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.

New Contact Lenses Prevent Sight From Worsening!

asphalt road between trees

When I was eight, my eye doctor prescribed glasses for me to see the blackboard. The truth was, my vision was so bad I should have worn glasses all the time, but my mother told me that wearing glasses would make my vision worse so I walked around in a blurry haze for ten years until I got my first pair of contact lenses. When my own daughter needed glasses at the age of six (bad genetics from her dad) I made sure she wore them all the time so she would not miss out on seeing the beautiful details in the world around her the way I did (love you mom). One thing that concerned me however was how quickly her prescription changed, sometimes every six months. Back then the idea of slowing the progression of nearsightedness was not even in its infancy and according to the conventional wisdom of the time I had her wear bifocals. Fast forward almost twenty years and controlling the progression of nearsightedness is now a reality. 

There are a couple of options out there such as Ortho K (wearing hard lenses overnight to reshape the cornea), atropine eye drops, and soft multifocal lenses with specific parameters to help blur certain parts of the vision and attenuate others. Although these modalities are FDA approved, they are not necessary FDA approved for myopia (nearsightedness) control. A few days ago CooperVision announced that they came out with a daily disposable soft multifocal lens called MiSight  which is specifically approved by the FDA for myopia control. This is a very exciting addition to our arsenal of myopia control tactics and one that I believe will be embraced by both parents and eye care professionals alike due to its ease of use and availability. As soon as I get more information on the accessibility of the lens I will post a little more on how the technology works and who would be a good candidate for this treatment.

Don’t Blame The French Fries!

bowl of french fries

Last month a story came out of England about a teenager who went blind from eating only junk food. I found this very interesting and bookmarked the article so I could blog about it when I had the time. Well oopsie, September passed by in a blur and the email I had saved with the link to the article got buried in my inbox until yesterday when in a frantic attempt to organize my life by starting with my work emails I encountered the article I had saved. After doing a little research on the story I was glad I waited to share the information because the initial story that most of the media outlets shared left out certain details that misrepresented the real lesson to be learned from this young man’s tragic vision loss.

The basic story is that a teenager in the UK whose diet consisted of Pringles, white bread, french fries and occasionally some ham lost his eyesight to a condition called nutritional optic neuropathy which like it sounds, develops due to the lack of the proper nutrients that the eyes need in order to function. Many of the articles used this story as a cautionary tale, admonishing junk food eaters and parents of picky eaters that this is what could happen if you don’t eat a healthy diet. Turns out the young man who went blind was not a “picky eater” but rather , he had an eating disorder called ARFID (Avoidant Restrictive Food Intake Disorder) which led to various nutritional illnesses. The media however jumped on the bandwagon of the evils of junk food and fad diets instead of using the story as an opportunity to bring awareness to the importance of detecting mental health disorders in children and teenagers. Does poor nutrition due to a diet limited to french fries lead to blindness? Absolutely that can happen, but this story was way more complex than simply blaming Pringles and fries. 

June = Cataract Awareness Month

pexels-photo-902194.jpegContrary to popular belief, a cataract is not an eye disease, rather it is a natural age related change to the lens of the eye which causes it to become opaque and difficult to see through. Generally cataracts are very slow growing and most commonly develop in people over the age of 55. Signs and symptoms can be subtle at first, ranging from blurry vision, glare from headlights, difficulty driving at night and frequent eyeglass prescription changes. Most people come into the office complaining that their glasses are not working when in reality they are experiencing blurred vision from cataracts.

So what exactly is a cataract? There is a part of the eye called the lens which is located behind the iris, the colored part of the eye and it functions to focus light on the retina. When we are young the lens is clear and flexible but as we age the lens becomes opaque or cloudy and consequently images on the retina become blurred. Cataracts can also form in patients with diabetes, smokers, and those on certain medications like steroids. There is no proven way to prevent cataracts but UV protection, smoking cessation and a healthy diet that includes antioxidants can help prevent their premature development.

pexels-photo-690887.jpegHow do we treat cataracts? When cataracts start to interfere with quality of life and ability to function, surgical removal of the cataract is indicated. The lens of the eye is removed and replaced with an artificial lens which greatly improves vision. The most common comment I get on the first day after the operation is how bright and beautiful colors look. As with any surgery there are risks, but we co-manage surgery with the best cataract surgeons in order to ensure the best possible outcomes.

Vitamin “See”

yellow health medicine wellness

If you’ve read enough of my blog posts, you’ve probably figured out that I am a little obsessed with both the short and long term effects that digital devices have on our eyes. I am particularly interested in the effects it has on kids since many of them are exposed to some kind of tech as early as the first year of life. Recently,  a company called EyePromise debuted a vitamin named Screen Shield Teen aimed at kids aged 4-17 that is a supplement meant to support and preserve visual comfort and wellness for this age group. The main ingredients are 5 mg of dietary zeaxanthin and 2.5 mg of lutein which are antioxidants that help eradicate free radicals produced by blue light and help protect the macular pigment which is crucial for developing eye health. The vitamin is a fruit punch flavored chewable that is gluten free and can be taken together with regular multivitamins. Increasing amounts of children and teens are coming into my practice with complaints of tired eyes, headaches and eye strain from too much screen time and aside from the common sense advice of decreasing screen time this vitamin could play a part as well in protecting young eyes from future damage. 

photography of women using mobile phones