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.