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Can Too Much Coffee Cause Glaucoma?

Can too much coffee cause glaucoma? Yes, no, and maybe. A recent study published in the June edition of Ophthalmology determined that consuming large amounts of caffeine daily increased the risk of glaucoma by more than three fold for those with a genetic predisposition for higher eye pressure. Glaucoma is the leading cause of blindness in the United States and often goes undetected for years since it’s first impact is on peripheral vision. Although many factors contribute to glaucoma, high intraocular pressure is an important risk factor in the disease as well as being the primary target of glaucoma drops whose goal is to decrease elevated eye pressure. Researchers studied the relationship between caffeine, eye pressure and patients who had glaucoma, and concluded that caffeine intake was not associated with causing glaucoma or high eye pressure overall, BUT, in patients with a high genetic predisposition to elevated eye pressure, greater caffeine consumption was associated with higher eye pressure and higher prevalence of glaucoma. So how much caffeine are we talking about? The study determined that patients who consumed more than 321 mg of caffeine (about 3 cups) were at risk for high eye pressure and glaucoma, but again, only if they were in that high genetic risk category. 

March Is Workplace Eye Wellness Month

20-20-20 Rule

Prevent Blindness, the nation’s leading volunteer eye health and safety organization has declared March as Workplace Eye Wellness Month. In a pre COVID world this topic would be geared mostly to work environments such as construction or medical labs, but now that working from home has become the new normal during the pandemic, it is crucial to address the specific challenges associated with working remotely. 

In a work setting such as manufacturing or construction, OSHA (Occupational Safety and Health Administration) requires employers to provide eye and face protection against chemical, environmental, radiological and mechanical irritants and hazards. Various forms of safety eyewear include prescription and non-prescription safety glasses, goggles, face shields, welding helmets, and full face respirators. 

WFH (working from home) has created increased awareness of a common condition known as computer vision syndrome (CVS). Symptoms of CVS include blurred vision, eye strain, headaches, and tired, burning, itchy eyes. Home offices which are often just the kitchen table or a folding chair and desk set up in the basement lend themselves to poor ergonomics which also contributes to exacerbating digital eye strain. 

Some tips to reduce symptoms of CVS include:

  • Placing computer screens 20-26” away from the eyes and below eye level
  • Computer glasses with antireflective coatings and blue light filters
  • Following the 20-20-20 rule – every 20 minutes look 20 feet away for 20 seconds 
  • Using high quality artificial tears for dry eye

January Is Glaucoma Awareness Month

Glaucoma is one of most misunderstood eye diseases that eye doctors treat. Most people have heard of glaucoma and know they don’t want to have it, but I’ve found that most of my patients aren’t really sure how it damages vision or how it gets treated. 2.7 million people in the United States have glaucoma and it is the second leading cause of blindness.

Certain types of glaucoma are painless, which gives the disease the dubious distinction of being called “the sneak thief of vision”. It is a disease that damages the optic nerve in the eye causing progressive loss of peripheral vision, and by the time someone notices that they have lost portions of their visual field it is too late, and that visual loss is irreversible. One of the variables that causes the optic nerve to sustain damage is elevated intraocular pressure. If the pressure in the eye is extremely high, the eye will be painful, but the majority of patients only have moderately elevated pressure and will not know it is high until it is detected on a routine eye exam. Factors that increase the risk of developing glaucoma include being African American, having a family history, hypothyroidism, being over 60, and previous eye trauma. Typically, the initial treatment modality is using eye drops that lower the intraocular pressure,  but more advanced or complicated cases may need laser or surgery.

A disease such as glaucoma is a perfect example of why everyone needs routine eye care, even if they have 20/20 vision, since evaluation of the optic nerve, peripheral vision, and eye pressure measurements in the office are key to preventing devastating and permanent vision loss. 

How To Combat M.A.D.E. (Mask Associated Dry Eye)

Aside from staying home with minimal to no contact with the outside world, face masks, hand washing, and social distancing remain the key ways to slow and prevent the transmission of COVID-19. The most common complaint I hear from my patients relating to their eyes and the usage of masks has been foggy glasses, but an interesting study recently published by C.O.R.E. (Center For Ocular Research and Education) found an increase in dry eye and ocular irritation in people who wear masks for long periods of time. The reason for this has to do with the mechanics of mask wearing. When a mask is worn, especially when it is worn loosely, air flow from our breath is directed upwards towards our eyes and has the potential to cause the tear film to evaporate and cause dry eyes. This upwards flow of exhaled air  is also what causes glasses to fog. 

So what do we do? The first thing is to make sure your mask fits really well over your nose. Patients have asked me how I function wearing a mask all day vis-a-vis the fogging and I show them that when I have my mask on I wear it high on my nose with the wire on top sealed in such a way that air is not constantly escaping from the top. Other ways to seal the mask are by using a cool adhesive called Nerdwax or actually taping the mask on top. If your eyes feel dry, use a high quality artificial tear 3-4 times a day and make sure you remember to blink!  Lastly, the use of digital devices also contributes to dry eyes so make sure you are taking breaks during the workday.

Makeup Tips For Contact Lens Wearers

cosmetic products

This month’s post was originally going to discuss eye makeup tips for everyone, whether you wear contacts or not, but an interesting patient encounter last week prompted me to address contact lens wearers first. A young woman came in for her yearly eye exam and contact lens renewal complaining that a few hours after putting her contacts in her eyes the lenses became foggy and she had trouble seeing. She was wearing a two week lens, meaning she takes it out every night and cleans it and puts in a fresh lens every two weeks. This kind of contact lens usage can lead to a condition called GPC (giant papillary conjunctivitis) where one becomes sensitive/allergic to the proteins that build up on the lens over time. At first I thought this is what she had but when I looked at her contacts under the biomicroscope I immediately saw that her contacts were coated with bronze shimmery deposits that looked nothing like anything found in nature and everything like someone took blobs of makeup and threw them on her contact lenses. This prompted a conversation about her makeup habits, which actually were not bad except that when the problem would not go away she decided to put her makeup on first and then put the contact lens in. Bad move, it only made things worse. Next month we will talk more about makeup and eyes but here are some quick tips specifically about contacts and makeup.

  1. Contacts first, makeup second, and wash your hands first!
  2. Using primer on your lids prevents eye shadow from creeping into your eyes and onto your contacts, I like the one by Urban Decay.  
  3. Do not use eyeliner on your waterline – it will clog every oil gland you own and cause dry eye as well as migrating onto your contacts. 
  4. Use high quality eyeliner – I love Urban Decay 24/7, NYX waterproof retractable eye liner and Marc Jacobs Highliner gel eye crayon – they stay put without sliding around.  
  5. At the end of the day remove contacts first then remove your eye makeup.
  6. Daily disposable contacts will help prevent sensitivity to accidental buildup of anything on your lenses, whether it be makeup or proteins, this is the safest and healthiest way to successfully wear contact lenses.