4 things ophthalmologists wish you knew about your eyes
When I wrote a column on tips from E.R. doctors last year, I heard one piece of advice over and over: Wear safety glasses whenever you’re doing yardwork — even for jobs that take only a minute. The doctors shared graphic descriptions of objects removed from the eyes of patients. Those stories didn’t make it into the column, but they will stay in my head forever. (I now wear goggles whenever I do any yardwork.) To make sure I’m doing everything I can take care of my eyes, I decided to talk to ophthalmologists. Here is what they want you to know about your eyes. Your eyes can get sunburnedWhen you expose your eyes to prolonged or intense UV light, you can develop a condition called photokeratitis, which is basically sunburn. It can feel like redness, pain and sensitivity, “as if you had a scratched cornea,” said Dr. Vincent K. Young, chief of ophthalmology at Jefferson Einstein Philadelphia Hospital. It happens in sunny locations, such as at the beach or on the slopes, Dr. Young added. “We get a lot of people who have been skiing over the weekend, and they come to us on Monday morning, and their eyes are in tremendous pain because of all of that UV damage,” he said. The condition usually heals within a day or two, said Dr. Zubair Ansari, an ophthalmologist at the University of Miami’s Bascom Palmer Eye Institute. But you may need lubrication drops, cool compresses, rest and possibly antibiotics. While your corneas are regenerative, he added, longtime exposure to the sun without protection can increase the risk of certain kinds of cataracts. So protect your eyes by wearing sunglasses or ski goggles that offer UVA and UVB protection, Dr. Ansari said. “I tell my patients that if you’re in a situation where you’re using sunblock, you also want to be wearing protective eyewear,” he said. Contacts should not be worn while swimming or sleepingIf you wear contacts, the Centers for Disease Control and Prevention recommends that you remove lenses before swimming. That includes any body of water: oceans, lakes, and even pools, said Dr. Farihah Anwar, an assistant professor of ophthalmology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell. These bodies of water, she said, can harbor various bacteria, organisms and chemicals — some of which can be hard to treat if they get in your eye. Contact lenses provide the perfect atmosphere for a germ to thrive, she added, “because it’s literally sitting in a suction cup between the eyeball and the contact lens.” Not everyone who wears contacts while swimming gets an infection, “but it does increase your risk exponentially,” said Dr. Melissa Daluvoy, an associate professor of ophthalmology at Duke University. The “best-case scenario” is to wear prescription goggles, Dr. Daluvoy said; the next best option is to use “daily-wear contacts that you wear under goggles and then throw them immediately away.” Similarly, Dr. Daluvoy said, “sleeping overnight in your contacts does increase your risk of infection.” During sleep, your body slows tear production, delivers less oxygen to your cornea, and soft contact lenses can also dehydrate and tighten slightly, Dr. Ansari said. As a result, the contact lens can stick to the cornea. “And once the contact lens is pulled off, it can actually rip the superficial layers of the cornea,” leaving it more open to infection, he explained. So take out your contacts at the end of the night, he added, no matter how late it is, or how many cocktails you’ve had. Staring at your screen can cause dry eyesWe normally blink, which helps moisten the eye, around 15 times a minute — but when we are staring at screens, our blink rate can be cut in half. So if you experience dry eyes when you stare at your devices, use the 20-20-20 rule, Dr. Daluvoy said: Every 20 minutes, look at something 20 feet away or farther for 20 seconds, the combination of which encourages blinking and reduces eye strain. “That’s something we preach all the time for dry eyes,” she said. And use artificial tears to lubricate them, Dr. Daluvoy added, but make sure the drops are free of preservatives, which can actually irritate eyes. An eye exam can reveal a wide range of diseasesDuring a comprehensive eye exam, a doctor often dilates your eyes by using eyedrops that expand your pupils so that the back of your eyes can be more easily examined. While the primary purpose is to screen for eye diseases, your doctor can detect a number of other conditions through the exam, Dr. Daluvoy said, among them diabetes, high blood pressure, high cholesterol and heart disease. According to the American Academy of Ophthalmology, eye doctors can even detect sexually transmitted infections such as chlamydia, herpes and gonorrhea. “You can pick up on some cancers or brain diseases, too,” Dr. Daluvoy said. “I’ve actually found a brain tumor in a patient who had complaints about difficulty reading.” The A.A.O. recommends that adults with no signs or risk factors for eye disease get a comprehensive exam at 40 to establish a reference point. Then, you should get a checkup every 1 to 4 years, depending on your age. Once you hit 65, you should be evaluated every 1 to 2 years, even if you don’t symptoms. Such an exam includes getting checked for glaucoma, a group of eye diseases that can damage your optic nerve, causing your vision to deteriorate. Many people who have glaucoma aren’t aware, Dr. Young said, but it can eventually cause blindness if untreated. If Dr. Young had his way, he would prefer annual visits. The more regular the checkups, the sooner he can catch something in the early stages, he said. “Do you see your dentist every two years?” he said. “I mean, come on! I would think you should be seeing your eye doctor once a year.” Seems reasonable to me. I’m making my appointment now. Like this email?
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