

Section: Discussionmentioning

confidence: 99%

Single-cell atlas of keratoconus corneas revealed aberrant transcriptional signatures and implicated mechanical stretch as a trigger for keratoconus pathogenesis

et al. 2022

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Keratoconus is a common ectatic corneal disorder in adolescents and young adults that can lead to progressive visual impairment or even legal blindness. Despite the high prevalence, its etiology is not fully understood. In this study, we performed single-cell RNA sequencing (scRNA-Seq) analysis on 39,214 cells from central corneas of patients with keratoconus and healthy individuals, to define the involvement of each cell type during disease progression. We confirmed the central role of corneal stromal cells in this disease, where dysregulation of collagen and extracellular matrix (ECM) occurred. Differential gene expression and histological analyses revealed two potential novel markers for keratoconus stromal cells, namely CTSD and CTSK. Intriguingly, we detected elevated levels of YAP1 and TEAD1, the master regulators of biomechanical homeostasis, in keratoconus stromal cells. Cyclical mechanical experiments implicated the mechanical stretch in prompting protease production in corneal stromal cells during keratoconus progression. In the epithelial cells of keratoconus corneas, we observed reduced basal cells and abnormally differentiated superficial cells, unraveling the corneal epithelial lesions that were usually neglected in clinical diagnosis. In addition, several elevated cytokines in immune cells of keratoconus samples supported the involvement of inflammatory response in the progression of keratoconus. Finally, we revealed the dysregulated cell-cell communications in keratoconus, and found that only few ligand-receptor interactions were gained but a large fraction of interactional pairs was erased in keratoconus, especially for those related to protease inhibition and anti-inflammatory process. Taken together, this study facilitates the understanding of molecular mechanisms underlying keratoconus pathogenesis, providing insights into keratoconus diagnosis and potential interventions.

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Section: Discussionmentioning

confidence: 99%

Single-cell atlas of keratoconus corneas revealed aberrant transcriptional signatures and implicated mechanical stretch as a trigger for keratoconus pathogenesis

et al. 2022

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“… 36 Rubbing with knuckle (proximal interphalangeal joint) was found to apply more force on the eyelids than rubbing with the fingernail or with the fingertip. 36 …”

Section: Discussionmentioning

confidence: 99%

“…They studied the average amount of mechanical forces applied to the lids of KC patients during eye rubbing according to the type of eye rubbing. 36 Rubbing with knuckle (proximal interphalangeal joint) was found to apply more force on the eyelids than rubbing with the fingernail or with the fingertip. 36 Epithelial thickness seemed to be lower in inferior and temporal octants in both right and left eyes compared with controls.…”

Section: Discussionmentioning

confidence: 99%

“…36 Rubbing with knuckle (proximal interphalangeal joint) was found to apply more force on the eyelids than rubbing with the fingernail or with the fingertip. 36 Epithelial thickness seemed to be lower in inferior and temporal octants in both right and left eyes compared with controls. 21 McMonnies has previously examined the possible causal mechanisms for rubbing-related corneal trauma and cone formation and concluded that eye rubbing leads to epithelial thinning which further increases the concentration of proinflammatory molecules in tear film of normal corneas.…”

Section: Discussionmentioning

confidence: 99%

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Corneal Epithelium Asymmetry in Children With Atopy: The Effect of Hand Dominance

Loureiro¹,

Rodrigues-Barros²,

Carreira³

et al. 2022

OPTH

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Purpose To evaluate the effect of eye rubbing on the epithelial thickness profile in tomographically normal corneas by AS-OCT and to compare right and left eyes in right-handed children. Methods Thirty right-handed boys (mean age 11.2 years) with ocular allergy and history of eye rubbing were evaluated using Scheimpflug (Pentacam HR, Oculus Wetzlar, Germany) and anterior segment optical coherence tomography. Epithelial thickness (ET) and full corneal thickness (CT) parameters were compared between right and left eyes with a non-parametric Mann–Whitney test. A p-value lower than 0.05 was considered for statistical significance. Results No eyes had topometric nor tomographic criteria for keratoconus. The min-max ET was lower in right eyes (−2.8 µm vs −3.5; p = 0.02). The difference between inferior and superior (I-S) octants was lower in right eyes (1.1 µm vs 1.9 µm; p = 0.03) as a result of inferotemporal thinning. The highest ET difference was registered between nasal and temporal octants and was more pronounced in the right eyes (2 µm vs 3.1 µm; p < 0.001). Conclusion AS-OCT analyses reveal different epithelial thickness patterns between the eyes in young atopic patients, likely eye rubbers. Inferior and temporal epithelial thickness seem to be more affected by thinning in the eye on the side of the dominant hand.

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“…Directed history taking regarding eye rubbing should include not only questioning whether or not the patient rubs their eyes, but also in what way the eyes are rubbed as patients rub their eyes in a number of different ways; with the pulp of their fingertips, their fingernails or their knuckles. Hafezi et al conducted a prospective study to assess the average forces typically applied to the globe during eye rubbing in 57 patients with keratoconus [108], where patients were asked to perform their individual eye rubbing movement and then repeat the same movement on a surface of a high-precision balance. At the same time the authors observed which part of the finger came into contact with the eyelids every time an eye-rubbing movement was performed, while hand dominance was also recorded.…”

Section: • Eye Rubbingmentioning

confidence: 99%

Tear Film and Ocular Surface in Keratoconus

Hamada

Matsou

2021

Keratoconus

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Keratoconus (KC) is an ectatic corneal disorder, characterised by progressive stromal thinning and structural weakening with apical cone-like protrusion, leading to progressive myopia, irregular astigmatism, scarring and decreased vision. It is a leading cause of corneal transplantation in the developed world. While keratoconus has been traditionally considered a predominantly degenerative, non-inflammatory disease of multivariate origin, the exact aetiology remains largely unknown. There is now evidence of genetic inheritance and possible association with systemic disease, as well as substantial evidence that certain environmental factors, such as ocular surface disease, atopy and contact lens wear, and behaviours, such as excessive eye rubbing, may play a key role. The factors that determine or affect the progression or stabilisation of the disease are not well characterised or understood.A number of studies suggest a pivotal role of inflammation in the pathogenesis and progression of KC, contradicting the dogma that traditionally classified keratoconus as a non-inflammatory condition. Elevated levels of inflammatory mediators, such as pro-inflammatory cytokines, tumour necrosis factor, interleukins, cell adhesion molecules, and matrix metalloproteinases (MMPs) have been detected in keratoconic eyes compared to normal, implying that chronic inflammatory events are involved in the manifestation and progression of the disease. Many studies have attempted to investigate in depth the pathogenesis of keratoconus. And while it is widely accepted that complex interactions between genetic and environmental factors, both mechanical and biochemical, influence the development and course of

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Assessment of the mechanical forces applied during eye rubbing

Cited by 14 publications

References 11 publications

Single-cell atlas of keratoconus corneas revealed aberrant transcriptional signatures and implicated mechanical stretch as a trigger for keratoconus pathogenesis

Single-cell atlas of keratoconus corneas revealed aberrant transcriptional signatures and implicated mechanical stretch as a trigger for keratoconus pathogenesis

Corneal Epithelium Asymmetry in Children With Atopy: The Effect of Hand Dominance

Tear Film and Ocular Surface in Keratoconus

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