Why taking care of eyes is an everyday job

India is the 'blind capital of the world'

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India is the ‘blind capital of the world’ due to a high prevalence of avoidable blindness. Besides loss of vision we also have high rates of moderate to severe vision impairment. Dr Bela Kamboj, our expert for this column attributes a lot of this to ‘pseudo literacy’ about eye health and our penchant for doctor shopping till we find one who is willing to tell us what we want to hear. Regular eye check-ups must figure on our list of health checks, and we must accept changes that come with age and hormones. She also tackles some of the most popular myths and marketing gimmicks about eye care.

Allow the eyes time to self-heal: Not every redness/irritation of the eye is indicative of an infection. Towards the end of last year, many people self-medicated or took drugs on the prescription of chemists to treat ‘eye-flu’. A flu virus always comes back with some genetic modification. This time, it required no treatment and healed within two to three days. But with medication, it took one week to two months. Also, self-medication by antibiotics or steroids caused loss of vision for many. Continued, unsupervised use of such drugs lowers the immunity, could make you more prone to infections and lower your body’s response to the medicine when you really need it.

Eye make-up: Ideally kajal should not be applied at the rim of the eyes. Apply it outside. Eyelids have glands and their openings are on the margins of the eyelids. When the glands are clogged (because of the particles in kajal), they are unable to make/drain tears and can also cause stye. The best way to clean eye make-up is using just water. Look upward and pull the lower eyelid down, swab a cotton bud with water and gently remove the make-up. Sometimes, when a patient is listed for LASIK, we instruct her not to use kajal for a week to 10 days because that is how much time it takes for the eyelid to clear up completely.

Dr Bela Kamboj is an eye surgeon who has studied at Lucknow’s King George’s Medical University and the Manipal Academy of Higher Education. A fellow of the LV Prasad Eye Institute, Hyderabad, and Sankara Nethralaya, Chennai, she is an avid painter and bird photographer | Puja Awasthi Dr Bela Kamboj is an eye surgeon who has studied at Lucknow’s King George’s Medical University and the Manipal Academy of Higher Education. A fellow of the LV Prasad Eye Institute, Hyderabad, and Sankara Nethralaya, Chennai, she is an avid painter and bird photographer | Puja Awasthi

The importance of tears: Every time we blink, a thin layer of tears (tear film) is formed across the cornea. Tears provide oxygen and nutrition to the eyes, contain good bacteria and have naturally produced antibiotics. There are three layers of tears―an oily outer layer which keeps the cornea smooth, a watery middle layer which nourishes the eye, and an inner layer of mucus which helps the tear stick to the eye. If you have tears coming out of the corners of your eyes, these are not excess tears but symptomatic of some other problem. You might be touching your eyes too often, or these could be brought on by the excess use of chemicals (in make-up) or be indicative of dry eyes.

Dry eyes: This is a condition when your eyes do not produce the required amount of tears or there is something impacting a layer of the tear film. The most common symptoms are a feeling of grittiness, and the need to rub eyes or to splash them with water. Dry eyes can happen at any age but they become more common with women as they age and the production of oestrogen falls. The most common treatment is to use an eye lubricant. Splashing one’s eyes with water is the worst thing that can be done, as it just wipes off the naturally produced tears.

The myth of clean eyes: Splashing your eyes with water is not recommended. The blinking action is a natural eye cleaning mechanism as tears are produced and wiped off constantly. Think of it as your eyes being mopped naturally. Avoid putting in random things like rose water or eye drops.

Can one be too young to get spectacles? No. Parents often argue that a young child cannot manage spectacles. The counter is that if a child can see better with spectacles she will manage it, too. Also, do not get expensive glasses if management is a worry. The sooner a problem is identified and the sooner it is addressed, the surer we can be of nipping further problems.

Almost everyone over the age of 40 will require spectacles: We must make peace with the fact of ageing, though there shall always be exceptions. After 40, one should get one’s first eye checkup if never done earlier. Subsequently, this should be done every 3-5 years. As we age, the lens in the eyes becomes less flexible and is unable to focus light correctly on the retina. To patients who are resistant to glasses, there are options like contact lenses. To those who refuse to accept ageing, I tell them if they choose not to use glasses and strain their eyes, they will develop deeper lines/wrinkles near their eyes and appear even older.

The benefits of eye checkups: The eye is the only organ that when examined can detect other problems as well. For instance, if there are deposits on the blood vessels in the eyes, it is likely that the person has high levels of cholesterol. Similarly, if the retina’s blood vessels are leaking, it is an indication of diabetes. Certain cancers also show changes first in the eyes.

We will all develop cataract: With age there will be the development of a cloudy area in the lens of the eye. However, while everyone will get cataract, not everyone will require surgery for it. For example, if your work requires use of near vision (goldsmiths, tailors), you will require surgery quickly. Or suppose you drive during the night and the glare becomes unbearable, then you would require surgery. However, if you have enough clarity of vision to carry on normal activities, surgery is not required. Earlier, surgery would be delayed till the cataract was fully mature. However, now we do it as early as required so that the incision is small and healing is faster.

Glaucoma: This is a group of eye diseases that damage the nerve connecting the eye to the brain because of fluid build-up which in turn exerts pressure on the eye. The two most common forms are open angle, which has no symptom except gradual vision loss, and angle closure, which has more marked symptoms like nausea, severe eye pain and sudden blurry vision. If left untreated glaucoma will lead to blindness.

Too much screen time is ruining our eyes: No. We only need to look away from the screen for 20 seconds every 20 minutes. It is a marketing gimmick that blue ray glasses are helpful. All they do is soothe the eye as the screen does not look as bright. The same impact can be achieved by reducing the brightness of our screens. I am yet to come across a patient who has shown marked difference because of the use of such glasses. In fact, such glasses can impact the contrast sensitivity of some patients. We need to think and blink during screen time.

The loss of the blackboard: More and more schools now use white boards. Children not sitting directly in front of such boards can struggle with light refection and glare and thus are unable to clearly see what is written on the board. Such boards also develop scratches with time.

What kinds of glasses are must: Night vision glasses (the ones with a yellow coating) should be used while night driving. The level of UV protection that we need from glasses varies. Most of us are not even up during sunrise (when UV rays are most harmful). These become more important when in the hills. While a pair of glasses that cost Rs100 will definitely not have UV protection, it does not mean that branded is better. Branded glasses will have better scratch resistance, look better but will in no way give you new eyes―that is more a function of marking the glasses precisely so that the lenses can be placed in the frame properly. Those who work on construction sites, those who use their helmets without visors and those who play sports such as squash, tennis, badminton or lawn tennis, and those who swim or cycle should also wear glasses.

Vision versus power: How much you can see is vision. What you use to see better is power. Thus, our spectacles have power; while near sightedness and far-sightedness are forms of vision.