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.

Can I Swim In My Contact Lenses?

woman in water clearing his face of waterNo, 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.

Do I Have Pink Eye?

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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:

  1. 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.
  2. 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.
  3. 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.  

Contact Lens Health Week

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Although we have talked about good contact lens hygiene in the past (remember the underwear analogy?) in honor of Contact Lens Health Week (August 20-24) I will reiterate some of the dos and don’ts of proper contact lens usage.

  • Don’t sleep or nap in your contacts. Ever. This kind of risky behavior increases the chances of contact lens related eye infection by 6-8 times. These types of eye infections can lead to using drops hourly, vision loss, and surgery. Just Don’t Do It.
  • Wash your hands before putting your fingers in your eyes to touch your contacts.
  • Daily disposables are the healthiest modality of contact lens wear. If you do wear bi-weekly or monthly contacts make sure you are using fresh solution in your clean case every day and don’t wear your contacts beyond the recommended wear schedule. Yuk. An old dirty contact lens can also cause infections.
  • No swimming or showering with contact lenses. Microbes in water can adhere to contacts and cause…you guessed it – terrible eye infections.
  • If your eye hurts or looks red or weird don’t put your contact lenses in your eye and hope for the best – make an appointment ASAP with your optometrist.
  • Make an appointment yearly to see your optometrist. Not all contact lens related complications are visible to the naked eye and a thorough professional evaluation is necessary to ensure your eyes are getting enough oxygen and have no corneal defects.

#onepairtakecare – you only get one pair of eyes – treat them well!

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Orange You Glad You Ate An Orange?

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Eating just one orange a day can slash your risk of developing macular degeneration by 60%. A recent study in the American Journal Of Clinical Nutrition followed 2,000 patients over the age of 50 for 15 years and found that the patients who ate an orange a day had a significantly decreased risk of AMD (age related macular degeneration) compared to those patients who ate no oranges at all. Usually research involving oranges concentrates on the effects of the vitamin C, E, and A the oranges contain, but this study put an emphasis on theflavonoids found in oranges. Flavonoids are powerful antioxidants that have immune and anti-inflammatory effects and are found in most fruits and vegetables. sliced orange fruits on round white ceramic plateThe study examined other foods that have flavonoids such as tea, apples and red wine (yes please) but for some reason oranges were the only food that aided in the prevention of AMD. The authors of the study acknowledge that more research has to be done before doctors can definitely prescribe an orange a day to keep AMD away.

https://academic.oup.com/ajcn/advance-article-abstract/doi/10.1093/ajcn/nqy114/5049680?redirectedFrom=fulltext