Incorrect sleeping position and eye rubbing in patients with unilateral or highly asymmetric keratoconus: a case-control study

Purpose To evaluate eye rubbing and sleeping position in patients with Unilateral or Highly Asymmetric Keratoconus (UHAKC). Methods Case-control study of consecutive UHAKC patients diagnosed at the Rothschild Foundation. Controls were age- and sex-matched, randomly selected refractive surgery clinic...

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Published in:Graefe's archive for clinical and experimental ophthalmology Vol. 258; no. 11; pp. 2431 - 2439
Main Authors: Mazharian, Adrien, Panthier, Christophe, Courtin, Romain, Jung, Camille, Rampat, Radhika, Saad, Alain, Gatinel, Damien
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.11.2020
Springer Nature B.V
Subjects:
Allergies
Case-Control Studies
Cornea
Corneal Topography
Daytime
Eye
Humans
Keratoconus
Keratoconus - diagnosis
Keratoconus - epidemiology
Keratoconus - etiology
Mathematical models
Medicine
Medicine & Public Health
Ophthalmology
Risk factors
Sleep
Stomach
Surgery
Eye rubbing
Sleeping position
Asymmetric keratoconus
Unilateral keratoconus
Risk factors
Case-control
ISSN:0721-832X, 1435-702X, 1435-702X
Online Access:Get full text
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Summary:Purpose To evaluate eye rubbing and sleeping position in patients with Unilateral or Highly Asymmetric Keratoconus (UHAKC). Methods Case-control study of consecutive UHAKC patients diagnosed at the Rothschild Foundation. Controls were age- and sex-matched, randomly selected refractive surgery clinic patients. Patients self-administered questionnaires regarding their family history of keratoconus, eye rubbing, and sleeping habits. All the eyes underwent a comprehensive ocular examination. Logistic regression was used to analyze univariate and multivariate data to identify risk factors for keratoconus. Results Thirty-three UHAKC patients and 64 controls were included. Univariate analyses showed that daytime eye rubbing [OR = 172.78], in the morning [OR = 24.3], or in eyes with the steepest keratometry [OR = 21.7] were significantly different between groups. Allergy [OR = 2.94], red eyes in the morning [OR = 6.36], and sleeping on stomach/sides [OR = 14.31] or on the same side as the steepest keratometry [OR = 94.72] were also significantly different. The multivariate model also showed statistical significance for most factors including daytime eye rubbing [OR = 134.96], in the morning [OR = 24.86], in the steepest eye [OR = 27.56], and sleeping on stomach/sides [OR = 65.02] or on the steepest side [OR = 144.02]. A univariate analysis in UHAKC group, comparing the worse and better eye, showed that eye rubbing [OR = 162.14] and sleeping position [OR = 99.74] were significantly ( p  < 0.001) associated with the worse eye. Conclusion Our data suggests that vigorous eye rubbing and incorrect sleeping position are associated with UHAKC. This is especially true in rubbing the most afflicted eye, and contributory sleep position, including positions placing pressure on the eye with the steepest keratometry.
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ISSN:0721-832X
1435-702X
1435-702X
DOI:10.1007/s00417-020-04771-z