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Home » Eye Health Blog

Eye Health Blog

June 13, 2019

A buyer's guide to swim goggles and dive masks

By Gary Heiting, OD, and Donald S. Teig, OD

child wearing swim goggles in pool

Scuba diving masks and swim goggles can sharpen your vision and keep you and your eyes safer while you swim, snorkel or explore underwater.

If you normally wear eyeglasses or contact lenses, prescription swimming goggles and dive masks will increase your enjoyment underwater and help you avoid possible hazards.

Why Dive Masks And Swim Goggles Are Needed

Light behaves differently in water than in air, distorting what you see. Particularly when you are swimming or diving, objects appear larger and closer than they actually are. This can hamper your hand-eye coordination.

Swim goggles

Wearing prescription swim goggles means you don't have to swim with blurry vision and you don't have to risk losing your contacts or getting eye infections from waterborne microorganisms. Shown here are Shark swim goggles by Liberty Sport.

Swim goggles and diving masks work by providing a pocket of air in front of you that enables light rays to travel to and through your eyes in a more precisely focused way.

Because water refracts (bends) light differently than air, your vision will be blurred and out of focus if your eyes are in direct contact with water — even if you normally see perfectly well.

In fact, in such conditions, a person who has 20/20 visual acuity on land will be legally blind underwater.

If you wear prescription eyewear because you are nearsighted, are farsighted or have astigmatism, you also will need corrective lenses to see clearly underwater.

But your prescription may need to be changed, because the distance between the lens of your goggles or diving mask and your eyes typically is different from the distance between your eyeglasses lenses and your eyes.

(This also is one of the reasons your contact lens prescription is different from your eyeglass prescription if you have moderate or high myopia.) An eye care professional specializing in sports eyewear can adjust your prescription for underwater use.

Your choice of a diving mask or goggles will depend on your activities and specific needs.

Tips For Buying Scuba Diving And Snorkeling Masks

Diving masks, which are designed for scuba diving or snorkeling, tend to be large and rectangular, rising high and across the forehead and dipping down low, almost to the bottom of the nose. Most diving masks are made of soft silicone, which is hypoallergenic and resists deterioration. Most have a double-flanged face seal to keep the mask watertight.

SCUBA mask

The Leader xRx Custom Rx-able dive mask with a tempered glass lens is suitable for diving & snorkeling, and it can be worn with or without the Rx adapter. Special features include side windows for a 180-degree view and a hypo-face skirt with purge valve.

Prescription diving masks work in one of two ways:

  • The entire lens area is a prescription lens, or
  • Prescription lenses are inserted separately between the mask face shield and your eyes.

If the dive mask comes with prescription lenses, it can be made to your specific measurements and correction. Also, masks are available pre-made with prescription lenses that have an equal correction for nearsightedness or farsightedness for both eyes.

Although these pre-made lenses don't correct astigmatism, most people who need corrective lenses can see well enough with them in most underwater situations. But if you have a lot of astigmatism, this solution may not be for you.

Alternatively, some diving masks have a fixed lens area in the front that allows an insert containing custom-made prescription lenses to slide in behind it.

Prescription lens inserts are especially handy for contact lens wearers, because the same diving mask can be used depending on your choice of vision correction. If you wear your contact lenses for a dive, you don't need to use the prescription insert. If you prefer not to wear your contacts, you can slide in the insert for a clear underwater experience.

Keep in mind that not all contact lenses are suitable for diving, and swimming or diving while wearing contacts can cause problems.

Gas permeable lenses (GP lenses) can "dig in" to the eyes below certain depths because of pressure, and soft contact lenses can collect waterborne organisms, become contaminated and cause eye infections. This can happen in swimming pools, lakes, rivers and the ocean.


Goggle/Mask Tips

How To Prevent Fogging And Leaking

Fogging and leaking are common and annoying problems with both swimming goggles and diving masks.

To avoid leakage, always try on goggles or masks before buying to make sure they fit snugly and comfortably.

With masks, remember that tighter is not always better. Masks that are too tight might pull away from the face and release the suction.

To keep lenses from fogging, try these tips:

  • Use gentle soap such as baby shampoo to clean lenses, particularly on the day you plan to swim or dive.
  • Consider buying lenses with anti-fog coatings.
  • Anti-fog sprays, drops and gels often work well, too. Always read the label before buying, because some of these products are meant for snorkeling and dive masks only — not swim goggles.
  • Store goggles and masks in protective cases to prevent dirt and scum from building up on lenses. This will also prevent scratching.
  • Placing your mask or goggles in the water just before wearing them also may help prevent fogging. — M.H.

Tips For Buying Swim Goggles

Swimming goggles are similar to diving masks, but they are much smaller and usually are round or oval in shape. They also fit closer to the eyes than dive masks.

Goggles protect your eyes from the water and are sleek and unobtrusive so they won't interfere with your speed and motion. In prescription goggles, corrective lenses are integrated into the watertight silicone frame.

Generally, swim goggles are used in pools, a setting where prefabricated prescription goggles provide adequate vision. If necessary, however, custom lenses — including lenses that correct astigmatism — can be made for nearly any model of goggles.

Lenses for diving masks and swim goggles are available in a variety of materials, including glass, acrylic, plastic and polycarbonate.

If you swim competitively, you might consider buying two sets of swim goggles — one pair that is rounder and less snug for practice and the other that fits tightly but somewhat uncomfortably in the eye socket to achieve the best aerodynamics for racing.

Ask your eyewear provider for assistance in adapting your eyeglass prescription for use in goggles or masks. Many such providers can point you to companies that will match the scuba masks or swimming goggles you want with prescription inserts. Your prescription must be provided by your eye doctor.

Your regular eye doctor or a sports vision specialist may be able to give you other recommendations.


May 23, 2019

Are learning-related vision issues holding your child back?

By Rob Murphy, with updates and review by Gary Heiting, OD

Vision and learning are intimately related. In fact, experts say that roughly 80 percent of what a child learns in school is information that is presented visually. So good vision is essential for students of all ages to reach their full academic potential.

When children have difficulty in school — from learning to read to understanding fractions to seeing the blackboard — many parents and teachers believe these kids have vision problems.

And sometimes, they're right. Eyeglasses or contact lenses often help children better see the board in the front of the classroom and the books on their desks.

Ruling out simple refractive errorsis the first step in making sure your child is visually ready for school. But nearsightednessfarsightedness and astigmatism are not the only visual disorders that can make learning more difficult.

Less obvious vision problems related to the way the eyes function and how the brain processes visual information also can limit your child's ability to learn.

Any vision problems that have the potential to affect academic and reading performance are considered learning-related vision problems.

Vision And Learning Disabilities

Learning-related vision problems are not learning disabilities. The U.S. Individuals with Disabilities Education Act (IDEA)* defines a specific learning disability as: ". . . a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in an imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia."

IDEA also says learning disabilities do not include learning problems that are primarily due to visual, hearing or motor disabilities. Mental retardation and emotional disturbances also are excluded as learning disabilities, along with learning problems related to environmental, cultural or economic disadvantage.

But specific vision problems can contribute to learning problems, whether or not a child has been diagnosed as "learning disabled." In other words, a child struggling in school may have a specific learning disability, a learning-related vision problem, or both.

If you are concerned about your child's performance in school, you need to find out the underlying cause (or causes) of the problem. The best way to do this is through a team approach that may include the child's teachers, the school psychologist, an eye doctor who specializes in children's vision and learning-related vision problems and perhaps other professionals.

Identifying all contributing causes of the learning problem increases the chances that the problem can be successfully treated.

Types Of Learning-Related Vision Problems

Vision is a complex process that involves not only the eyes but the brain as well. Specific learning-related vision problems can be classified as one of three types. The first two types primarily affect visual input. The third primarily affects visual processing and integration.

Eye health and refractive problems.These problems can affect the visual acuity in each eye as measured by an eye chart. Refractive errors include nearsightedness, farsightedness and astigmatism, but also include more subtle optical errors called higher-order aberrations. Eye health problems can cause low vision — permanently decreased visual acuity that cannot be corrected by conventional eyeglasses, contact lenses or refractive surgery.

Functional vision problems. Functional vision refers to a variety of specific functions of the eye and the neurological control of these functions, such as eye teaming (binocularity), fine eye movements (important for efficient reading), and accommodation (focusing amplitude, accuracy and flexibility). Deficits of functional visual skills can cause blurred or double vision, eye strain and headaches that can affect learning. Convergence insufficiency is a specific type of functional vision problem that affects the ability of the two eyes to stay accurately and comfortably aligned during reading.

Perceptual vision problems. Visual perception includes understanding what you see, identifying it, judging its importance and relating it to previously stored information in the brain. This means, for example, recognizing words that you have seen previously, and using the eyes and brain to form a mental picture of the words you see.

Most routine eye exams evaluate only the first of these categories of vision problems — those related to eye health and refractive errors. However, many optometrists who specialize in children's vision problems and vision therapy offer exams to evaluate functional vision problems and perceptual vision problems that may affect learning.

Color blindness, though typically not considered a learning-related vision problem, may cause problems in school for young children if color-matching or identifying specific colors is required in classroom activities. For this reason, all children should have an eye exam that includes a color blind test prior to starting school.

Symptoms Of Learning-Related Vision Problems

Symptoms of learning-related vision problems include:

  • Headaches or eye strain
  • Blurred vision or double vision
  • Crossed eyes or eyes that appear to move independently of each other (Read more about strabismus.)
  • Dislike or avoidance of reading and close work
  • Short attention span during visual tasks
  • Turning or tilting the head to use one eye only, or closing or covering one eye
  • Placing the head very close to the book or desk when reading or writing
  • Excessive blinking or rubbing the eyes
  • Losing place while reading, or using a finger as a guide
  • Slow reading speed or poor reading comprehension
  • Difficulty remembering what was read
  • Omitting or repeating words, or confusing similar words
  • Persistent reversal of words or letters (after second grade)
  • Difficulty remembering, identifying or reproducing shapes
  • Poor eye-hand coordination
  • Evidence of developmental immaturity

If your child shows one or more of these symptoms and is experiencing learning problems, it's possible he or she may have a learning-related vision problem.

To determine if such a problem exists, see an eye doctor who specializes in children's vision and learning-related vision problems for a comprehensive evaluation.

If no vision problem is detected, it's possible your child's symptoms are caused by a non-visual dysfunction, such as dyslexia or a learning disability. See an educational specialist for an evaluation to rule out these problems.

Signs Of Attention And Developmental Disorders

Many people know attention disorders by the names attention deficit disorder (ADD) or attention deficit/hyperactivity disorder (ADHD). Children with these conditions frequently are prescribed drugs like Ritalin. Occasionally, children with attention disorders experience other problems that contribute to inattentiveness, such as a speech and language dysfunction or nonverbal disorder. Consult a pediatric neurologist for a definitive diagnosis.

Parents can easily identify the three components of the autism spectrum disorder: lack of eye contact, inability to relate socially or inappropriate social interaction, and unusual repetitive interests that exclude other activities. Any or all of these early signs should prompt a consultation with your family doctor or pediatrician.

Treatment Of Learning-Related Vision Problems

If your child is diagnosed with a learning-related vision problem, treatment generally consists of an individualized and doctor-supervised program of vision therapy. Special eyeglasses also may be prescribed for either full-time wear or for specific tasks such as reading.

If your child is also receiving special education or other special services for a learning disability, ask the eye doctor who is supervising your child's vision therapy to contact your child's teacher and other professionals involved in his or her Individualized Education Program (IEP) or other remedial activities.

In some cases, vision therapy and remedial learning activities can be combined, and a cooperative effort to address your child's learning problems may be the best approach.

Also, keep in mind that children with learning difficulties may experience emotional problems as well, such as anxiety, depression and low self-esteem.

Reassure your child that learning problems and learning-related vision problems say nothing about a person's intelligence. Many children with learning difficulties have above-average IQs and simply process information differently than their peers.


May 15, 2019

Boost your diet to protect aging eyes

By Shereen Jegtvig, Certified Nutrition Specialist (CNS), with contributions and review by Gary Heiting, OD

Age-related eye diseases such as macular degeneration and cataracts commonly cause impaired vision and blindness in older adults.

But lifestyle changes, including good nutrition, could help delay or prevent certain eye problems.

Besides adopting a healthy diet, you can help protect your eyes by avoiding prolonged exposure to ultraviolet (UV) rays and high-energy blue light, quitting smoking and getting annual eye exams.

During a dilated eye exam, your eye doctor can carefully examine the health of your eyes and check for eye diseases such as macular degeneration, glaucoma and diabetic retinopathy. Detecting these conditions early may help prevent permanent vision loss.

Diet, antioxidants and healthy eyes

Diet is an extremely important part of the daily lifestyle choices you make. Foods you eat and the dietary supplements you take affect your overall health as well as the health of your eyes.

elderly couple making salad 1200×630

A diet high in saturated fat and sugar may increase your risk of eye disease. On the other hand, healthy foods such as greens and fruits may help prevent certain eye diseases and other health problems.

Cardiovascular disease, diabetes and eye conditions including cataracts and age-related macular degeneration (AMD) have been shown to occur less frequently in people who eat diets rich in vitamins, minerals, healthy proteins, omega-3 fatty acidsand lutein.

All healthy diets should include ample amounts of fresh, colorful fruits and vegetables. In fact, experts recommend that you consume at least five to nine servings of these foods daily.

Choose dark green or brightly colored fruits and vegetables to obtain the most antioxidants, which protect your eyes by reducing damage related to oxidizing agents (free radicals) that can cause age-related eye diseases.

Lutein and zeaxanthin are plant pigments called carotenoids that have been shown to protect the retina from oxidative changes caused by ultraviolet light.

Spinach and kale are excellent food sources of lutein and zeaxanthin, which are also found in sweet corn, peas and broccoli.

Vitamin A, vital for healthy vision, is found in orange and yellow vegetables such as carrots and squash.

Fruits and vegetables also provide essential vitamin C, another powerful antioxidant.

Other diet tips for healthy eyes

Try following these diet guidelines to improve your chance of healthy vision for a lifetime:

Supplements, such as these containing essential fatty acids and vitamin E, can help maintain vision.

Eat whole grains and cereals. Sugars and refined white flours commonly found in breads and cereal may increase your risk of age-related eye diseases. Instead, choose 100 percent whole-grain breads and cereals that have lots of fiber, which slows down the digestion and absorption of sugars and starches. Fiber also keeps you feeling full, which makes it easier to limit the amount of calories you consume.

Eat healthy fats. The omega-3 essential fatty acids found in fish, flaxseed oil, walnuts and canola oil help to prevent dry eyes and possibly cataracts. Eat fish or seafood twice weekly, or take flax oil every day. Use canola oil for cooking and walnuts for snacking.

Choose good sources of protein. Remember that the fat content of meats and the cooking method used to prepare them contribute to making them healthy or unhealthy. Also, limit your consumption of saturated fats from red meats and dairy products that may increase your risk of macular degeneration. Choose lean meats, fish, nuts, legumes and eggs for your proteins. Most meats and seafood also are excellent sources of zinc. Eggs are a good source of lutein.

Avoid sodium. High sodium intake may add to your risk of cataract formation. Use less salt, and look for sodium content on the labels of canned and packaged foods. Stay below 2,000 mg of sodium each day. Choose fresh and frozen foods whenever possible.

Stay hydrated. Round out a healthy diet with low-fat dairy products such as skim or 1 percent milk for calcium, and healthy beverages such as 100 percent vegetable juices, fruit juices, non-caffeinated herbal teas and water. Proper hydration also may reduce irritation from dry eyes.

Eye vitamins and vision supplements

Always wear sunglasses for protection from the sun's harmful UV rays.

Even if you exercise regularly and eat a healthy diet with plenty of fruits and vegetables (and substitute fish for red meat a few times each week), you may be able to do even more to protect your vision by taking a daily nutritional supplement.

vitamin e 330x220 1.25x

Two large, five-year clinical trials called the Age-Related Eye Disease Studies (AREDS and AREDS2) have provided valuable information about the benefits of vision supplements.

AREDS and AREDS2 specifically investigated the effect of taking a daily antioxidant multivitamin on the development and progression of AMD and cataracts among adults ages 55 to 80.

The original AREDS study found that a supplement containing the following ingredients reduced the risk of advanced AMD among study participants at high risk of vision loss due to pre-existing intermediate AMD (or advanced AMD in one eye) by 25 percent:

  • beta-carotene (15 mg)
  • vitamin C (250 mg)
  • vitamin E (400 IU)
  • zinc (80 mg)

The AREDS2 study investigated whether including or substituting other nutrients in the original AREDS formulation might provide even greater eye benefits.

Specifically, AREDS2 investigated the effect of adding either a combination of lutein and zeaxanthin (10 mg and 2 mg, respectively) or omega-3 fatty acids (350 mg DHA and 650 mg EPA) to the original AREDS supplement.

AREDS2 also removed beta-carotene from the original AREDS formulation, since other studies have found too much of this vitamin A precursor, particularly when taken in supplement form, is associated with increased risk of lung cancer among smokers and previous smokers.

AREDS2 also decreased the amount of zinc — from 80 mg in the original AREDS formulation to 20 mg — to reduce the potential for stomach upset some people experience when taking the higher dose.

Results of the AREDS2 study showed that use of a daily multivitamin supplement that also contained lutein and zeaxanthin (and no beta-carotene) reduced the risk of progression of AMD to advanced stages by up to 25 percent, with the greatest risk reduction occurring among participants whose diets were low in lutein and zeaxanthin at the time of enrollment in the study.

Daily multivitamin supplements containing omega-3 fatty acids (and no lutein, zeaxanthin or beta-carotene), on the other hand, failed to show any benefit toward reducing the risk of progressive AMD.

Neither AREDS nor AREDS2 found that use of daily multivitamins — with or without lutein/zeaxanthin or omega-3 fatty acids — prevented or reduced the risk of cataracts among the study participants.

Also, the AREDS and AREDS2 supplements did not prevent or reduce the risk of AMD among study participants who had no signs of macular degeneration at the onset of the five-year studies.

Another influential and large-scale nutritional study is the Blue Mountains Eye Study. Conducted in Australia, this study found that daily multivitamins and B vitamin supplements — especially those containing folic acid and vitamin B12 — reduced the risk of cataract formation in study participants. Results also showed that daily omega-3 fatty acid supplements also reduced the risk of cataracts.

The Blue Mountains Eye Study also reported on the long-term effects of adherence to a healthy diet. The study authors found that individuals who were 65 and older and had maintained a better diet had less risk of visual impairment over a 10-year follow-up period.

Based on the results of these and other studies, and because it can be difficult to obtain the same level of nutrients investigated in these studies by diet alone, you may want to consider taking a daily eye supplement.

Experts suggest high-quality eye and vision supplements should contain at least the following ingredients for optimum effect:

  • vitamin C (250 to 500 mg)
  • vitamin E (400 IU)
  • zinc (25 to 40 mg)
  • copper (2 mg)
  • vitamin B complex that also contains 400 mcg of folic acid
  • omega-3 fatty acids (2,000 mg)

Taking eye vitamins and vision supplements generally is very safe. But be sure to check with your doctor first if you are on medications, are pregnant or nursing, or are considering taking higher daily doses than those listed above.


May, 7, 2019

Nutrition for healthy eyes

By Gary Heiting, OD

illustration of an eye with healthy foods

Research suggests that antioxidants and other important nutrients may reduce your risk of cataracts and macular degeneration. Specific antioxidants can have additional benefits as well; for example, vitamin A protects against blindness, and vitamin C may play a role in preventing or alleviating glaucoma.

Omega-3 essential fatty acids appear to help the eye in a variety of ways, from alleviating symptoms of dry eye syndrome to guarding against macular damage.

Eye Benefits Of Vitamins And Micronutrients

The following vitamins, minerals and other nutrients have been shown to be essential for good vision and may protect your eyes from sight-robbing conditions and diseases.

Fruits & vegetables

A healthy diet for your eyes should include plenty of colorful fruits and vegetables.

Incorporating the following foods in your diet will help you get the Recommended Dietary Allowance (RDA) of these important eye nutrients. Established by the Institute of Medicine (National Academy of Sciences), the RDA is the average daily dietary intake level of a nutrient sufficient to meet the requirements of nearly all healthy individuals in a specific life stage and gender group.

While the RDA is a useful reference, some eye care practitionersrecommend higher daily intakes of certain nutrients for people at risk for eye problems.

Beta-carotene

  • Eye benefits of beta-carotene: When taken in combination with zinc and vitamins C and E, beta-carotene may reduce the progression of macular degeneration.
  • Food sources: Carrots, sweet potatoes, spinach, kale, butternut squash.
  • RDA: None (most supplements contain 5,000 to 25,000 IU).

Bioflavonoids (Flavonoids)

  • Eye benefits of bioflavonoids: May protect against cataracts and macular degeneration.
  • Food sources: Tea, red wine, citrus fruits, bilberries, blueberries, cherries, legumes, soy products.
  • RDA: None.

Lutein and Zeaxanthin

  • Eye benefits of lutein and zeaxanthin: May prevent cataracts and macular degeneration.
  • Food sources: Spinach, kale, turnip greens, collard greens, squash.
  • RDA: None.

Omega-3 Fatty Acids

  • Eye benefits of omega-3 fatty acids: May help prevent macular degeneration (AMD) and dry eyes.
  • Food sources: Cold-water fish such as salmon, mackerel and herring; fish oil supplements, freshly ground flaxseeds, walnuts.
  • RDA: None; but for cardiovascular benefits, the American Heart Association recommends approximately 1,000 mg daily.

Selenium

  • Eye benefits of selenium: When combined with carotenoids and vitamins C and E, may reduce risk of advanced AMD.
  • Food sources: Seafood (shrimp, crab, salmon, halibut), Brazil nuts, enriched noodles, brown rice.
  • RDA: 55 mcg for teens and adults (60 mcg for women during pregnancy and 70 mcg when breast-feeding).

Vitamin A

  • Eye benefits of vitamin A: May protect against night blindness and dry eyes.
  • Food sources: Beef or chicken liver; eggs, butter, milk.
  • RDA: 3,000 IU for men; 2,333 IU for women (2,567 IU during pregnancy and 4,333 IU when breast-feeding).

Vitamin C

  • Eye benefits of vitamin C: May reduce the risk of cataracts and macular degeneration.
  • Food sources: Sweet peppers (red or green), kale, strawberries, broccoli, oranges, cantaloupe.
  • RDA: 90 mg for men; 70 mg for women (85 mg during pregnancy and 120 mg when breast-feeding).

Vitamin D

  • Eye benefits of vitamin D: May reduce the risk of macular degeneration.
  • Food sources: Salmon, sardines, mackerel, milk; orange juice fortified with vitamin D.
  • RDA: None, but the American Academy of Pediatrics recommends 400 IU per day for infants, children and adolescents, and many experts recommend higher daily intakes for adults.
  • The best source of vitamin D is exposure to sunlight. Ultraviolet radiation from the sun stimulates production of vitamin D in human skin, and just a few minutes of exposure to sunlight each day (without sunscreen) will insure your body is producing adequate amounts of vitamin D.

Vitamin E

  • Eye benefits of vitamin E: When combined with carotenoids and vitamin C, may reduce the risk of advanced AMD.
  • Food sources: Almonds, sunflower seeds, hazelnuts.
  • RDA: 15 mg for teens and adults (15 mg for women during pregnancy and 19 mg when breast-feeding).

Zinc

  • Eye benefits of zinc: Helps vitamin A reduce the risk of night blindness; may play a role in reducing risk of advanced AMD.
  • Food sources: Oysters, beef, Dungeness crab, turkey (dark meat).
  • RDA: 11 mg for men; 8 mg for women (11 mg during pregnancy and 12 mg when breast-feeding).

In general, it's best to obtain most nutrients through a healthy diet, including at least two servings of fish per week and plenty of colorful fruits and vegetables.

If you plan to begin a regimen of eye vitamins, be sure to discuss this with your optometrist or ophthalmologist. Taking too much of certain vision supplements can cause problems, especially if you are taking prescription medications for health problems.

Bon appétit!

Original Article

 

April 29. 2019

UV and sunglasses: How to protect your eyes

By Gary Heiting, OD

illustration of sun's UV rays falling on a person's eyes

You probably know that too much exposure to the sun's ultraviolet (UV) rays can cause sunburn and skin cancer. But did you know UV also can harm your eyes?

Extended exposure to the sun's UV rays has been linked to significant eye problems, including cataractsmacular degenerationpingueculaepterygia and photokeratitis.

Protecting your eyes from UV

To protect your eyes from harmful solar radiation, your should wear sunglasses that block 100 percent UV whenever you are outdoors in daylight. Your eyes need protection even on cloudy days because the sun's damaging UV rays can penetrate cloud cover.

Sunglass frames with a close-fitting wraparound

style provide the best protection because they limit how much sunlight reaches your eyes from all sides.

What is UV?

Electromagnetic Spectrum

Ultraviolet (UV) rays are higher in energy and do not fall within the realm of visible light, as shown here. In the electromagnetic spectrum, radio waves have the lowest energy, and gamma rays have the highest energy.

While many people refer to ultraviolet radiation as "UV light," this term technically is incorrect because you cannot see UV rays. Ultraviolet radiation is invisible.

There are three categories of UV radiation:

UVC

These are the highest energy UV rays and potentially could be the most harmful to your eyes and skin. Fortunately, the atmosphere's ozone layer blocks virtually all UVC rays.

But this also means depletion of the ozone layer potentially could allow high-energy UVC rays to reach the Earth's surface and cause serious UV-related health problems.

UVC rays have wavelengths that range from 100 to 280 nanometers (nm).

UVB

UVB rays have slightly longer wavelengths (280-315 nm) and lower energy than UVC rays. These rays are filtered partially by the ozone layer, but some still reach the Earth's surface.

In low doses, UVB radiation stimulates the production of melanin

(a skin pigment), causing the skin to darken, creating a suntan.

But in higher doses, UVB rays cause sunburn that increases the risk of skin cancer. UVB rays also cause skin discolorations, wrinkles and other signs of premature aging of the skin.

Overexposure to the sun's UVB radiation also is associated with a number of eye problems, including pinguecula, pterygium and photokeratitis ("snow blindness").

Because the cornea appears to absorb 100 percent of UVB rays, this type of UV radiation is unlikely to cause cataracts and macular degeneration, which instead is linked to UVA exposure (see below).

UVA

UVA rays are closer to visible light rays and have lower energy than UVB and UVC rays. But UVA rays can pass through the cornea and reach the lens

 and retina inside the eye.

Overexposure to UVA radiation has been linked to the development of certain types of cataracts, and research suggests UVA rays may play a role in development of macular degeneration.

UV risk factors

UV index chart

This UV Index devised by the Environmental Protection Agency and National Weather Service provides a color-coded warning system to alert people to the dangers of being outdoors on certain days.

Anyone who spends time outdoors is at risk for eye problems from UV radiation. The actual dose of UV radiation you get outdoors depends on a number of factors, including:

  • Geographic location UV exposure is greater in tropical areas near the earth's equator. The farther you are from the equator, the smaller your risk.
  • Altitude UV exposure is greater at higher altitudes.
  • Time of day UV exposure is greater when the sun is high in the sky, typically from 10 a.m. to 2 p.m.
  • Setting UV exposure generally is greater in wide open spaces, especially when highly reflective surfaces are present, like snow and sand. In fact, UV exposure can nearly double when UV rays are reflected from the snow. UV exposure is less likely in urban settings, where tall buildings shade the streets.
  • Medications Certain medications, such as tetracycline, sulfa drugs, birth control pills, diuretics and tranquilizers, can increase your body's sensitivity to UV radiation.

Measuring Ultraviolet Rays

In the United States, the risk for UV exposure is measured using the UV Index.

Developed by the NWS and EPA, the UV Index predicts each day's ultraviolet radiation levels on a simple 1 to 11+ scale.

In addition to publishing the UV Index daily, the EPA also issues a UV Alert when the level of solar UV radiation that day is expected to be unusually high.

Children need UV protection, too

The risk of damage to our eyes and skin from solar UV radiation is cumulative — meaning the danger continues to grow the more time you spend in sunlight throughout your lifetime.

With this in mind, it's especially important for kids to protect their eyes from the sun. Children generally spend much more time outdoors than adults.

In fact, some experts say that because children tend to spend significantly more time outdoors than most adults, up to half of a person's lifetime exposure to UV radiation can occur by age 18.

Also, children are more susceptible to eye damage from UV rays because the lens inside a child's eye is clearer than an adult lens, enabling more UV to penetrate deep into the eye.

Make sure your children's eyes are protected from the sun with good quality sunglasses or photochromic lenses when they go outdoors. Also, encourage your child to wear a hat on sunny days to further reduce UV exposure.

Sunglasses: your best protection against UV

To best protect your eyes from the sun's harmful rays, always wear good quality sunglasses when you are outdoors.

Look for sunglasses that block 100 percent of all UV rays. Your optician can help you choose the best sunglass lenses for your needs.

To protect as much of the delicate skin around your eyes as possible, try at least one pair of sunglasses with large lenses or a close-fitting wraparound style.

Depending on your outdoor lifestyle, you also may want to explore performance sunglasses or sport sunglasses.

The amount of UV protection sunglasses provide is unrelated to the color and darkness of the lenses.

For example, a light amber-colored lens can provide the same UV protection as a dark gray lens. Your optician can verify that the lenses you choose provide 100 percent UV protection.

In addition to sunglasses, wearing a wide-brimmed hat on sunny days can reduce your eyes' exposure to UV by up to 50 percent.

More tips about sunglasses and UV exposure

Many misconceptions exist about sun protection for your eyes. Keep these tips in mind:

  • Not all sunglasses block 100 percent of UV rays. If you're unsure about the level of UV protection your sunglasses provide, take them to your eye doctor or optician for an evaluation. Many eye care professionals have instruments that can measure the amount of UV radiation your lenses block.
  • Remember to wear sunglasses even when you're in the shade. Although shade reduces your UV and HEV exposure to some degree, your eyes still will be exposed to UV rays reflected from buildings, roadways and other surfaces.
  • Sunglasses also are important in winter, because fresh snow can reflect 80 percent of UV rays, nearly doubling your overall exposure to solar UV radiation. If you ski or snowboard, choosing the right lenses is essential for adequate UV protection on the slopes.
  • Even if your contact lenses block UV rays, you still need sunglasses. UV-blocking contacts shield only the part of your eye under the lens. UV rays still can damage your eyelids and other tissues not covered by the lens. Wearing sunglasses protects these delicate tissues and the skin around your eyes from UV damage.
  • If you have dark skin and eyes, you still need to wear sunglasses. Although dark skin color may give you a lower risk of skin cancer from UV radiation, your risk of eye damage from UV rays is the same as that of someone with fair skin.

Everyone enjoys a sunny day. But be safe and make sure you have the right sunglasses to shield your eyes from the sun's harmful UV rays.

 

April 23, 2019

Infographic: A look at eye exams

 

April 11,2019

Sjogren's Syndrome

Men and women of any age or race can develop Sjogren's syndrome, but it is most prevalent among Caucasian women, with onset usually beginning between ages 40 and 60. The Sjogren's Syndrome Foundation (SSF) estimates that as many as 4 million Americans have the disease, and about 90 percent are women. As many as 3 million may be unaware they have the condition.

Because dry eyes are such a distinctive feature of Sjogren's syndrome, many cases of the disease go unreported. It's estimated that 1 in 10 dry eye patients also have Sjogren's syndrome; and it can take up to four years or longer from onset of the disease to get an accurate diagnosis, according to researchers.

Causes Of Sjogren's Syndrome

Sjogren's syndrome is one of the more common autoimmune disorders. In these diseases, a person's white blood cells attack his or her own tissues and organs, damaging them.

Why abnormal immune responses develop and destroy a body's own tissues is not clearly understood. Ordinarily, our immune system recognizes our own body parts as "friendly," and becomes activated only to fight and destroy "foreign" substances or harmful organisms, such as viruses.

Abnormal immune responses may be inherited, or they may be related to prior viral or bacterial infections.

Sjogren's syndrome can occur alone (primary Sjogren's syndrome) or it can occur along with other autoimmune diseases, such as rheumatoid arthritis, lupus, celiac disease or scleroderma (secondary Sjogren's syndrome).

How To Know If You Have Sjogren's Syndrome

The classic symptoms of Sjogren's syndrome are: dry eyes, dry mouth, fatigue and joint pain. Other symptoms may include:

  • Contact lens discomfort
  • Dry sinuses and frequent sinus infections or nosebleeds
  • Sore mouth, tongue or throat
  • Difficulty chewing or swallowing
  • Dry or peeling lips
  • Blepharitis
  • Dry and sore skin
  • Muscle pain without accompanying swelling
  • Vaginal dryness

Other eye symptoms that can occur with Sjogren's syndrome include blurred vision, a gritty or burning sensation and light sensitivity.

Your eye doctor may perform a number of tests to confirm a diagnosis of Sjogren's syndrome. In one common test (called a Schirmer's test), the tip of a small strip of test paper is inserted under your lower eyelid to measure the amount of tears you produce over a certain period of time (usually five minutes).

Other tests may include use of dyes that color your tears; your doctor will then examine your eyes with a microscope to see how quickly your tears evaporate and whether any dryness-related damage has occurred to your cornea or conjunctiva.

The amount and quality of saliva produced in your mouth may also be measured. Your doctor may order other related tests, including blood tests. (Certain antibodies in the blood are commonly found in people with Sjogren's syndrome.)

A diagnostic test called Sjö (Bausch + Lomb) offers an even more sensitive and specific means of detecting Sjogren's syndrome. In addition to checking for the traditional antibodies commonly found in the bloodstream of patients with the disease, the Sjö checks for three additional biomarkers that are specific to Sjogren's syndrome for greater diagnostic accuracy, according to Bausch + Lomb.

How Dry Eye From Sjogren's Syndrome Is Treated

Dry eye resulting from Sjogren's syndrome may require ongoing treatment with artificial tears, ointments or other remedies.

You may need lubricating eye drops or ointments to treat dry eye caused by Sjogren's syndrome.

Because many people with Sjogren's syndrome have a problem with their tears evaporating too quickly, oil- or lipid-based eye drops sometimes are especially helpful. These drops help slow down tear evaporation so the eyes can stay moist longer between blinks.

Your eye doctor also will check for a problem called meibomian ("my-BOH-me-un") gland dysfunction (MGD), which is a leading cause of evaporative dry eye. In this condition, the glands in the eyelids that secrete oil (meibum) into the tear film become inflamed and obstructed. A decrease in the amount or quality of the meibum also may be involved. This oil is essential to keep tears from evaporating too quickly. Successfully treating MGD can help reduce Sjogren's-related dry eye discomfort.

For pain or inflammation, you may also need to take nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin or ibuprofen. If you have a severe case of Sjogren's syndrome, your doctor also may recommend immunosuppressant medications.

Side Effects Of Sjogren's Syndrome

Because chronic dry eye is one of the major symptoms of Sjogren's syndrome, you must make sure your eyes are lubricated to avoid damage that can lead to scarring and infection of the eye.

Sjogren's syndrome destroys glands responsible for lubricating eyes and other parts of the body.

Sjogren's syndrome also can cause dryness of the mouth that can lead to tooth decay or even loss of teeth. Use of mouth lubricants (artificial saliva) may be needed to keep the mouth adequately moist and to assist in swallowing.

Also, people with Sjogren's syndrome are more likely to develop lymphoma (cancer of the lymphatic system, which contains white blood cells that play a major role in fighting disease). Lymph nodes may become enlarged or swollen.

Sjogren's syndrome also can lead to vasculitis (inflammation of blood vessels) that can cause problems throughout the body.

Pregnant women diagnosed with Sjogren's syndrome should notify their doctors. Certain proteins produced by the immune system that are capable of attacking other potentially beneficial proteins in the body can be passed along to infants.

Using artificial tears and drinking plenty of water can alleviate symptoms of Sjogren's syndrome.

How To Prevent Dry Eye And Other Sjogren's Syndrome Symptoms

There are no known ways to prevent Sjogren's syndrome, but these steps may help ease symptoms:

  • Drink more fluids, especially water.
  • Chew sugarless gum or use hard candies to moisten your mouth.
  • Regularly use artificial tears and ointments to keep your eyes moistened. (Your doctor can recommend the best brands for your needs.)
  • Use saline spray for your nose.
  • Install a humidifier to help reduce dry eyes, nose, mouth and skin.
  • Tell your eye doctor about any drugs you are taking, because some, such as antihistamines for allergies, can cause dryness.
  • Use vaginal lubricants if needed.
  • Don't smoke, and avoid alcohol.

April 3, 2109

Myopia control - a cure for nearsightedness?

By Gary Heiting, OD.

If your child has myopia (nearsightedness), you're probably wondering if there is a cure — or at least something that can be done to slow its progression so your child doesn't need stronger glasses year after year.

For years, eye care practitioners

and researchers have been wondering the same thing. And there's good news: A number of recent studies suggest it may indeed be possible to at least control myopia by slowing its progression during childhood and among teenagers.

What Is Myopia Control?

Although an outright cure for nearsightedness has not been discovered, your eye doctor can now offer a number of treatments that may be able to slow the progression of myopia.

These treatments can induce changes in the structure and focusing of the eye to reduce stress and fatigue associated with the development and progression of nearsightedness.

Why should you be interested in myopia control? Because slowing the progression of myopia may keep your child from developing high levels of nearsightedness that require thick, corrective eyeglasses and have been associated with serious eye problems later in life, such as early cataracts or even a detached retina.

Currently, four types of treatment are showing promise for controlling myopia:

  • Atropine eye drops
  • Multifocal contact lenses
  • Orthokeratology ("ortho-k")
  • Multifocal eyeglasses

[See also: What is Myopia Control?]

Here's a summary of each of these treatments and of recent myopia control research:

Atropine Eye Drops

Atropine eye drops have been used for myopia control for many years, with effective short-term results. But use of these eye drops also has some drawbacks.

ATROPINE AND MYOPIA

Nearly Half Of Nearsighted Schoolchildren In Taiwan Prescribed Atropine For Myopia Control

A study has revealed that eye doctors in Taiwan are routinely prescribing atropine eye drops for nearsighted schoolchildren in hopes the treatment will slow the progression of childhood myopia.

Chinese girl wearing glasses and doing her schoolwork.Sidebar continued >>

Topical atropine is a medicine used to dilate the pupil and temporarily paralyze accommodation

and completely relax the eyes' focusing mechanism.

Atropine typically is not used for routine dilated eye exams because its actions are long-lasting and can take a week or longer to wear off. (The dilating drops your eye doctor uses during your eye exam typically wear off within a couple hours.)

A common use for atropine these days is to reduce eye pain associated with certain types of uveitis.

Because research has suggested nearsightedness in children may be linked to focusing fatigue, investigators have looked into using atropine to disable the eye's focusing mechanism to control myopia.

And results of studies of atropine eye drops to control myopia progression have been impressive — at least for the first year of treatment. Four short-term studies published between 1989 and 2010 found atropine produced an average reduction of myopia progression of 81 percent among nearsighted children.

However, additional research has shown that the myopia control effect from atropine does not continue after the first year of treatment, and that short-term use of atropine may not control nearsightedness significantly in the long run.

Interestingly, one study found that when atropine drops were discontinued after two years of use for myopia control, children who were using drops with the lowest concentration of atropine (0.01 percent) had more sustained control of their nearsightedness than children who were treated with stronger atropine drops (0.1 percent or 0.5 percent). They also had less "rebound" myopia progression one year after treatment.

Also, many eye doctors are reluctant to prescribe atropine for children because long-term effects of sustained use of the medication are unknown.

Other drawbacks of atropine treatment include discomfort and light sensitivity from prolonged pupil dilation, blurred near vision, and the added expense of the child needing bifocals or progressive eyeglass lenses during treatment to be able to read clearly, since his or her near focusing ability is affected.

Orthokeratology

Orthokeratology is the use of specially designed gas permeable contact lenses that are worn during sleep at night to temporarily correct nearsightedness and other vision problems so glasses and contact lenses aren't needed during waking hours.

But some eye doctors use "ortho-k" lenses to also control myopia progression in children. Evidence suggests nearsighted kids who undergo several years of orthokeratology may end up with less myopia as adults, compared with children who wear eyeglasses or regular contact lenses during the peak years for myopia progression.

Many eye care practitioners refer to these lenses as "corneal reshaping lenses" or "corneal refractive therapy (CRT)" lenses rather than ortho-k lenses, though the lens designs may be similar.

Uncorrected myopia illustration

In 2011, researchers from Japan presented a study that evaluated the effect of ortho-k lenses on eyeball elongation in children, which is a factor associated with myopia progression.

A total of 92 nearsighted children completed the two-year study: 42 wore overnight ortho-k lenses and 50 wore conventional eyeglasses during the day. The average age of children participating in the research was about 12 years at the beginning of the study, and children in both groups had essentially the same amount of pre-existing myopia (-2.57 D) and the same axial (front-to-back) eyeball length (24.7 mm).

At the end of the study, children in the eyeglasses group had a significantly greater increase in the mean axial length of their eyes than children who wore the ortho-k contact lenses. The study authors concluded that overnight orthokeratology suppressed elongation of the eyes of children in this study, suggesting ortho-k might slow the progression of myopia, compared with wearing eyeglasses.

In 2012, the same researchers published the results of a similar five-year study of 43 nearsighted children that showed wearing ortho-k contact lenses overnight suppressed axial elongation of the eye, compared with wearing conventional eyeglasses for myopia correction.

Also in 2012, researchers in Spain published study data that revealed children 6 to 12 years of age with -0.75 to -4.00 D of myopia who wore ortho-k contact lenses for two years had less myopia progression and reduced axial elongation of their eyes than similar children who wore eyeglasses for myopia correction.

Girl wearing glasses.Kids do look cute in glasses! But with the proliferation of ortho-k and other myopia control techniques, fewer kids may need eyeglasses for myopia in the future.

In October 2012, researchers in Hong Kongpublished yet another study of the effect of ortho-k contact lenses on controlling myopia progression in children. A total of 78 nearsighted children ages 6 to 10 years at the onset of the investigation completed the two-year study.

Children who wore ortho-k lenses had a slower increase in axial length of their eyes by 43 percent, compared with kids who wore eyeglasses. Also, the younger children fitted with the corneal reshaping GP lenses had a greater reduction of myopia progression than the older children.

Furthermore, as myopia control expert Jeffrey J. Walline, OD, PhD, from The Ohio State University College of Optometry pointed out in his analysis of the study published in the same issue of Investigative Ophthalmology & Visual Science, the benefit of slowed myopia progression from wearing the corneal reshaping lenses extended beyond the first year of myopia treatment.

In March 2014, researchers in Taiwan published results of a study that compared the use of ortho-k contact lenses vs. atropine eye drops for the control of myopia in children ages 7 to 17. Participants had myopia ranging from -1.50 to -7.50 D (with up to -2.75 D of astigmatism) at the beginning of the three-year study period.

The two myopia control treatments produced comparable results: children wearing the ortho-k lenses experienced myopia progression of -0.28 D per year, and those who wore eyeglasses and applied 0.125 percent atropine eye drops nightly had an average myopia progression of -0.34 D per year.

Although this study did not include a control group that received no treatment to control myopia, the study authors mentioned that in similar studies the progression of nearsightedness among children wearing ortho-k lenses for myopia control was roughly half that of those who received no myopia control treatment over a two-year period.

Multifocal Contact Lenses

Multifocal contacts are special lenses that have different powers in different zones of the lens to correct presbyopia as well as nearsightedness or farsightedness (with or without astigmatism).

But researchers and eye doctors are finding that conventional or modified multifocal soft contact lenses also are effective tools for myopia control.

In 2010, researchers from Australia, China and the United States presented data from a study of experimental myopia control contact lenses worn by Chinese schoolchildren for six months. The contacts had a special dual-focus multifocal design with full corrective power in the center of the lens and less power in the periphery.

Participants were between the ages of 7 and 14 at the onset and had -0.75 to -3.50 diopters (D) of myopia, with no more than 0.50 D of astigmatism. A total of 65 children wore the experimental multifocal contacts, and 50 children wore eyeglasses. After six months, the children wearing the multifocal contact lenses had 54 percent less progression of their myopia than the children wearing eyeglasses.

In June 2011, researchers in New Zealand reported on a comparison of an experimental multifocal soft contact lens and conventional soft lenses for myopia control in children. A total of 40 nearsighted children ages 11 to 14 participated in the study. The children wore the multifocal contact lens on one randomly assigned eye and a conventional soft contact lens on the fellow eye for 10 months, then switched the lenses to the opposite eye for another 10 months.

In 70 percent of the children, myopia progression was reduced by 30 percent or more in the eye wearing the experimental multifocal contact lens in both 10-month periods of the study.

In November 2013, researchers in the U.S. published the results of a two-year study that revealed nearsighted children who wore multifocal soft contact lenses on a daily basis had 50 percent less progression of their myopia, compared with similarly nearsighted children who wore regular soft contact lenses for two years.

Children participating in the study ranged in age from 8 to 11 years and had -1.00 to -6.00 D of myopia at the time of enrollment.

The study authors concluded that the results of this and previous myopia control studies indicate a need for a long-term, randomized clinical trial to further investigate the potential of multifocal soft contact lenses to control the progression of nearsightedness in children and thereby reduce risks associated with high myopia.

CHILDREN'S VISION NEWSEyeglasses on a globe map of the earth

Nearly Half Of The Global Population May Be Nearsighted By 2050, Researchers Say

February 2016 — Researchers at the Brien Holden Vision Institute in Sydney, Australia, recently pored over data from 145 studies and analyzed the prevalence of myopia and high myopia among 2.1 million study participants. The group also used data published since 1995 to estimate trends from 2000 to 2050.

What they found was alarming.

Sidebar continued >>

Multifocal Eyeglasses

Multifocal eyeglasses also have been tested for myopia control in children, but results have been less impressive than those produced with multifocal contacts.

A number of studies published between 2000 and 2011 found that wearing multifocal eyeglasses does not provide a significant reduction in progressive myopia for most children.

The Correction of Myopia Evaluation Trial (COMET), a study published in 2003, found that progressive eyeglass lenses, compared with regular single vision

lenses, did slow myopia progression in children by a small but statistically significant amount during the first year. But the effect wasn't significant in the next two years of the study.

But in March 2014, researchers in Australia and China published the results of a three-year clinical trial that evaluated the progression of nearsightedness among 128 myopic children ages 8 to 13 years. All participants had experienced at least -0.50 D of myopia progression the year preceding the start of the study.

One group of children wore conventional single vision eyeglasses, a second group wore bifocals, and a third group wore bifocal lenses with prism. After three years, children who wore either type of bifocal eyeglasses had significantly less mean progression of nearsightedness (-1.01 D to -1.25 D) than children who wore single vision lenses (-2.06 D).

Myopia infographic thumbnailWhen your child is nearsighted

Detecting Myopia Early

The best way to take advantage of methods to control myopia is to detect nearsightedness early.

Even if your child is not complaining of vision problems (nearsighted kids often are excellent students and have no visual complaints when reading or doing other schoolwork), it's important to schedule routine eye exams for your children, starting before they enter preschool.

Early childhood eye exams are especially important if you or your spouse are nearsighted or your child's older siblings have myopia or other vision problems.

What About Myopia Control In Adults?

Myopia typically develops during the early school years and tends to progress more rapidly in pre-teens than in older teenagers. This is why myopia control studies usually involve relatively young children.

While it's true that myopia also can develop and progress in young adults, this is less common. And it's possible that an adult's eyes may not respond to myopia control treatments the same way a child's eyes do. For these reasons, it's likely that most research on controlling myopia progression will continue to focus on nearsighted children rather than adults.

Can Eye Exercises Cure Myopia?

You no doubt have seen or heard advertisements on television and the Internet that claim eye exercises can reverse myopia and correct your eyesight "naturally."

Some of these eye exercise programs recommend you ask your eye doctor to write you an eyeglasses prescription that intentionally under-corrects your nearsightedness for full-time wear as an adjunct treatment to performing the exercises. The claim is that the exercises and undercorrection of your myopia will reduce your nearsightedness, so you will need less vision correction as time goes on.

It's worth noting here that research has shown undercorrection of myopia is ineffective at slowing myopia progression and may in fact increase the risk of nearsightedness getting worse. Also, intentional undercorrection of myopia causes blurred distance vision, which may put your child at a disadvantage in the classroom or in sports and affect their safety.

My opinion (and the opinion shared by most eye doctors and vision researchers) is that eye exercises do not cure myopia, are highly suspect, and are not supported by well-designed independent research. Buyer beware!


March 25, 2019

EYE ALLERGIES

Eye allergies — red, itchy, watery eyes that are bothered by the same irritants that cause sneezing and a runny nose among seasonal allergy sufferers — are very common.

The American College of Allergy, Asthma and Immunology estimates that 50 million people in the United States have seasonal allergies, and its prevalence is increasing — affecting up to 30 percent of adults and up to 40 percent of children. In addition to having symptoms of sneezing, congestion and a runny nose, most of these allergy sufferers also experience itchy eyes, watery eyes, red eyes and swollen eyelids.

And in some cases, eye allergies can play a role in conjunctivitis (pink eye) and other eye infections.

If you think you have eye allergies, here are a few things you should know — including helpful tips on how to get relief from your red, itchy, watery eyes.

Red, itchy, watery eyes are the distinctive signs and symptoms of allergies.

What Causes Eye Allergies

Normally harmless substances that cause problems for individuals who are predisposed to allergic reactions are called allergens. The most common airborne allergens that cause eye allergies are pollen, mold, dust and pet dander.

Eye allergies also can be caused by reactions to certain cosmetics or eye drops, including artificial tears used for treating dry eyes that contain preservatives.

Food allergies and allergic reactions to bee stings or other insect bites typically do not affect the eyes as severely as airborne allergens do.

Eye Allergy Relief

To get relief from your eye allergies and itchy, watery eyes, you can take a few approaches:

Avoiding allergens. As the old saying goes: "An ounce of prevention is worth a pound of cure." (By the way, Benjamin Franklin said that — the same guy who invented bifocals!) The best approach to controlling your eye allergy symptoms is to do everything you can to limit your exposure to common allergens you are sensitive to.

For example, on days when the pollen count is high, stay indoors as much as possible, with the air conditioner running to filter the air. Use high quality furnace filters that can trap common allergens and replace the filters frequently.

When you do go outdoors during allergy season, wear wraparound

 sunglasses to help shield your eyes from pollen, ragweed, etc., and drive with your windows closed.

Removing your contacts. Because the surface of contact lenses can attract and accumulate airborne allergens, consider wearing only eyeglasses during allergy season. Or consider switching to daily disposable contacts that you discard after a single use to avoid the buildup of allergens and other debris on your lenses.

Often the best choice if allergies are bothering your eyes is to discontinue wearing contacts altogether — at least until all your allergy symptoms are gone. Also, wearing eyeglasses with photochromic lenses can reduce allergy-related sensitivity to light and can help shield your eyes from airborne allergens.

Over-the counter eye drops. Because eye allergies are so common, there are a number of brands of non-prescription eye drops available that are formulated to relieve itchiness, redness and watery eyes caused by allergies.

If your eye allergy symptoms are relatively mild, over-the-counter eye drops for allergy relief may work very well for you and may be less expensive than prescription eye drops or other medication. Ask your eye doctor to recommend a brand to try.

STRATEGIES FOR YOU

8 Tips For Eye Allergy Sufferers

  1. Get an early start. See your eye doctor before allergy season begins to learn how to reduce your sensitivity to allergens.
  2. Try to avoid or limit your exposure to the primary causes of your eye allergies. In the spring and summer, pollen from trees and grasses are the usual suspects. Ragweed pollen is the biggest culprit in late summer and fall. Mold, dust mites and pet dander are common indoor allergens during winter.
  3. Protect your eyes from airborne allergens outdoors by wearing wraparound-style sunglasses.
  4. Don't rub your eyes if they itch! Eye rubbing releases more histamine and makes your allergy symptoms worse.
  5. Use plenty of artificial tears to wash airborne allergens from your eyes. Ask your eye doctor which brands are best for you.
  6. Cut down your contact lens wear or switch to daily disposable lenses to reduce the buildup of allergens on your lenses.
  7. Shower before bedtime and gently clean your eyelids to remove any pollen that could cause irritation while you sleep.
  8. Consider purchasing an air purifier for your home, and purchase an allergen-trapping filter for your heating/cooling system.

Prescription medications. If your allergy symptoms are relatively severe or over-the-counter eye drops are ineffective at providing relief, you may need your eye doctor to prescribe a stronger medication.

Prescription eye drops and oral medications used to relieve eye allergies include:

    • Antihistamines. Part of the body's natural allergic response is the release of histamine
    • , a substance that dilates blood vessels and making the walls of blood vessels abnormally permeable. Symptoms caused by histamine include a runny nose and itchy, watery eyes. Antihistamines reduce allergic reactions by blocking the attachment of histamine to cells in the body that produce an allergic response.
    • Decongestants. Decongestants help shrink swollen nasal passages for easier breathing. They also reduce the size of blood vessels on the white (sclera) of the eye to relieve red eyes. Common decongestants include phenylephrine and pseudoephedrine. Combination drugs are available that contain both an antihistamine and a decongestant.
    • Mast cell stabilizers. These medications cause changes in mast cells
  •  that prevent them from releasing of histamine and related mediators of allergic reactions. Because it may take several weeks for the full effects of mast cell stabilizers to take effect, these medications are best used before allergy season starts as a method to prevent or reduce the severity of future allergic reactions (rather than to treat acute allergic symptoms that already exist).
  • Nonsteroidal anti-inflammatory drugs. NSAID eye drops may be prescribed to decrease swelling, inflammation and other symptoms associated with seasonal allergic conjunctivitis, also called hay fever.
  • Steroids. Corticosteroid eye drops are sometimes prescribed to provide relief from acute eye allergy symptoms. But potential side effects of long-term use of these medications include high eye pressureglaucoma and cataracts, so they typically are prescribed for short-term use only.

Immunotherapy. This is a treatment where an allergy specialist injects you with small amounts of allergens to help you gradually build up immunity.

EYE ALLERGIES SELF-TEST

Common allergens include pollen, animal dander and mold.

Take this quiz to see if you might have eye allergies. Always consult your doctor if you suspect you have an eye condition needing care.

  • Do allergies run in your family?
  • Do your eyes often itch, particularly during spring pollen season?
  • Have you ever been diagnosed with "pink eye" (conjunctivitis)?
  • Are you allergic to certain animals, such as cats?
  • Do you often need antihistamines and/or decongestants to control sneezing, coughing and congestion?
  • When pollen is in the air, are your eyes less red and itchy when you stay indoors under an air conditioner?
  • Do your eyes begin tearing when you wear certain cosmetics or lotions, or when you're around certain strong perfumes?

If you answered "yes" to most of these questions, then you may have eye allergies. Make an appointment with an optometrist or ophthalmologist to determine the best course of action.

Eye Allergies And Contact Lenses

Contact lens discomfort is a common complaint during allergy season, leading some wearers to question whether they are becoming allergic to contact lenses.

The issue of being allergic to contacts also comes up from time to time when a person starts wearing silicone hydrogel contact lenses after successfully wearing standard soft (hydrogel) contact lenses and experiences allergy-like symptoms.

Studies have shown that the culprit behind eye allergies associated with contact lens wear is not an allergic reaction to the contact lens itself, but to substances that accumulate on the surface of the lenses.

In the case of switching from regular soft contacts to silicone hydrogel lenses, the surface and chemical characteristics of the lens material may attract lens deposits more readily than the previous lens material, causing discomfort.

Many eye care practitioners believe the best type of soft contact lenses for people prone to eye allergies are daily disposable lenses that are discarded after a single use, which decreases the buildup of allergens and other debris on the lens surface.

Silicone hydrogel often is the preferred lens material for these lenses, because it allows significantly more oxygen to pass through the lens, compared with conventional soft contact lens materials.

About the Author: Gary Heiting, OD, is senior editor of AllAboutVision.com. Dr. Heiting has more than 30 years of experience as an eye care provider, health educator and consultant to the eyewear industry. His special interests include nearsightedness, myopia control, and the effects of blue light on the eye.


March 15, 2019

Lutein And Zeaxanthin: Eye And Vision Benefits

By Gary Heiting, OD

Like This Page? Please Share! On This Page: Eye benefits of lutein and zeaxanthinLutein and zeaxanthin foodsSupplements

Good nutrition is important to keep your eyes healthy and functioning their best throughout your lifetime. Two very important eye nutrients that may reduce your risk for macular degeneration and cataracts have names you may not be familiar with: lutein (LOO-teen) and zeaxanthin (zee-ah-ZAN-thin).

Lutein and zeaxanthin are two types of carotenoids (kuh-RAH-teh-noids), which are yellow to red pigments found widely in vegetables and other plants. Though lutein is considered a yellow pigment, in high concentrations it appears orange-red.

Cooked spinach is one of the best natural food sources of lutein and zeaxanthin.Cooked spinach is one of the best natural food sources of lutein and zeaxanthin.

In nature, lutein and zeaxanthin appear to absorb excess light energy to prevent damage to plants from too much sunlight, especially from high-energy light rays called blue light.

In addition to being found in many green leafy plants and colorful fruits and vegetables, lutein and zeaxanthin are found in high concentrations in the macula

of the human eye, giving the macula its yellowish color. In fact, the macula also is called the "macula lutea" (from the Latin macula, meaning "spot," and lutea, meaning "yellow").

Recent research has discovered a third carotenoid in the macula. Called meso-zeaxanthin, this pigment is not found in food sources and appears to be created in the retina from ingested lutein.

Lutein and zeaxanthin appear to have important antioxidant

 functions in the body. Along with other natural antioxidants, including vitamin Cbeta-carotene and vitamin E, these important pigments guard the body from damaging effects of free radicals, which are unstable molecules that can destroy cells and play a role in many diseases.

In addition to important eye and vision benefits, lutein may help protect against atherosclerosis (buildup of fatty deposits in arteries), the disease that leads to most heart attacks.

Eye Benefits Of Lutein And Zeaxanthin

It is believed that lutein, zeaxanthin and meso-zeaxanthin in the macula block blue light from reaching the underlying structures in the retina, thereby reducing the risk of light-induced oxidative damage that could lead to macular degeneration (AMD).

A number of studies have found that lutein and zeaxanthin either help prevent AMD or may slow progression of the disease:

  • Research published in Nutrition & Metabolism found that a nutritional supplement containing meso-zeaxanthin, lutein and zeaxanthin effectively increased the optical density of the macular pigment in eyes of the majority of human subjects. The macular pigment is believed to offer protection against the development of macular degeneration.
  • Studies published in American Journal of EpidemiologyOphthalmology and Archives of Ophthalmologyfound higher levels of lutein and zeaxanthin in the diet are associated with a lower incidence of AMD.
  • Two studies published in Investigative Ophthalmology and Visual Science found that eyes with greater levels of macular pigments were less likely to have or develop macular degeneration.
  • In research published in Archives of Biochemistry and Biophysics, the study authors conclude that lutein, zeaxanthin and meso-zeaxanthin filter short-wavelength light and prevent or reduce the generation of free radicals in the retinal pigment epithelium and choroid. They also suggest that a mixture of these carotenoids is more effective than any one of the individual carotenoids at the same total concentration.
  • In a study published in the journal Optometry, participants with early AMD who consumed 8 mg per day of dietary zeaxanthin for one year improved their night driving and their visual acuity improved an average of 1.5 lines on an eye chart.

In May 2013, the much-anticipated results of the second large-scale Age-Related Eye Disease Study (AREDS2) sponsored by the National Eye Institute were published.

AREDS2 and other studies found evidence that lutein and zeaxanthin play a role in preventing macular degeneration or reducing the risk of progression of the disease. But it is less certain that these carotenoids help prevent cataracts.

AREDS2 was a follow-up to the original 5-year AREDS study published in 2001, which found use of a daily antioxidant supplement containing beta-carotene, vitamin C, vitamin E, zinc and copper reduced the risk of progressive AMD by 25 percent among participants with early and intermediate macular degeneration.

The goal of AREDS2 was to evaluate the effect of other nutrients — including lutein and zeaxanthin — on the prevention of AMD and other age-related eye diseases. AREDS2 also investigated the effect of removing beta-carotene from the AREDS supplement, since supplementation of this vitamin A precursor has been associated with increased risk of certain cancers among smokers and previous smokers.

The AREDS2 results revealed study participants with early signs of macular degeneration who took a modification of the original AREDS nutritional supplement that contained 10 mg lutein and 2 mg zeaxanthin (and no beta-carotene) every day for the 5-year study period had a 10 to 25 percent reduced risk of AMD progression. Study participants whose diets contained the lowest amounts of foods containing natural lutein and zeaxanthin experienced the greatest AMD risk reduction from taking the daily nutritional supplement.

While AREDS2 and other studies provide evidence that lutein and zeaxanthin may play a role in preventing macular degeneration (or at least reducing the risk of progression of AMD), it's less clear if these carotenoids help prevent cataracts.

Research published in Archives of Ophthalmology suggests women whose diets include high amounts of healthful foods containing lutein, zeaxanthin and other carotenoids have a lower risk of cataracts than women whose diets contain lower amounts of these nutrients.

In AREDS2, however, supplemental lutein and zeaxanthin had no effect on cataract risk or progression.

Book Explains How To Eat Better For Healthy Eyes

Eyefoods: A Food Plan for Healthy Eyes is a new book designed to help you improve the health of your eyes.

Written by eye doctors Laurie Capogna, OD, and Barbara Pelletier, OD, the book describes nutrients such as lutein, zinc and vitamin C and tells you which foods they are found in and how much you need each day to help maintain healthy eyes.

The book also presents research that links good nutrition to reduced risk of eye disease, as well as quick recipes for incorporating eye-healthy vitamins and minerals in your daily diet. The text is easy to understand, and the big, colorful food photos will inspire you to eat better.

Eyefoods is available at eyefoods.com .

Foods Containing Lutein And Zeaxanthin

The best natural food sources of lutein and zeaxanthin are green leafy vegetables and other green or yellow vegetables. Among these, cooked kale and cooked spinach top the list, according to the U.S. Department of Agriculture (USDA).

Non-vegetarian sources of lutein and zeaxanthin include egg yolks. But if you have high cholesterol, you're much better off getting most of these yellow nutrients from fruits and vegetables.

[Try these easy recipes — all contain lutein and zeaxanthin: sunset gazpachochicken chopped saladafter-workout tropical smoothiebroccoli rabe with tempeh and pine nuts.]

Lutein And Zeaxanthin Supplements

Because of the apparent eye and cardiovascular benefits of lutein and zeaxanthin, many nutritional companies have added these carotenoids to their multiple vitamin formulas. Others have introduced special eye vitamins that are predominantly lutein and zeaxanthin supplements.

There currently is no Recommended Dietary Allowance (RDA) or Recommended Daily Intake (RDI) for lutein or zeaxanthin, but some experts say you should ingest at least 6 milligrams (mg) of lutein per day for beneficial effects.

It remains unclear how much lutein and zeaxanthin is needed daily for adequate eye and vision protection. Also, it is unknown at this time whether supplements have the same effect as lutein and zeaxanthin obtained through food sources.

There are no known toxic side effects of taking too much lutein or zeaxanthin. In some cases, people who eat large amounts of carrots or yellow and green citrus fruits can develop a harmless yellowing of the skin called carotenemia. Though the appearance of the condition can be somewhat alarming and may be confused with jaundice, the yellow discoloration disappears by cutting back on consumption of these carotenoid-rich foods. (Carotenemia also can be associated with over-consumption of carotenoid-rich nutritional supplements.)

EYE NUTRIENT AWARENESS

Do You Know Which Nutrients Are Good for Your Eyes?

In a 2011 survey of Americans aged 45-65, more than half the respondents said they take nutritional supplements to protect joints, bones or heart health. But fewer than a fifth said they take eye health supplements.

In addition, 66 percent were unaware of the key role that lutein plays in eye health.

For more results of the Bausch + Lomb-sponsored survey, click here for a brief slide show.

Popular lutein and zeaxanthin supplements include:

  • MacuHealth with LMZ3 (MacuHealth LLC)
  • EyePromise Zeaxanthin (Zeavision)
  • ICaps Eye Vitamin Lutein & Zeaxanthin Formula (Alcon)
  • Macula Complete (Biosyntrx)
  • MacularProtect Complete (ScienceBased Health)
  • MaxiVision Ocular Formula (MedOp)
  • OcuGuard Plus (TwinLab)
  • Ocuvite (Bausch + Lomb)

The source of lutein in many lutein supplements is marigold flowers, while for zeaxanthin it is often red peppers. If you choose a lutein and zeaxanthin supplement, make sure it's a high quality product from a reputable dietary supplement company.

Remember that taking dietary supplements does not replace a healthy diet. Eating a well-balanced diet that includes plenty of fruits and vegetables usually is the best way to get the important eye nutrients you need.

If you have low macular pigment levels and are sensitive to light, ask your eye care professional about photochromic lenses. These eyeglass lenses protect your eyes from UV and high-energy visible blue light that can damage retinal tissue, and they darken automatically in sunlight to ease light sensitivity.

Also, remember that individuals sometimes react differently to certain supplements, which can have unintended effects such as adverse reactions with medications. Consult with your physician or eye doctor before trying any vision supplements.

For the latest Eye Nutrition news, click here.

EYE NUTRITION NEWS

Animal Study Finds Nutritional Supplements Reduce Risk Of Diabetic Retinopathy

Nutritional supplements.

Nutritional supplements containing lutein and zeaxanthin, lipoic acid, and omega-3 fatty acids are effective in preventing the development of retinopathy among diabetic rats, according to a study.

Researchers at the Kresge Eye Institute in Detroit investigated the effect of carotenoid-containing supplements on retinal oxidative stress and inflammation and the development of diabetic retinopathy.

Diabetes was induced and confirmed in all rats in the study, and then some rats were given a diet that included the nutritional supplements while others were given the same food but without the supplements. After 11 months, the retinas of the rats were evaluated for changes in blood vessels, cellular damage and other retinal changes characteristic of diabetic retinopathy.

In rats that had not received the nutritional supplements, diabetes-induced damage to retinal blood vessels was three to four times greater than among rats who had received the added nutrients.

The study authors concluded that the nutritional supplements used in this study prevented diabetic retinopathy and preserved normal retinal functioning. They also said that, though human testing is required to confirm, these supplements "could represent an achievable and inexpensive adjunct therapy" to inhibit diabetic retinopathy in people with diabetes.

A full report of the study was published online in January 2014 by Nutrition & Metabolism.


March 7, 2019

How To Put In Eye Drops

By Amy Hellem; reviewed by Gary Heiting, OD

Like This Page? Please Share! See Also: Eye drops: which ones work best?

Eye drops are used to treat a wide variety of conditions — from glaucoma and eye infections to allergiesand dry eyes. In many cases, eye drops (or "eyedrops") are essential to preserving your vision and protecting your eyes.

To get the greatest benefit from eye drops, you must use them properly. Whether you need one drop per day or 10, there's a right way and a wrong way to put eye drops in your eyes.

Your eye doctor or pharmacist may give you instructions that are specific to the prescription eye drops you need. But in most cases, the proper technique for applying eye drops is the same, whether you are using prescription or over-the-counter formulas that you can purchase without a prescription.

Failing to learn how to correctly put drops in your eyes not only can defeat the purpose of having them, it also can get expensive. Each time you miss your eye and have to use more drops than you should, it costs you money — potentially a lot of money in the case of some prescription eye drops.

Step-By-Step Approach To Putting In Eye Drops

1. Wash your hands with soap and water; then dry them with a clean towel.

2. If you are wearing contact lenses, remove them. The only exception is if you are using eye drops that are specifically formulated to remoisten your contacts or if your doctor advised you to use the drops in this manner.

3. Remove the dropper cap and look closely at the tip to make sure it's not cracked or otherwise damaged. Do not touch the tip.

4. Either lie down or tilt your head back, and look up at the ceiling. Concentrate on a point on the ceiling, keeping your eye wide open.

5. Place one or two fingers on your face about an inch below your eye; gently pull down to create a pocket between your lower eyelid and your eyeball.

6. Use your other hand to hold the eye drop bottle, pointing the tip downward. Resting your hand on your forehead may help steady it.

7. Hold the bottle close to your eye (about an inch away). Be careful not to let the dropper touch your eye or eyelashes, since this can introduce bacteria and other organisms into the eye drops in the bottle.

8. Squeeze lightly to instill one drop inside your lower lid.

9. Remove your hands from your face, gently close your eyes and tilt your head down for a few seconds. Try not to blink, as this can force some of the drop out of your eye before it has had a chance to be absorbed.

10. To keep as much of the drop on your eye as possible, press lightly on the inner corner of your eyelid, next to your nose. A small duct that drains tears away from your eye and into your nose is located here. By pressing at this point, you close down the opening of this drainage duct, allowing the eye drop to remain on the surface of your eye longer.

This technique also minimizes the funny taste you may get in your mouth after applying certain eye drops.

11. Use a clean tissue to absorb and wipe away any drops that spill out of your eye and onto your eyelids and face.

12. If you are using eye drops on both eyes, repeat this procedure for the second eye.

13. Replace the cap of the bottle and screw it on securely. Never wipe the dropper tip with anything, as this may contaminate the drops.

14. Wash your hands to clean away any stray eye drops.

What To Do If You Need To Use More Than One Eye Drop

Sometimes, you may be prescribed more than one type of medicated eye drop. But if you apply the drops too quickly in succession, they may drip out of the eye and not be absorbed properly, reducing the therapeutic effect.

If you need to put a second eye drop in the same eye, wait at least five minutes. This will give time for the first drop to be fully absorbed and create more space for the second drop on the eye.

If you use both a medicated eye drop and a lubricating eye drop on the same eye, many doctors prefer that you start with the prescription (medicinal) eye drop first and save over-the-counter products, such as artificial tears, for later.

Practice With Artificial Tears

If you aren't comfortable putting drops in your eyes, a little practice can help you master the task quickly.

Purchase a package of preservative-free artificial tears to use for practice. (Don't practice with prescription eye drops — you don't want to risk over-medicating.) Using a preservative-free formula eliminates the risk of you being allergic to preservatives found in many artificial tears. Also, choose a product formulated for mild dry eyes — these drops aren't as thick as those made for moderate or severe dry eyes, so they won't cause any temporary blurred vision.

Ask a friend to coach you while you are practicing. In particular, have them help you position the applicator at the proper distance and location above your eye so the drops fall directly on the surface of your eye or in the space between your eye and your pulled-down lower lid.

In less time than you might think, you will become a pro at applying eye drops. Also, it's a good idea to keep a supply of preservative-free artificial tears on hand. These drops can help relieve discomfort associated with computer eye strain and are soothing at other times when your eyes are tired or dry.

Read Full Article HERE.


February 28, 2019

Chalazion

By Brian Chou, OD

Like This Page? Please Share! On This Page: Chalazion causesTreatment See Also: How to get rid of a stye

A chalazion is a benign, painless bump or nodule inside the upper or lower eyelid.

Chalazia (plural for chalazion) result from healed internal styes that no longer are infectious. These cyst-like nodules form around an oil gland (meibomian

) within the eyelid, resulting in red, swollen eyelids.

The contents of a chalazion include pus and blocked fatty secretions (lipids) that normally help lubricate the eye but can no longer drain out.

ChalazionNormally chalazia will drain on their own, but a persistent chalazion requires treatment by an eye doctor. [Enlarge]

Many chalazia drain, resolving on their own, especially if you facilitate the process with periodic warm compresses and gentle massage of the eyelid.

However, some chalazia persist for more than several weeks and grow large enough to become cosmetically unappealing.

A larger chalazion may press on the cornea, temporarily creating irregularity on the eye surface and inducing astigmatism. This can cause blurry vision.

What Causes A Chalazion?

It is not always possible to identify a cause for a chalazion. However, chalazia are more common in those with blepharitis (eye inflammation) and rosacea.

People with rosacea, characterized by facial redness and swollen bumps under the skin (papules and pustules), are prone to have certain eye problems such as blepharitis and chalazia.

Rosacea can affect eyelids, the eye's thin outer membrane (conjunctiva), the clear eye surface (cornea) and the white of the eye (sclera).

These manifestations of rosacea on the eye collectively are referred to as ocular rosacea. Causes of rosacea itself can be difficult to pinpoint, although environment and inherited tendencies are likely factors.

Certain microorganisms living in or near eyelash roots also may exacerbate inflammation around the eye.

How Is A Chalazion Treated?

If you are prone to developing chalazia, your doctor can prescribe preventative regimens, such as cleaning your eyelids, applying medicine on your eyelid and even using oral medication for underlying conditions.

The most commonly prescribed oral medicine for blepharitis and meibomian gland dysfunction is doxycycline (antibiotic). Sometimes tetracycline and minocycline, both of which are in the same drug family of antibiotics, are prescribed. However, doxycycline tends to be better tolerated.

Topical and oral antibiotics usually are ineffective as direct treatments for chalazia, which have no active infectious component that would require this kind of approach.

If you develop a chalazion, your eye doctor may have you regularly apply a warm, moist compress on the outside of your closed eyelid to promote drainage from the eye's blocked oil gland.

COMMON EYELID BUMPS

Chalazion. A cyst-like nodule inside the upper or lower eyelid caused by a blocked oil gland.

Stye. A bacterial infection caused by a blocked oil-secreting gland at the edge of the upper or lower eyelid; resembles a pimple in appearance.

Milia. Tiny white "pinhead" bumps commonly appearing around the eyes due to a pocket of trapped skin cells on the surface of the skin.

Xanthelasma. Flat, yellow growths on the eyelid caused by a build-up of fatty deposits under the skin.

Small, inconspicuous chalazia may require no treatment at all. However, some blockages causing chalazia do not clear up on their own. These may remain indefinitely or even grow larger.

In the case of a bothersome and persistent chalazion, you may undergo a simple in-office surgery to excise it.

An eye surgeon will use local anesthesia to numb the area before making a small incision, typically from underneath the eyelid to clear the contents of the lesion without visible scarring.

An alternate procedure involves injecting the chalazion with corticosteroid to allow better drainage. A potential side effect of steroid injection is lightening of the surrounding skin, which can be more problematic in dark-skinned people.

In cases where a chalazion recurs in the same part of the eyelid or has a suspicious appearance, the removed tissue may be sent to a laboratory to rule out tumorous growth.

Fortunately, most chalazia are relatively harmless.

Read full article HERE.


February 22, 2019

11 Steps To Help Prevent Macular Degeneration

Though currently there is no cure for age-related macular degeneration (AMD), it appears there are a number of things you can do to reduce your risk of getting the disease and experiencing AMD-related vision loss.

You should be especially diligent about taking steps to prevent macular degeneration if there is a history of AMD in your family, which has been shown to be a risk factor for the disease.

AMD is the leading cause of irreversible vision loss among elderly people, who slowly lose their central vision. In time, a person with macular degeneration may find it difficult or impossible to read, drive or recognize familiar faces.

Here is a list of 11 steps you can take to prevent or slow the progression of macular degeneration, followed by a brief discussion of each step:

  1. Don't smoke.
  2. Eat plenty of dark, leafy green vegetables, such as raw spinach.
  3. Take a balanced multivitamin/multimineral supplement, such as Centrum Silver, unless your doctor advises otherwise.
  4. If you already have AMD, ask your doctor about one of the AREDS formulations or other supplements specially formulated for macular health, such as I-Caps AREDS 2 (Alcon), PreserVision AREDS 2 (Bausch + Lomb), Eyepex Macula (Eyepex Formulas) or MacularProtect Complete AREDS2 (ScienceBased Health).
  5. Eat fish or take a fish oil supplement.
  6. Exercise regularly, and maintain a healthy weight.
  7. Eat fruit and nuts daily.
  8. Limit your intake of refined carbohydrates (high-glycemic index foods).
  9. Keep your blood pressure and cholesterol under control.
  10. Wear sunglasses outdoors to block UV and blue light that may cause eye damage.
  11. Have regular eye exams.

Step One: Stop Smoking

Probably the number one way to prevent AMD is to stop smoking or not smoke in the first place. Consider findings from these studies:

Give up cigarettes to reduce your risk for macular degeneration.If you are a smoker, stop now. Smoking is a major risk factor for developing macular degeneration.

  • Smokers are up to four times more likely than non-smokers to have macular degeneration, public health experts at the University of Manchester said in a British Medical Journalreport. In Great Britain, an estimated 53,900 people older than 69 have AMD attributed to smoking. Of that number, 17,900 are legally blind.
  • Another study from the Massachusetts Eye and Ear Infirmary showed that current and past smokers had a 1.9- and 1.7-fold greater risk, respectively, of AMD compared with non-smokers.

Step Two: Eat Plenty Of Greens To Prevent AMD

Eating plenty of dark, leafy greens may help with macular degeneration prevention.

A study published by researchers at the Massachusetts Eye and Ear Infirmary reported that people who consumed the most vegetables rich in carotenoids (lutein and zeaxanthin) had a 43 percent lower risk of AMD than those who ate these foods the least.

Carotenoid-rich vegetables include dark, leafy greens, especially raw spinach, kale and collard greens.

"In particular, a higher frequency of intake of spinach or collard greens was associated with a substantially lower risk for AMD," researchers said.

The authors concluded that "consumption of foods rich in certain carotenoids, in particular dark green, leafy vegetables, may decrease the risk of developing advanced or exudative ('wet') AMD, the most visually disabling form of macular degeneration among older people."

Step Three: Take Multivitamins/Multiminerals

Taking vitamins and minerals in the form of from a trusted source may be a good idea for many reasons, including general eye health.

Particularly for an older person, it may be difficult to obtain all the nutrients you need from diet alone. Ask your doctor for advice about which supplements might work best for you based on your specific health needs.

Step Four: Consider An AREDS Nutritional Supplement

Two large clinical trials sponsored by the National Eye Institute (NEI) have suggested certain nutritional supplements can slow the progression of AMD among people with early and intermediate stages of macular degeneration.

AREDS1. The antioxidant vitamin formula used in the first AREDS study contained the following ingredients:

The results of AREDS1, published in 2001, revealed patients at high risk of progressive AMD who took the daily antioxidant and zinc supplement had up to a 25 percent reduced risk of their macular degeneration progressing to an advanced stage (depending on the degree of AMD present at the start of the trial), compared to matched participants who took a daily placebo pill.

It should be noted, though, that among study participants who had either no AMD or only early AMD, the supplement did not provide any apparent benefit. Also, the antioxidant formula in the study did not have any significant effect on the development or progression of cataracts.

Still, because of the demonstrated protective effect of the supplement used in the AREDS1 study against AMD progression among high-risk patients, many pharmaceutical companies have developed "AREDS formula" supplements sold as eye vitamins.

Popular AREDS-formula eye vitamins include I-Caps (Alcon), Ocuvite PreserVision (Bausch + Lomb) and MacularProtect Complete (ScienceBased Health). Variations of these products and eye vitamins from other manufacturers also may contain lutein and zeaxanthin and/or omega-3 fatty acids.

Since the results of AREDS1 were published, researchers have found that supplements containing beta-carotene, a vitamin A precursor, may increase the risk of lung cancer among smokers and previous smokers. (Eating foods containing beta-carotene, however, does not appear to cause a similar risk, and may in fact be protective against certain cancers.)

Due to these findings, many health professionals are advising smokers and previous smokers to avoid beta-carotene found in nutritional supplements.

AREDS2. Based on the positive outcome of the original AREDS study, the NEI began a second round of clinical trials in 2006 — called AREDS2 — to see if the AREDS-formula supplement could be improved and provide added eye benefits.

Some vitamins and minerals can help prevent or slow the onset of macular degeneration.Certain nutritional supplements have been shown to help stop the progression of macular degeneration, or prevent it.

AREDS2, a five-year study with more than 4,000 participants who had varying stages of AMD at the time of enrollment, evaluated the effect of adding lutein (10 mg) and zeaxanthin (2 mg) and/or omega-3 fatty acids (350 mg DHA and 650 mg EPA) to the original AREDS formula. These nutrients were chosen because they have demonstrated eye benefits in other studies.

The AREDS2 researchers also investigated the effect of eliminating beta-carotene and reducing the zinc dosage of the original formula.

Results of the AREDS2 study were published in May 2013. The outcomes revealed that study participants taking the modified AREDS formula with added lutein and zeaxanthin had a 10 to 25 percent reduction in the risk of AMD progression. Those participants with the lowest dietary intake of foods containing these carotenoids experienced the greatest benefit.

Another important finding was that patients who were randomly assigned to take the original AREDS formula containing 15 mg beta-carotene had a greater risk of lung cancer during the course of the AREDS2 study, compared with those who were randomly assigned to take the revised formula without beta-carotene. Most of the participants who developed lung cancer during the study were former smokers.

A finding that was a surprise to many eye care professionals was that the addition of omega-3 fatty acids to the AREDS formula did not significantly reduce the risk of AMD progressing to advanced stages.

Based on the AREDS2 results, the study authors concluded that adding lutein and zeaxanthin to the original AREDS formula and removing beta-carotene from the supplement may increase its safety and effectiveness in preventing the progression of macular degeneration among certain people with high risk of vision loss from AMD.

Step Five: Prevent AMD By Eating More Fish

Research also has shown the benefits of eating fish for macular degeneration prevention:

Eating fish may help prevent macular degeneration.Some studies show that eating fish regularly can help prevent macular degeneration.

  • A study at the Massachusetts Eye and Ear Infirmary showed that senior men with the highest levels of fish consumption (more than two servings weekly) were 45 percent less likely to have AMD than those who ate the least amount of fish (less than one serving per week).
  • Brian Chua and researchers at the University of Sydney demonstrated similar findings. They evaluated 2,900 people aged 49 or older. Participants who ate fish at least once a week were 40 percent less likely to have beginning-stage AMD develop than those who reported eating fish less than once a month or not at all. Those who ate fish at least three times weekly were less likely to have late-stage AMD.

Step Six: Exercise Regularly And Maintain A Healthy Weight

Regular exercise reduces macular degeneration risk, according to a study in the British Journal of Ophthalmology.

In this study, 4,000 people ages 43 to 86 were monitored for 15 years. After considering other risk factors such as weight, cholesterol levels and age, researchers found that people who led an active lifestyle were 70 percent less likely to have AMD develop during the follow-up period.

To be included in the active group, participants must have walked at least two miles a day, three times weekly, or the equivalent.

Step Seven: Eat Fruit And Nuts Daily

Eating fruits and nuts can help reduce your risk of macular degeneration:

  • A 2004 study at Harvard Medical School showed that participants who ate three or more servings of fruit daily had a substantially lower risk of "wet" or advanced AMD.
  • Another study from the Massachusetts Eye and Ear Infirmary demonstrated that eating nuts helped deter progression of early or intermediate AMD to more advanced stages.

Step Eight: Reduce Refined Carbs In Your Diet

Diets high in refined carbohydrates increase the risk of AMD, which was confirmed in a study published in the American Journal of Clinical Nutrition. Highly refined foods have a high glycemic index, causing a rapid increase in blood sugar and insulin release.

Examples of refined carbohydrates include white bread, white rolls, baked white potatoes, donuts and pretzels. Low glycemic index foods include most fruits, brown rice, multi-grain and whole grain breads, apple juice and carrot juice.

Be careful, though, when considering the glycemic index of foods. The glycemic index (GI) was developed in 1981 by researchers at the University of Toronto. It is a value from 1 to 100 that indicates a food's effect on a person's blood sugar level, with a value of 100 being equivalent to the change caused by the same amount of pure glucose. A food with a high glycemic index increased blood sugar level more severely than foods with lower GI values.

But glycemic index values do not take into account the available carbohydrate (total carbohydrate minus fiber) in a food, and does not reflect the actual amount of carbohydrate in a typical serving of the food. So a food that may at first seem like "bad" food because it has a high glycemic index may in fact be very healthful due to other components (other than available carbohydrate) in the food and the actual amount of carbohydrate consumed in a typical serving.

To avoid "good" foods seeming "bad" because of misleading GI values, researchers at Harvard later came up with a measure called the "glycemic load." The glycemic load of a serving of food can be calculated as its carbohydrate content measured in grams (g), multiplied by the food's glycemic index, and divided by 100. For one serving of a food, a glycemic load (GL) greater than 20 is considered high, a GL of 11-19 is considered medium, and a GL of 10 or less is considered low. Foods that have a low GL in a typical serving size almost always have a low GI — but not always!

For example, watermelon has a high glycemic index (72). So if we judged it by its glycemic index alone, we might consider watermelon a "bad" food that could increase your risk of macular degeneration. But watermelon contains a very high amount of water, along with healthful vitamin C and lycopene (a substance that has been shown to be helpful for heart health), and the amount of available carbohydrate in a slice of watermelon is quite low (only 5 percent, based on weight) due to its high water content.

If you calculate the glycemic load of watermelon, these factors result in it having a GL value of only 3.6! So, as you might have guessed even without all this math, watermelon is a healthful food despite its high glycemic index. Eat as much as you want! And, when possible, consider the glycemic load (GL), not the glycemic index (GI), of foods you eat when evaluating your dietary risk factors for AMD.

Step Nine: Control Blood Pressure And Cholesterol

Some evidence indicates that controlling cholesterol can protect you from macular degeneration. Cholesterol is a fatty substance that can build up in blood vessels, inhibiting blood flow necessary for maintaining health of eye tissue.

Also, blood pressure control may be important for macular degeneration prevention. Major investigations including the Framingham Heart and Eye Studies and Beaver Dam Eye Study indicate a significant link between high blood pressure and development of advanced, potentially blinding forms of macular degeneration.

Step Ten: Wear Sunglasses With UV & Blue Light Protection

Major studies show no conclusive evidence that overexposure to the sun directly causes macular degeneration. But some findings suggest at least an association between AMD and cumulative eye damage from overexposure to both UV and high energy visible (HEV) or "blue" light.

As an example, a recent major study found that people who consumed too few antioxidants, in combination with overexposure to blue light, were four times more likely to develop advanced or "wet" AMD. For this reason, it is a good idea to wear sunglasses that protect against both UV and HEV light outdoors.

Step Eleven: Have Regular Eye Exams

Last but not least, have regular eye exams. The American Academy of Ophthalmology recommends a dilated eye exam at least every two to three years if you're between 45 and 60 and every year after the age of 60.

By following these steps, you'll know you've done everything you can to prevent AMD. But if you're strongly genetically predisposed to develop macular degeneration, it still may develop and worsen.

Regular eye exams can help your eye doctor detect AMD and monitor it so that you can receive proper AMD treatment, if appropriate, beyond these preventive measures.  READ FULL ARTICLE HERE.


Children and Technology: Protecting Your Child’s Eyes

Children and technology are practically inseparable these days. Whether for educational purposes or just fun, children are spending a good portion of their day on “screen time” — staring at the LED screens of computers, tablets, smartphones and other digital devices.

According to Common Sense Media, children under age 8 now spend more than two hours a day with screen media. For 8- to 10-year-olds, screen time triples to six hours a day. And it’s not unusual for kids in middle school and high school to spend up to nine hours per day looking at digital displays.

If you’re wondering if all this screen time might cause problems for your child’s eyes and vision, the short answer is, “yes, it does.”

Risks associated with too much screen time

Children who spend multiple hours staring at digital devices are at risk of developing these vision-related problems:

Computer vision syndrome

Three kids having fun with a laptop computer

Computer vision syndrome (CVS) — also called digital eye strain — is a condition that’s caused by visual stress and has a combination of symptoms, including fluctuating vision, tired eyes, dry eyes, headache and fatigue. Other non-visual symptoms of CVS include neck, back and shoulder pain.

Unhealthy posture

When using a computer or digital device for prolonged periods, it’s common to start slouching inward, rounding the back and shoulders, and then tilt the head back and jut the chin forward. This unnatural (and unhealthy) posture — called “turtling” — leads to many of the non-visual symptoms of computer vision syndrome.

Nearsightedness

Vision researchers believe increased screen time among children is a significant risk factor for the development and progression of nearsightedness (also called myopia). The prevalence of myopia has grown significantly in the last few decades and this trend coincides with the increased use of computers and digital devices by children.

Increased exposure to blue light

High-energy visible light called blue light is emitted by the LED screens of computers, tablets, smartphones and other digital devices. Although the most significant source of blue light exposure is natural sunlight, many researchers and eye doctors are concerned that the added blue light exposure from computers and digital devices might increase a person’s risk of age-related eye diseases like macular degeneration later in life.

What to do

Boy using a digital tablet

Digital devices such as tablets can cause eye strain in kids, so monitor their use as well as that of desktops and laptops.

It’s unrealistic to think that children will stop using modern technology. Thankfully, there are some easy things you can do to decrease your child’s risk of eye and vision problems from prolonged use of computers and digital devices.

Encourage frequent visual breaks

It may sound simplistic, but one of the best things you can do for your child is to get them to follow the “20-20-20” rule — every 20 minutes, take your eyes off your screen and look at something that’s at least 20 feet away for at least 20 seconds. This simple task relaxes the focusing and eye alignment muscles, reducing the risk of many of the symptoms of digital eye strain.

The 20-20-20 rule also might decrease the risk of myopia progression. Some research suggests focusing fatigue may be associated with the onset and worsening of myopia. Taking frequent breaks from staring at digital screens helps reduce this fatigue.

Encourage frequent postural corrections

The time taken to follow the 20-20-20 rule is also a good time to sit up straight and realign the head, neck and shoulders. Moving the head slowly to the right and left and also up and down can relieve strained muscles and reduce fatigue. If it’s possible, getting up to walk and stretch the entire body also is a good idea to reduce the risk of non-visual symptoms of computer vision syndrome. [Read more about computer ergonomics.]

Protect their eyes from blue light

Currently, no one knows for sure how damaging the added exposure to blue light emitted by computers and digital devices might be to a child’s eyes over time. It may take researchers decades to sort that out. In the meantime, it’s prudent to protect your child’s eye from blue light from both sunlight and digital devices.

Outdoors, polarized sunglasses offer the best protection from glare and blue light, blocking roughly 90 percent or more of the sun’s harmful blue light.

For indoor and outdoor wear, photochromic lenses such as Transitions lenses (Essilor) are an excellent choice. Transitions Signature lenses block 1.4 times more harmful blue light indoors than a basic clear lens, and they filter more than 8 times more harmful blue light outdoors than clear lenses. Transitions XTRActive lenses filter at least 2 times more harmful blue light indoors than clear lenses, and 8 times more harmful blue light outdoors.

For indoor wear, eyeglass lenses with an integrated blue light filter are a good choice. Examples include BluTech lenses (BluTech, LLC), which block up to 59 percent of harmful blue light, and Eyezen lenses (Essilor), which block at least 20 percent. Be aware that different eyeglass lens companies may measure blue light filtration properties differently, and lenses with the most effective blue light filters have a tint that will affect the appearance of these lenses.

Finally, certain anti-reflective coatings can help eyeglass lenses filter blue light. One example is Crizal Prevencia (Essilor), which blocks at least 20 percent harmful blue light.

Establish media-free times

The American Academy of Pediatrics advises parents to establish media-free times each day to break their children’s fixation on digital device and spend time to connect as a family. These times have the added benefit of reducing eye fatigue and blue light exposure.

Schedule annual eye exams

Finally, schedule a comprehensive eye exam for your children prior to the start of every school year. In addition to making sure your child’s eyes are healthy and seeing well, your eye doctor can perform special tests and provide specific suggestions to reduce the risk and symptoms of computer eye strain.

Children and technology are the future. Taking these simple measures can go a long way toward keeping your tech-savvy child seeing clearly and comfortably for years to come.

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