I was interested to see Tseng and associates’ report in the May issue of the Journal . I remain curious as to why there is no mention of the most obvious confounding variable to the results of their work: namely, eye-rubbing. Eye-rubbing has been implicated as a cause of optic neuropathy that can imitate (if not duplicate) the mechanism for glaucoma. As rubbing one’s eyes is a common sequela of allergic inflammation, the relationship appears to be a significant issue that could explain the authors’ published findings. Rather than rely on specific immunoglobulin E results as a risk factor for the development of glaucoma (or, theoretically, an optic nerve disorder similar to glaucoma), these findings may simply imply that someone who is prone to eye-rubbing may be more at risk of such a disease.