Eye-rubbing optic neuropathy.

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

DESIGN

Observational case report.

METHODS

A 46-year-old man presented with a "haze" over the left eye and had progressive bilateral optic neuropathy associated with bilateral normal intraocular pressure, pathological cupping of the optic disks, and nerve fiber bundle visual field defects.

RESULTS

Over a 4-year period, vision in the left eye deteriorated to no light perception. Progressive deterioration in the right eye stopped only after the patient ceased a 20-year habit of forceful rubbing of his eyes. After that, the decline in vision was terminated and both visual acuity and visual field were stabilized over an 8-year follow-up.

CONCLUSION

It may be appropriate to include "eye rubbing" in the differential diagnosis of unexplained progressive optic neuropathy in presumed normal tension glaucoma.