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.
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.
No, no and no. Not only can you not swim in them, but you can not expose your contact lenses to any type of water at all. This includes tap water, oceans, swimming pools, lakes, hot tubs, and even showers! Soft contact lenses absorb not only the water, but any viruses, bacteria, or other microbes that are living in the water. Although rare, an organism called Acanthamoeba which lives in impure water can attach itself to your contacts and cause your cornea to become extremely infected and inflamed and can cause permanent vision loss and/or a corneal transplant if not treated quickly and aggressively. A couple of weeks ago a young man from the UK shared his personal story of how he contracted Acanthamoeba – he initially thought he just scratched his eye putting in his contacts, but instead of getting better over time it got worse. Ultimately he was diagnosed with Acanthamoeba keratitis and even after months of different treatments and procedures he unfortunately lost the vision in his eye. The doctors concluded that he contracted the infection because he showered daily in his contact lenses. Although this is definitely a worse case scenario at the very least the water can cause your contacts to tighten up on your eye and create discomfort or can wash away your natural tears causing dry eyes. Waterproof well fitting swim goggles can be worn over contacts but an even safer option is to purchase a pair of prescription swim goggles to eliminate all risks of contamination.
Okay guys, here’s the scoop – there is no such thing as pink eye. Oh sure, your eye can be pink, but “pink eye” is not a diagnosis, it’s a description of the way your eye looks. So now that we’ve cleared that misconception up, what causes eyes to become pink?
One of the most common causes of pink (or red) eyes is some form of conjunctivitis. The term conjunctivitis is also very nonspecific and vague – so let’s break it down into more understandable terms. The conjunctiva is the clear thin covering of the white part of the eye and the insides of the lids and the term “itis” derives from the Greek and means “inflammation of”. So quite simply, conjunctivitis means that the white part of the eye is inflamed, and when body parts become inflamed, they get red or pinkish. There are three main forms of conjunctivitis:
- Bacterial Conjunctivitis – like it sounds, it’s caused by bacteria – not only is the eye red but there is usually green discharge as well that can cause the eyes to be glued shut upon awakening in the morning. This is pretty contagious and is treated with topical antibiotic drops or ointment.
- Viral Conjunctivitis – caused by viruses, the eyes are watery, red and sometimes itchy. This is also very contagious and since it is a virus, antibiotic drops don’t work. This usually runs its course over a week or so – cool compresses and artificial tears can be helpful.
- Allergic Conjunctivitis – the hallmark symptom of this type of conjunctivitis is unbearable itching. Usually this is a reaction to pollen or ragweed during peak allergy season (spring or fall) or to pets, dust, or other known allergens. It is not contagious and can be treated conservatively with cool compresses or high quality artificial tears. Oral antihistamines are helpful if there is also nasal congestion and sneezing, prescription eye drops work best if it only affects the eyes.
Other causes of pink or red eyes are dry eye and blepharitis (inflammation of the eyelids) as well as contact lens complications which can range from infections to corneal ulcers. Environmental causes of pink eye are irritants such as dust, smoke, air pollution and chemical exposure. It is important not to self diagnose or use somebody else’s eye drops. If your eyes get red or pink and your symptoms are getting worse or not going away it is important to have your eyes checked by an eye doctor to ensure proper and prompt treatment.