1. Introduction

Everyone rubs their eyes — but it may do more harm than you think. Eye rubbing is a frequent, almost instinctive way to soothe discomfort, yet it’s something we rarely register in our daily routine. It can be triggered by dryness, allergies, or tiredness after long hours of screen time, making people instinctively rub their eyes for quick relief. However, eye rubbing can actually cause damage over time. From the risk of spreading bacteria to putting pressure on the delicate structures of the eye, eye rubbing can have serious consequences. Therefore, understanding why this common habit should be avoided is important.

2. Why Do We Rub Our Eyes?

Common triggers of eye rubbing include:

• Fatigue and Eye Strain. Extended screen time and insufficient sleep are key contributors to eye strain and fatigue, often causing dryness, a gritty sensation, and general discomfort. When focusing on screens, people tend to blink less frequently, leaving the eye surface exposed for longer and increasing the risk of dryness (HealthHub, 2021).
• Dry Eyes. Similarly, environmental factors such as wind or air conditioning increase the dryness of the eye. Air conditioning reduces the humidity in the air and wind increases the airflow across the eye surface. These lead to increased evaporation rate of the eyes’ natural tear film, causing dryness and irritation.
• Allergies and Irritation. Dust, pollen, and pet dander can irritate our eyes, causing itchiness, redness, and watering — making it tempting to rub them for relief. Allergies also trigger the release of histamines and other inflammatory chemicals which make eye rubbing almost instinctive.
• Habit or Reflex. Eye rubbing can also simply be due to habit or reflex, an unconscious behaviour that occurs when stressed or bored.

3. What Happens When You Rub Your Eyes?

While eye rubbing may seem like a harmless gesture done out of habit, it brings about numerous concerns.

Firstly, our hands are one of the dirtiest parts of our body. On average, our hands carry up to 3,200 different germs (Pfizer, 2022), some of which can be harmful and cause infections. Eye rubbing would spread bacteria, effectively infecting ourselves and increasing the risk of eye infection.

Secondly, the eyes are one of the most vulnerable entry points to the body. Their moist and exposed surface makes them prone to infections. Eye rubbing after touching common surfaces can transfer bacteria or viruses between people, often leading to conjunctivitis, or pink eye. This common infection can be viral or bacterial and is typically characterized by redness, itchiness, burning, and discharge.

Additionally, eye rubbing would lead to micro-scratches on the cornea. The cornea, a transparent dome-shaped layer on the outer eye, is responsible for transmitting over 90% of incoming visible light into the eye (Meek, 2008). In the long term, friction from eye rubbing can lead to more serious conditions such as keratoconus, a non-inflammatory disease characterised by the cornea thinning and bulging into a cone shape (also known as ectatic protrusion) (Najmi, 2019). This distortion can lead to blurred vision, severe astigmatism, and glare.

Lastly, rubbing your eyes too hard can cause tiny blood vessels in the white of your eyes and the delicate skin around them to break. This can lead to bloodshot eyes (or a condition called subconjunctival hemorrhage). While it is normally harmless and will heal on its own, do see a doctor if it does not get better within 2 weeks, or if you experience eye pain. The thin skin under your eyes is also especially vulnerable where repeated rubbing can contribute to dark circles. Over time, this friction can also accelerate wrinkles and the natural aging of your skin.

4. How to Stop Rubbing Your Eyes

Here are some easy tips to relieve eye discomfort, without rubbing them!

• Use Lubricating Eye Drops. It is recommended to use lubricating or hydrating eye drops for dry eyes.

If you’re looking for a gentle, everyday option, give Evolve eye drops a try. They’re preservative-free, phosphate-free, safe to use with contact lenses, and stay sterile for up to 90 days after opening. These benefits make them a great choice for sensitive eyes and post-procedure care.

• Remove and Avoid Allergens. Identify and avoid any allergens affecting your eyes and use air purifiers if needed. If symptoms persist despite taking precautions, try using antihistamine eye drops. However, if the reaction does not improve or worsens, seek evaluation by a doctor.
• Apply a Cold Compress. The low temperature can help to relieve inflammation and itchiness in the eyes.
• Practice Better Eye Hygiene. It is understandable that sometimes eye rubbing is unavoidable, especially when it is out of reflex. So, wash your hands frequently to lower the chances of eye infections.
• Stay Well Rested. Reduce digital eye strain by taking regular eye breaks, and by adjusting the screen brightness and room lighting. Sleep and hydration are also key for reducing eye dryness and maintaining eye health.

5. When to Be Concerned

While occasional eye rubbing is usually harmless, it can become a concern when it is accompanied by persistent itchiness, pain, or blurred vision. While these symptoms may stem from pre-existing issues such as allergies or dry eye syndrome, some other symptoms such as redness, discharge, swelling, or sensitivity to light, should not be ignored. In such cases, it would be best to consult a doctor for the right treatment.

References

1. HealthHub. (2021, November 23). Keep an eye on it – eye strain. https://www.healthhub.sg/well-being-and-lifestyle/personal-care/keep-an-eye-on-it–eye-strain
2. Meek, K. (2008). The Cornea and Sclera. In: Fratzl, P. (eds) Collagen. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-73906-9_13
3. Najmi, H. (2019). The correlation between keratoconus and eye rubbing: a review. International Journal of Ophthalmology, 12(11), 1775–1781. https://doi.org/10.18240/ijo.2019.11.17
4. Pfizer Inc. (2022, October 13). How clean are your hands? https://www.pfizer.com/news/articles/how_clean_are_your_hands

Prof. Dr. Louis Tong from Singapore National Eye Centre (SNEC)

1. What is dry eye disease?

Dry eye disease is a common condition that occurs when your eyes do not produce enough tears or when the quality of tears is poor and they evaporate too quickly. Tears are essential to keep the surface of the eye healthy, comfortable, and vision clear. When tear balance is disrupted, patients may experience dryness, irritation, redness, burning, fluctuating vision, excessive tearing, or a gritty “sand-like” sensation. Dry eye can be temporary or long-term, and its severity can vary from mild discomfort to symptoms that significantly affect daily life, work, and screen use.

2. Why is it important to treat dry eye early and consistently?

Dry eye is often a chronic condition, meaning it usually requires ongoing care rather than a one-time treatment. If left untreated, dry eye can lead to persistent discomfort, unstable vision, inflammation, and damage to the eye surface.

Regular treatment helps to:

• Improve eye comfort
• Stabilize vision
• Protect the ocular surface
• Prevent worsening of symptoms over time
• Consistency is important; treatments work best when eyedrops are used as prescribed by your eye doctor, even when symptoms feel better.

3. What are artificial tears and how do they help?

Artificial tears are lubricating eye drops designed to supplement your natural tears.

They help to:

• Moisten the eye surface
• Reduce irritation and dryness
• Improve visual clarity
• Support healing of the ocular surface

They are often the first-line treatment for dry eye and are safe for long-term use when used appropriately.

4. Why are there so many types of artificial tears in the market?

Not all dry eyes are the same. This is why there are many different formulations of artificial tears available. They may differ in:

• Thickness (viscosity):
  Thinner drops feel lighter and are suitable for mild dry eye or frequent use, while thicker gels or ointments provide longer relief but may blur vision temporarily
• Ingredients:
  Some focus on water replacement, others improve tear stability or reduce evaporation, while certain drops support the healing of the eye surface. For instance, formulations with sodium hyaluronate are hydrating and help promote ocular surface repair, making them especially useful for moderate to severe dry eye or tear instability.
• Preservative vs preservative-free:
  Preservative-free drops are often recommended for frequent use or sensitive eyes while preserved drops may be suitable for occasional use. Multi-dose preservative-free (MDPF) formulations like Evolve HA stay sterile for 90 days after opening and are suitable for sensitive eyes and post-procedure care.

Because dry eye can involve tear deficiency, tear instability, inflammation, or eyelid gland dysfunction, your doctor may recommend a specific type of artificial tear that best matches your condition.

5. Why does my eye doctor recommend a particular eye drop for me?

Your eye doctor’s recommendation is based on:

• The type and severity of your dry eye
• Your symptoms and examination findings
• How often you need to use the drops
• Your lifestyle (screen use, contact lenses, work environment)

Using the recommended drop correctly and consistently gives you the best chance of symptom relief. If a drop causes discomfort, blurring, or does not seem effective, it is important to inform your doctor rather than stopping it on your own.

6. Do you provide specialized care for dry eye?

Yes, for severe dry eye cases with other complications, we offer comprehensive assessment and personalized management through our dedicated Dry Eye Clinic services at Singapore National Eye Centre. Our approach focuses on identifying the underlying causes of dry eye and tailoring treatment plans that may include eye drops and advanced therapies when needed. Whereas for the mild and moderate types of dry eye with no other complications, you can be taken care by your regular eye care professionals like Optometrists and general ophthalmologists.

7. What is the key message for patients with dry eye?

Dry eye is common, manageable, and treatable. With the right diagnosis, appropriate eye drops, regular warm compresses, and ongoing education, most patients can achieve good symptom control and improved quality of life. Staying informed, consistent with treatment, and engaged in shared learning makes a meaningful difference.

8. Is there a platform where I can learn more and connect with other dry eye patients?

Yes. Patients with dry eye are encouraged to join our education and patient-sharing platform on the Friends of the Dry Eye Service Substack page here.

On this platform, patients can:

• Learn more about dry eye and available treatments
• Read educational articles written for patients
• Participate in constructive discussions
• Share real-life experiences and coping strategies
• Share your stories dealing with various types of treatment for dry eye

Melatonin is one of the most commonly used over-the-counter sleep aids worldwide. Marketed as a “natural” solution for insomnia, jet lag, and poor sleep quality, it has become a go-to option for adults and even children.But is melatonin really harmless? And is it even effective?

Here’s what you need to know before reaching for that next tablet.

What Is Melatonin?

Melatonin is a hormone naturally produced by the pineal gland in the brain. Its main job is to regulate the sleep–wake cycle, rising in the evening to signal that it’s time to wind down and dropping in the morning to help you wake up.

Synthetic Melatonin Supplements

The melatonin sold in pharmacies is a synthetic version of this hormone. Unlike prescription sleep medications, melatonin is often unregulated in dosage and purity in many countries, making its effects unpredictable.

Why Do People Take Melatonin?

Most people use melatonin for:

• Difficulty falling asleep
• Jet lag
• Shift-work sleep rhythm problems
• Stress-related insomnia
• Screen-related sleep disruption

While melatonin can help in certain cases, especially for circadian rhythm issues, many people use it incorrectly or unnecessarily.

Why Melatonin May Not Be Good for You

1. Your Body Can Become Dependent on It (Psychologically)

Melatonin doesn’t cause physical addiction, but people can quickly develop a mental dependence, feeling they cannot sleep without it—especially if used nightly.

2. Dosages Are Often Too High

The body naturally produces about 0.3 mg of melatonin per night. Most supplements sold are 3–10 mg—up to 30 times what your body needs.

High doses can:

• Disrupt your natural hormone rhythms
• Cause next-day grogginess
• Lead to vivid dreams or nightmares
• Affect mood and hormonal balance

3. Quality and Purity Are Unpredictable

Studies found that many melatonin supplements contain:

• Far more melatonin than the label claims
• Contaminants like serotonin, which is unsafe

Because it’s not strictly regulated, the actual dose you’re taking may be completely different from what’s printed.

4. Side Effects Are More Common Than People Think

Melatonin may cause:

• Morning sleepiness
• Headaches
• Dizziness
• Nausea
• Irritability
• Lower body temperature

In children and teens, long-term use may even affect puberty and hormonal development.

5. It Doesn’t Treat the Root Cause of Insomnia

If your sleep issues are due to:

• Stress
• Anxiety
• Irregular schedule
• Excess screen time
• Caffeine
• Hormonal changes
• Poor sleep habits

Melatonin won’t fix those problems. It may simply mask symptoms while the underlying issue continues.

6. Not Suitable for Certain People

Melatonin should be avoided or used cautiously if you have:

• Autoimmune disorders
• Depression
• Epilepsy
• Diabetes
• High blood pressure
• Are pregnant or breastfeeding

It can also interact with medications such as:

• Antidepressants
• Blood thinners
• Blood pressure medication
• Anti-seizure drugs

When Melatonin Can Be Helpful

Melatonin can be useful short-term, especially for:

• Jet lag
• Shift-work adjustments
• Circadian rhythm disorders
• Sleep pattern resetting after travel or illness

In these cases, low doses (0.5–1 mg) taken at the right time may help.

Better Alternatives to Improve Sleep

Instead of relying on melatonin, try improving your sleep hygiene:

1. Keep a regular sleep schedule

Go to bed and wake up at the same time daily.

2. Reduce screen time

Avoid phones and tablets 1 hour before bedtime.

3. Create a sleep-friendly environment

Cool, dark, quiet rooms help your body wind down.

4. Limit caffeine and heavy meals at night

5. Manage stress

Deep breathing, meditation, or gentle stretching can help.

6. Get natural sunlight

Daylight exposure helps regulate your internal clock.

If insomnia persists, it’s best to consult a doctor to evaluate underlying causes.

Conclusion

Melatonin is often thought of as a harmless, natural sleep aid—but the truth is more complicated. While it may help in specific, short-term situations, long-term or excessive use can disrupt your natural hormone balance, cause side effects, and create psychological dependence.

Before relying on melatonin nightly, consider addressing lifestyle factors, improving sleep habits, and seeking professional guidance if sleep problems persist. Understanding the root cause of your sleep difficulties not only leads to safer, more sustainable solutions, but also supports healthier sleep rhythms in the long run.

Why is an Eye doctor worried about Sleep?

Because Sleep Is Important for Preventing Dry Eyes

• During sleep, there are corneal cells that are important for retaining fluid that regenerate.
• Poor sleep reduces tear production and increases inflammation
• Lack of REM sleep can worsen eye fatigue, redness, and light sensitivity
• People with insomnia or irregular sleep cycles have higher rates of dry eye disease

Better sleep → Better tears → Happier eyes.

You may experience eye twitches or spasms when you have not had enough sleep. Your eyes may even be more sensitive to light, or you may have blurry vision. Sleep deprivation could lead to serious eye problems, such as glaucoma, over time. Research has shown that sleep helps clear out toxins that accumulate in the retina during the day.

Patients who see me know that I believe in the holistic approach and to manage the root cause of the problem. If sleep is the cause of the eye issues, I would work on the sleep and in meantime start on a supplement that is not a sleeping pill to help regulate the sleep cycle. I have had wonderful results with a supplement called Deeper Sleep. You can read more about it here.

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