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Tanning Bed Users: Watch Out for Your Eyes

Recently the British College of Optometrists have come out with an updated warning: people are putting their eyes at serious risk by skipping out on wearing protective goggles or shades when they hop into their local tanning bed.

Tanning bed users, be warned!  Any means of seeking the perfect tan, including tanning beds, can cause malignant melanoma, an aggressive and potentially fatal form of cancer that metastasizes to the brain.  Melanoma is a lethal possible outcome of sun- and fake sun-worshipping, but your eyes are at risk, as well.  Closing your eyes while lying down is not enough protection – your eyelids are extremely thin and therefore some of the sun’s rays pass right through them.  If you’ve read my previous article on Healthy Eyesight, I talked about how UVA and UVB rays from the sun are extremely damaging to eyes and therefore make wearing sunglasses necessary.  Tanning beds pose even more of a risk to eyes, since the ultraviolet light used in these beds produce concentrated UVA and UVB rays directly upon your face.  So, leaving out the protective goggles before climbing in is a major no-no.  You should be treating your eyes in a tanning bed the same way you would when heading out to the beach – protect them with sunglasses!  Standard UVA- and UVB-protected shades are readily available at your local drugstore.

Repeatedly exposing your eyes to the UVA and UVB rays in a tanning bed without protective goggles can lead to growths on the eye, cataracts, ocular melanoma and potentially cause long-term damage to your eyesight.  Even if you’re a contact lens-wearer and have UV protection built into your lenses, they do not cover the entire eye and therefore you are still exposed to dangerous UV rays.  Take my advice and goggle up!  Risking your skin is already scary enough; you don’t want to harm your eyes.

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Sources:

https://www.google.com/hostednews/ukpress/article/ALeqM5gPqkxbjWsuW8otNRWYFbH4eSedaQ

https://www.medindia.net/news/Sunbeds-Could-Cause-Eye-Damage-72803-1.html

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Tap Water Poses Threat to Contact Lens Wearers

Swimming, hot tubbing, and showering – what do all three of these activities have in common?  If you wear contacts, the answer to this question is not necessarily Happy Fun Water Time.  Tap water, hot tub water, and the ocean can all harbor a little culprit known as Acanthamoeba, an amoeba (a microscopic, single celled animal) that is commonly found in sources of tap water. These amoebas are generally rare in humans, but they can make their home in the space between the eye and the contact lens where they form severe infections in the eye known as acanthamoeba keratitis.

Acanthamoeba keratitis is the disease from an Acanthamoeba infection that can lead to severe pain and eventually blindness. Some of the symptoms reported are red irritated eyes, sensitivity to light, cloudy vision, and that niggling sense that there’s a foreign object in the eye. In the beginning stages of Acanthamoeba Keratitis it can commonly mistaken for other diseases such as conjunctivitis (see our post on pink eye).  However, one of the primary differences is a white ring on the cornea in advanced stages of the infection.

Here’s an  Animal Planet clip that shows a little of what it’s like to have the infection:

As scary as it seems, don’t be alarmed – acanthamoeba keratitis is easily preventable. Just follow these simple guidelines that help prevent eye infection:

  • Always wash your hands prior to handling your contact lenses.
  • Never expose your contact lenses to tap water – this means no swimming or showering with them on, and of course no cleaning them or soaking them in tap water!
  • Be sure to use the disinfecting solutions recommended by your doctor to properly clean the lenses daily.  Heat disinfection systems and hydrogen peroxide systems with at least two hours contact time are effective, but common chemical disinfectants are ineffective against acanthamoeba.  Also, don’t forget to clean and/or replace your lens case at least once a month.
  • Be sure to follow directions when using your contacts. If it says dispose daily, do not reuse them!

Prevention is the best weapon against acanthamoeba keratitis, because once you’ve become infected, the ameoba is extremely resistant to antibiotics.  In fact, patients are commonly treated with FOUR anti-amoebic agents, one of which is ophthalmic-grade swimming pool cleaner, as disgusting as it may sound.  I know I don’t want to have to take pool-cleaner drops every hour, do you?   One of the best ways I can think of preventing such issues with contacts is to eliminate them altogether – why not come in for a free consultation for LASIK?  You’d be amazed at how many contact lens-wearing patients have come in for LASIK after experiencing a corneal ulcer – the pain was so unbearable that they never wanted to risk wearing contacts again.

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Short Arm Syndrome, or Why Can’t I See Anymore?

What is Presbyopia?

Presbyopia is a condition of the eye where a progressive loss of magnification ability results in the inability to see near objects.

What causes it?

Presbyopia is caused by the hardening of the crystalline lens of your eye and occurs in a predictable fashion as a result of the natural process of aging.  The first symptoms of presbyopia normally occur between ages of 40-50 and the ability to focus on near objects continues to decrease.  In fact, if your eyes have a distance prescription of zero (“plano” in ophthalmology terms), you will first need reading glasses very predictably at 42 or 43 years old.

What happens if I have…

Myopia (nearsightedness) and Presbyopia?

If you’re myopic, as you age, you lose the magnification power of your lens just like any other person.

If you’re over 42 and wearing single vision distance contact lenses, you’ll notice that you have to hold things farther away when you’re wearing contact lenses for distance and trying to read, or that you need reading glasses on top of your contact lenses to see well up close.  You’ll also notice your presbyopia symptoms when you’re wearing glasses and have an irresistible urge to take them off to read.

Hyperopia (farsightedness) and Presbyopia?

If you’re a latent hyperope (person with farsightedness who doesn’t need glasses for distance until they get older), at a young age you probably had the best distance vision out of all of your friends.  However, as you get older, you need reading glasses far earlier than most people in your age group (even by your late 30s).

Here’s how it works:  hyperopes who don’t wear glasses in the distance are using their magnification power just to see far.  As you age, the lens in your eye becomes less flexible, decreasing its ability to magnify.   So, you’re a latent hyperope in your late 30’s  sitting in a chair, looking at the beautiful view, using most of your magnification power just to see far.  Now, you pick up something to read, and whammo!  It’s blurry.  This scenario happens earlier to untreated hyperopes than myopes (nearsighted people) or emmetropes (people who have no need for prescription in the distance) because their accomodation (ability to magnify) is already used up from looking far, and there’s not as much left to magnify to read.   Eventually, when the hyperopia is high enough or you get old enough, combining hyperopia and presbyopia blurs both your near vision and your distance vision.


What are the possible treatments for my eyes?

Bifocal spectacles – The most common type of bifocal spectacle is the Flat Top Bifocal and is comprised of two segments: one for far vision and one for near.  The segments are available in different sizes according to the field of vision you need to see.  The other bifocal “with line” spectacle style is the Executive Bifocal.  The lenses are also split into two segments, with a dividing line across the width of the lens.  They do not allow for a continuous range of vision and sometimes cause blurriness.  A third type of bifocal is the progressive or “no line” bifocal.  This is the type people are wearing when you see them bobbing their heads and looking for the sweet spot in their spectacles for focusing at that exact distance.

Monovision contact lenses – With monovision contact lenses for presbyopia, each eye is treated differently.  One eye (most commonly the dominant eye) is corrected for distance vision and the other eye is corrected for near vision.  Ideally, your brain will choose the magnified image and provide your eyes with what appears to be continuous, smooth vision.  However, Monovision contacts can sometimes cause a loss of depth perception which patients find difficult to adapt to.

Monovision LASIK or PRK – LASIK or PRK surgery is used to permanently correct one eye for near vision and the other eye for distance vision.  Monovision after LASIK or PRK tends to be better accepted by patients than contact lens monovision because the patient’s visual experience is the same all the time.  During LASIK surgery, a flap is created on the surface of the cornea (the front layer of the eye).  A laser is then used to re-shape the cornea back into a natural shape so that it focuses light more efficiently, and then the corneal flap is put back in place.

During PRK surgery, the surgeon removes the epithelium of the cornea altogether, and after the procedure, bandage contact lenses are worn to help in healing the epithelium.

About 10% of presbyopic patients prefer single vision distance correction over monovision.  I spend a great deal of time and care getting your prescription right (this includes whether to go with Monovision or not) and if so, the right amount.  I spend a significant amount of time learning about your daily activities and do my best to simulate your results so that you will be thrilled with the end product.

Most people find that they can adjust to Monovision LASIK or PRK far easier than contacts because the correction is 24/7, without the hassle of taking out and putting in contact lenses.  For the remaining 10%, single distance vision after LASIK or PRK with “drugstore readers” is an excellent choice.

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Sources:

https://www.seewithlasik.com/docs/presbyopia/presbyopia.html

https://www.pendletoneye.com/errors.htm

https://www.webmd.com/eye-health/tc/farsightedness-hyperopia-what-happens

https://www.docshop.com/education/vision/refractive/monovision/

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Pediatric Pink Eye

Your child wakes up in the morning and cries out because she cannot open her eyes.  You run to her and notice a thick lining of mucus along her eyelids.  You wipe off her eyes with a damp towel and inspect further – what are normally the “whites” of her eyes are now an angry red.  What is going on here?  Should you call the doctor?  What’s your next course of action?  Can your kid still go to school?

First things first – your child has the textbook symptoms of pink eye.

Wait… pink what?

“Pink eye,” a lay term for conjunctivitis, is an inflammation of the conjunctiva, the clear tissue covering the white of the eye and the inner eyelids.  Inflammation of the eye causes redness, hence the name pink eye.  The inflammation can be caused by an incredibly wide variety of conditions, including something in the eye, chemical irritation, trauma, uveitis (an inflammation of the eye that extends inside the eye), episcleritis (inflammation of the surface of the eye) , allergy, viral infection, bacterial infection, and inflammation of the eyelids (blepharitis).  More serious conditions inside the eye can also cause a red eye, such as endophthalmitis (infection inside the eye) and tumors.  The most common types of conjunctivitis in children won’t  cause any long-term visual damage, and will go away on their own.

Why does your child have it?

It’s pretty hard to tell what kind of conjunctivitis your kid has just by looking at the eye, but maybe this will help:  viral conjunctivitis has  a mild amount of watery discharge, whereas bacterial conjunctivitis has a small amount of white or yellow or green discharge.  Allergic conjunctivitis has a great deal of watery discharge in many cases.

There are many possible ways your child could have contracted pink eye. The source could be from everyday bacteria and viruses to allergens and irritants in the environment (such as chlorine and smoke).  Everything your child touches with their hands can be easily transferred to the eye, resulting in irritation, and then inflammation.

What should you do?

If your child has white or yellow or green discharge from the eye rather than clear, take her to the pediatrician or ophthalmologist for evaluation.  If the discharge is clear but the eye is incredibly painful, take her to the pediatrician or ophthalmologist.  If the eye is itchy or mildly irritated and has a clear discharge, care for it as below and wait a couple of days to see if it begins to improve.  Viral conjunctivitis is like a common cold of the eye.  It may look bad, but it clears on its own rapidly after passing to the other eye and everyone your child knows!  (Or at least it can seem that way.  See below how to lessen the spread.)

Pediatric pink eye treatment is generally uncomplicated. Antibiotics cure pink eye that is caused by bacteria.  Allergy medications treat allergy-induced pink eye.  Viral pink eye normally goes away on its own, and antibiotics are not necessary.

What can you do immediately to lessen the symptoms?

A clean, cool, moist towel can help soothe irritation and pain.  This can also be used to remove the crusty discharge that clings to the eye in the morning. The moist towel should soften the dried discharge.  Then you can use a cotton ball or q-tip to clean the edges of the eyelid.  One MAJOR point to remember: always fully wash and sanitize your own hands after cleaning your child’s eye or touching the washcloth that touched her eye – DON’T touch your eyes until you’ve washed your hands.  Pink eye can be extremely contagious.

 

Can your child still go to school?

Unfortunately, not if your child has viral conjunctivitis.  Since viral pink eye is extremely contagious, schools require a doctor’s note before your child can resume classes.

 

What can I do to prevent my child from getting pink eye again?

One of the best ways to reduce the likelihood that your child will contract pink eye is to reinforce hand-washing and to teach them to keep their hands away from their face and eyes.  As a parent, I know this is easier said than done!  Cutting down on sharing of towels, pillows and other near-face items also helps prevent contamination.

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How Long Does LASIK Eye Surgery Take?

LASIK surgery takes very little time to complete.  On average it takes about twenty minutes from the time my patient enters the operating room to when he or she gets up and leaves.

This means that the actual surgery takes an even shorter amount of time – each eye normally takes me 5-7 minutes to complete.

Most of my patients are amazed at how quickly the surgery is accomplished and even more amazed at how they notice a drastic improvement in their vision the same day.  But that’s how it works at La Jolla LASIK Institute – I provide efficient, professional medical services and deliver excellent results.

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“Get the Red Out” Drops – Not as Great as You Think

You’ve all seen the commercials for different drops available to “get the red out” of your eyes and you may have used them on yourselves and your kids – from Visine to Clear Eyes to Rohto and many more.  These drops seem great because they promise to eliminate the symptoms of red eyes, but are you aware of their side effects?

The active ingredient in “Get the Red Out” drops is a vasoconstrictor, which makes blood vessels shrink temporarily.  The problem is something called “reflex vasodilation.”  When the drop wears off, the constricted blood vessels relax, often bigger than before.  This may make you want another dose to achieve that whiteness again, and when that dose wears off, your eyes will be even redder, again.  So the vicious cycle goes, on and on.

Contact lens users really shouldn’t use “get the red out” drops.  Since contact lenses already significantly reduce oxygen flows to the eye, adding a vasoconstrictor drop into the mix only makes your eyes drier (narrowing blood vessels leads to less oxygen delivered to the tissues).

While these drops are good for an immediate aesthetic touch-up for special occasions such as a headshot or big event, I don’t recommend using them on a daily basis.  Don’t get trapped into rebound redness that leads you to reach for more drops and leaves you in a vicious cycle – it is possible to become extremely dependent.  Over time, the blood vessels in your eye will get damaged and your eyes will only get redder with continued use.

I recommend artificial tears like Systane or Theratears.  While artificial tears do not necessarily get the red out, they will most likely wash out what’s irritating your eyes and therefore what’s causing the redness.

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Sources:

https://healthmad.com/conditions-and-diseases/should-you-use-visine-eye-drops-if-you-have-dry-eyes/

https://www.allaboutvision.com/conditions/dryeye.htm