Alcohol-based sanitisers, apart from masks, have become our shield against Covid-19. But how safe are these liquids, gels and foams? A study conducted by a team of researchers at Narayana Nethralaya, Bengaluru, throws light on the potential side-effects of hand sanitisers on the eyes. “Sanitiser kills the virus, as it does other cells,” says Dr Rohit Shetty, the study’s lead researcher. “Frequent and obsessive use of hand sanitisers could damage a lot of cells in the eye. It could cause intermittent redness and irritation of eyes, without any eye discharge or signs of infection.” These issues owing to overuse of hand sanitisers have been clubbed as Sanitiser Aerosol Driven Ocular Surface Disease in the study, which was published in the Indian Journal of Ophthalmology.
“When you press the nozzle of the sanitiser, a lot of aerosols get generated,” says Shetty, a clinician-scientist, ophthalmic surgeon and vice chairman of Narayana Nethralaya. “If you are using the sanitiser in a closed, air-conditioned environment, you get exposed to the aerosol, which, in turn, could lead to a chemical reaction. Hand sanitisers are able to kill the virus because they are so strong. In case they go into your eye, they can burn off your cornea. So, we have to be very careful about how they are used.’’
It all started with a phone call from a patient, recalls Dr Pooja Khamar, a clinical and translational scientist who works as a consultant in cataract and refractive services at Narayana Nethralaya. Manushi Dhawan (name changed), 43, and her 14-year-old daughter had episodic redness, irritation and burning sensation in both eyes for a few weeks. Dhawan consulted Khamar on the tele-ophthalmology platform.
“On video examination, we found mild conjunctival congestion, but no obvious infection,” says Khamar. Dhawan, she says, denied any recent change in toiletries or cosmetics, but she confessed that “just to be on the safer side and to maintain hygiene, she and her daughter had been using a hand sanitiser spray almost hourly.”
Khamar and her team saw more patients with similar complaints in the following weeks. Jitendra, 35, had classic symptoms of Sanitiser Aerosol Driven Ocular Surface Disease. His distant relative living abroad was suspected of having Covid-19, and Jitendra, afraid of contracting the disease, would use hand sanitiser more than 20 times a day.
Shetty fears things may get worse once the lockdown is lifted. Every workplace has stocked up on sanitisers. On entering the office, the first thing most people do nowadays is squirt sanitiser generously into their hands and rub them as vigorously as they can. “Each time you press the nozzle, chemicals disperse into the air and they get into your eyes,” warns Shetty.
Frequent use of hand sanitisers could also raise the risk of dryness of eyes and discomfort during regular work. People predisposed to allergy (for instance, those with dermatitis or asthma) must take extra caution, for the response can be quicker and more aggressive in them. Aerosols can affect pets, too.
Sanitisers have become an essential in these pandemic times. But it is important to use them judiciously and carefully to prevent complications.
Eye care
· Keep your eyes closed while pressing the nozzle of the sanitiser and while rubbing your hands.
· Make sure the sanitiser is kept below the eye level during usage.
· Avoid using sanitisers in a closed room with the air conditioner on.
· In case irritation occurs, use lubricant eyedrops.