Eyes On Eye Care Blog

Tablets, Computers and Phones: What Are They Doing to Your Eyes?

Electronic screens are hard to miss these days. They form the screens of our work and home computers, our phones, our tablets and even our watches are getting in on the electronic display action. With so many screens commanding our attention, the question is often asked about how they are affecting our eyes and if it is safe for our children to use them. This article looks at some of visual concerns that surround the use of screens and what you can do to protect your eyes.

How do computer screens affect our eyes?

Computer Vision Syndrome

Computer vision syndrome (CVS) is a commonly reported side effect from those who regularly use computer screens for prolonged periods of time. It is estimated that approximately 65% of adults that use computers have reported symptoms of CVS, which include headaches, double vision, blurring of vision, irritated/burning sensation of the eyes and eyelid twitching. Most of these symptoms are reported for sessions on computers that exceed 2 hours in duration, but can happen soon after you log on to your device.

Adults are not the only ones that can struggle with CVS, with screens now occupying many hours of our children’s lives. School work, homework, videogaming/social media, playing on the tablet and using the phone means they are looking at screen for extensive periods during their day.

Headaches and eyestrain are symptoms of computer vision syndrome

It is caused by the difference in contrast of the characters on screen to what we see on printed material. As the characters on a screen are less defined around the edges than their printed counterparts, the eyes find it hard to focus on them and opt to go to their minimal level of focus. They will then strain to see things sharper, before going back to this resting focus level. This alternating of focus continually acting upon the eye muscles leads to fatigue and spasm, which then form the symptoms of CVS.  

Additionally, our blink rate drops significantly when using a computer. We stop “looking” at the screen and start “staring” at it. Blinking is necessary to distribute lubricating tears across the surface of the eye and to maintain a clear and smooth optical surface. When our blink rate drops the eyes can become drier, meaning the optical surface is less smooth thus making vision blurrier. They also begin to feel uncomfortable as the eyelid finds it harder to glide across the front surface of the eye, causing the eyes to feel irritable and tired.

Struggling to focus? Blurry screen? You may be suffering

from computer vision syndrome

To tackle CVS, optometrists recommend that you take frequent breaks from your computer screen and follow the 20-20-20 Rule – that is for every 20 minutes of screen time, look at something 20 feet away for 20 seconds. This allows the eyes to relax from their fluctuating focus and allows some recovery from the excessive work they have been doing.

Furthermore, it is recommended that you try to be aware of your blinking and make a conscious effort to do it whilst working. In some cases, computer glasses can be prescribed by your optometrist to help you focus, but be sure to request the anti-reflective coating to reduce the glare from the screen.

Blue Light

Blue light is a hot topic for computer users as there is increasing evidence that it may adversely affect your eyes. Blue light falls within the visible light spectrum, but has much higher energy to it than the other colours. The light is emitted naturally by the sun, but is also radiated in moderate concentrations from the screens that we use.

Are you aware of the effects of blue light on your eyes?

So why are we concerned by blue light? Some studies have shown that blue light can harm the eyes by causing changes at the macula and the crystalline lens, however the evidence is patchy. Furthermore, the blue light waves in natural daylight far exceed the levels from the screens, so concern on this is low. There has been some link that blue light reaching the retina can affect the circadian rhythym (your natural body clock) – with the blue light tricking your body into thinking it is day time and thus keeping you awake later. This in turn can make you (or your child) tired and more irritable.

Cutting out screen time an hour before bed may just help you sleep better

There are ways to combat this blue light, with optometrists recommending stopping screen use an hour before bed time (for both you and your child), switching on “night mode” on some devices, which switches the overall colour tone of the screen towards red – thus lessening the effect of the blue light on the body clock. There are some coatings that can filter out blue light from your eyes and your optometrist or dispensing optician can advise you further on the ones that they offer. That aside, there is little to no evidence that they prevent eye disease or reduce the effect on the body clock.

Myopia (Short-Sightedness)

Myopia is the official term for short-sightedness and there is growing evidence that prolonged near tasks, such as screen use can lead to myopia developing. Current proven risk factors of myopia include ethnicity, family history and the environment (such as excessive time indoors or in environments where the long-distance sight is not regularly needed). At present, screen time alone has not been attributed as a direct cause, but must be considered a risk to children developing myopia. This is supported by the evidence that children that spend more time outdoors are less likely to be myopic.

2 hours a day of outside play may reduce the

risk of myopia developing

To protect against the possible risk of myopia development through screen time, optometrists are currently recommending that your child spends 2 hours a day (where possible!) playing or taking supervised walks outside. It is also recommended that parents limit their child’s use of screens throughout the day and to not let their children take their tablets or phones to bed with them. Optometrists advise that parents should book their children in for eye examinations at least every two years, or more often if recommended.

In summary, there are multiple ways that screens affect your eyes and with the above advice to hand, may just help you combat back!

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Now as an optometrist, I am not keen on solar eclipses due to the countless cases I hear about people starring at the sun and ending up with visual problems. On August 21st 2017, a total solar eclipse is due to occur across the USA and, providing clear skies, a partial solar eclipse will be seen in the evening hours in parts of the UK. These events are incredibly rare and a solar eclipse is something you may want to witness as this natural phenomenon is one of nature’s finest performances. Day will seemingly become night for a few short minutes; leading to birds roosting and street lighting turning on, before it becomes like day again – it is as if the Earth has forgotten what time it is!

Total Solar Eclipse - how do we see this phenomenal event safely?

Watching an eclipse safely is our main concern, as the sun’s intense light is strong enough to burn the retina and cause permanent sight loss – even during parts of the eclipse. In fact, the only time that the eclipse is safe to observe directly with the naked eye is when the moon TOTALLY eclipses the sun, which only occurs in certain areas and for only a few short minutes. In areas where there is only a partial eclipse (i.e. the moon doesn’t block out the sun entirely) then it is not to safe to look at directly at all.

An eclipse as seen through solar viewer glasses

So how can you safely observe the eclipse? The only way to observe it whilst looking towards the sun is by using solar viewing glasses (personal solar viewers), which are made of a material a couple of hundred-thousand times darker than sunglasses. The amount of light that gets through these viewers is minimal, allowing for a clear view of the shape of the sun without the dangerous levels of light and radiation that it gives off. Do not mistake these solar filters with sunglasses – your sunglasses are simply not dark enough to allow direct viewing of the sun. Ignoring this advice can lead to loss of your central vision – which will most likely be permanent.

The basics of a pinhole projector

Another way to observe the eclipse is via a pinhole projector – something that you can easily make at home by using a piece of cardboard and a sharp pencil. Push the tip of the sharp pencil through the card and make a small hole towards the centre of the card. Then with your back to the eclipse, hold the card above a light surface (another piece of paper or even the pavement/sidewalk). Your paper should cast a shadow, with the hole in the centre being illuminated. As the moon passes in front of the sun, the moon’s shadow will be copied through this pinhole and you will see it moving across the small light dot projected onto your screen. To make the image larger, hold the piece of card further away from the object you are projecting it on to. This indirect method is the safest way (other than watching it on TV) to observe the eclipse.

Be sure to visit your optometrist should you develop any visual 

problems after viewing the eclipse.

If your eyes do feel uncomfortable or if your vision drops after viewing the eclipse, do not wait around to see if it improves. Make sure you visit your local optometrist for a comprehensive eye examination to rule out solar related damage.

Protecting Your Eyes From Injury

In relation to the rest of your body, your eyes are small. They come with an extensive set of protective features, including the thick bony areas of your skull (the orbit), eyebrows, eyelashes and the ever-protective eyelids that will want to close at the slightest inkling something may be heading towards your eyes. With all this going on, many people think that the risk of anything beating the eyes natural defences are slim. But eye injuries do happen regularly and from a range of sources too – with sometimes even the slightest injury causing irreversible damage that may lead to sight loss.

We only get two eyes - make sure you protect them!

Imagine being able to see perfectly well, but tomorrow you have an accident that leaves you partially sighted that now means you struggle to lead a normal life or even stop you from driving. Imagine still that the injury could have been avoided by wearing safety glasses or just observing other eye-safety tips.

A corneal abrasion caused by a metallic particle left this eye

in severe pain and very sensitive to light

Eye hazards are everywhere and most associate them with work. Such eye hazards at work may include airborne dust/wood/metal particles caught in a draught, chemical splashes, radiation (heat or ultraviolet sources) or even just from a use of your tools (pen/pencil or screwdriver in the eye – ouch!) Your employers should be aware of what hazards exist and can provide you with eye protection where required, but be sure to report any potential hazards you see. It is also your responsibility to wear them if instructed to do so!

Many injuries are caused by airborne particles, such as dust

They aren’t limited to the working environment either, there are thousands of eye hazards at home. Such hazards include mascara brushes and eyelash curlers (sharp/pointy objects that go close to the eye should be an obvious threat!), do-it-yourself accidents, prodding your eye with a fingernail (when rubbing the eye or handling your contact lenses) and even through accidents involving homebased cleaners and washing detergents. There have even been cases of eye injuries from children’s games and toys, as well as the odd wayward champagne cork.  Just exercising diligent care by being careful with make-up, not pointing objects towards the eyes and keeping short fingernails if you have contact lenses will help keep your eyes safer at home.

Everyday sharp objects such as pens and fingernails can

pose a serious risk to your eyes

Sports also cause a real threat to your eyes. A fast travelling squash ball or tennis ball can compress the eye and damage the bones surrounding. A paintball or BB pellet to the eye also doesn’t bare thinking about. If you are in a sport that uses any form of flying object or projectile, a pair of safety goggles or protective mask may be useful to wear. Your local optician will usually have a supply of safety goggles to try and your local optometrist and dispensing optician will be able to find the best one for your sporting needs.

Sports goggles may not look cool, but can save

you from a horrendous eye injury

 Any eye injury, no matter how small and insignificant you think it may be, should be examined by an optometrist – as even the smallest of injuries can lead to severe outcomes. If you treat every eye injury as a potential emergency appointment with us, it means we can get you the right help for when you need it, which can occasionally mean that we refer you on to see someone at your local eye hospital. If you are unable to see an optometrist due to their office being closed, you can head straight to your local accident and emergency department to be examined by an on-call ophthalmologist.

Eye injuries should be treated as an emergency -

get them checked out straight away

Exercising care around potential eye hazards, as well as wearing adequate eye protection will minimise your need for these appointments and will keep those precious eyes safe for another day! If you are concerned about your eye safety needs, it is recommended that you book an appointment to see your local optometrist, who can discuss your situation further.

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Top Tips For Looking After Your Eyes

We only get one pair of eyes and they work extremely hard for you during your life. With sight loss being the one sense that many fear about losing, it is vital that you look after your eyes in every way possible. I share a selection of ways to make sure you look after your eyes and eyesight in the best ways possible.

Regular Eye Examinations

Having an eye test isn't merely just to see if you need glasses, but now considered as an important health examination that looks at the health of your eye, as well as your general health. It is recommended that you have your eyes tested at least once every 2 years, although in some cases, such if you are diabetic or have a family history of glaucoma, more regular check-ups are advised.

Regular eye examinations can help keep your eyes working

optimally for longer - as well as detect early health problems

In the UK, if you are under 16, under 19 and in full time education, over 60, have been precribed complex lenses, are diabetic, have glaucoma or are a first degree relative of someone with glaucoma, you may be eligible for an NHS-funded eye examination. Additionally, if you are in receipt of a selection of financial benefits, you may also be eligible for an NHS-funded eye examination, with help towards the cost of any required spectacles. I advise visiting the NHS website for more categories and details, or contacting you local optician.

Eat Healthily

The right diet is key when looking after your eye health. A diet that is rich in fruit, vegetables and protein can really make a difference in regulating your eye health. Dark green leafy vegetables (such as kale and spinach) helps keep the retina healthy, with flaxseed oil and omega essential fatty-acids helping regulate a healthy tear film, reducing the feeling of a dry eye.

A healthy diet leads to healthy eyes

Nutrition and the eye is a huge area to cover and will be the focus of future blog posts. Drop me a like on my facebook pages (OptometryTweet and eyesonjason) to be notified of the latest posts.

Sun Protection

The sun is the biggest source of ultraviolet (UV) light that we encounter. We all think of sun cream to protect our skin but how do you protect your eyes?  UV causes changes to the conjunctiva, the cornea and the crystalline lens, leading to raised yellow regions around the white of the eye and also speeding up the development of cataracts. UV can also lead to skin cancers, so I advise use of suncream on the face and around the eyelids (just don't get it in your eyes - you won't be thanking me for that!)

UV light can lead to cataract formation

Protecting the eyes from UV light is relatively easy - invest in a good pair of large-framed sunglasses that have UV filters. These large UV-blocking lenses will keep the damaging rays away from the sensitive skin around your eyes and prevent them from damaging your eyes themselves. Be warned, look out for the CE mark and check to make sure they really are UV blocking - many online stores or marketstalls do not meet the requirement to pass trading standards and you may be putting your eyes at risk!

A good pair of UV-filtering sunglasses can help protect

your eyes from the harmful effects of ultraviolet light

If you are a contact lens wearer, there are some contact lenses that contain a UV-block. Talk with your optometrist or contact lens optician to discuss your contact lens and UV needs for further information.

Don't Smoke!

Smoking has been proven to damage your health in many ways, as well as cause irreversible sight-loss. The chemicals absorbed through smoking greatly accelerate the progression of cataracts and put your retina under great strain, leading to an increased risk of macular degeneration (a severe form of sight loss). You are also much more likely to have a contact lens problem if you smoke, which again may lead to a painful and sight threatening condition.

Smoking can drastically increase your chances of

going blind through cataracts and macular degeneration

Other health problems can arise through smoking, such as strokes and heart disease. These conditions can also seriously affect your sight, often leading to longstanding or peramanent blindness. For more information on smoking and vision, see my previous blog, Smoking and Your Vision.

Safety First

Make sure to consider your eye health when doing DIY or any other hazardous tasks. Safety lenses and frames can make a difference to being able to see your finished creation and a trip to the emergency room. Additionally, if you play a projectile sport, such as squash or tennis, really consider safety goggles. The damage that a squash ball can do to your eye can be horrific (I've seen the damage...it isn't pleasant!). Your eyes do a really good job at keeping themselves out of harms way, but taking a few precautions mean you can really keep them safe!

Wear protective eyewear when doing it yourself

Regular Breaks

It might not be something that causes a lot of harm to the eyes, but the way that computers, phones and a whole host of other gadgets can make your eyes feel if you use them too long makes this point worth a mention. Prolonged use of a screen (or even a book) can result in the eye muscles responsible for near focus going into a spasm and as such give us blurry vision for some time after. This near concentration can also give us eyestrain and some headaches. In order to give your eyes a break, optometrists recommend the 20-20-20 Rule: every 20 minutes, look up at something about 20 feet away for 20 seconds. This gives the eyes a chance to recover and you get a bit of a break too!

Every 20 minutes, take a 20 second break and

look at something 20 feet away

We don't just look at a screen, we stare at it. Our blinking rate drops dramatically, meaning our eyes are not having fresh tears over their surface to help keep them well lubricated. This leads to feelings of dry eye and can make them feel very irritiable. Make a conscious effort to blink where you can - your eyes will appreciate it! If dry eye is a continual problem, discuss with your optometrist about the best way to combat the symptoms. 

The above list is just a selection of general tips on how to look after your eyes, but if you wish to find out more, book an appointment to discuss your specific eye concerns with your local optometrist. 

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Smoking and Your Vision

The dangers of smoking to your general health is well known and widely accepted, but many do not realise the effects smoking can have on your eyes and vision. This post isn’t here to cover the general health effects, but to look closer at what smoking can do to your eyes and how it can cause you to go blind – with smoking related blindness more common than you may think.

Smoking - your sight's biggest enemy

Dry Eyes

Dry eye is where the eye is not lubricated as much as it should be – through lack of tears or through factors that can dry the surface of the eyes. Those with dry eye usually feel that their eyes are irritated and gritty, not to mention have the appearance of redness with the occasional report of blurry vision.  Tobacco smoke is a well-known eye irritant and can exacerbate dry eye. This is both to the smoker and anybody nearby (so be considerate!). It is thought that smokers are twice as likely to experience dry eye than non-smokers.

Smoking causes and exacerbates dry eye symptoms

Cataracts

A cataract is the clouding of the eye’s natural lens and is the leading cause of blindness in the world. Most people will develop a cataract at some point in their life, but those who smoke will accelerate the processes associated with cataract formation and thus suffer from cataracts in approximately half the time it would take a non-smoker.   The more that someone smokes, the faster they will likely to develop a cataract.

Cataracts develop twice as fast in smokers than non-smokers

Macular Degeneration

Age-Related Macular Degeneration (AMD/ARMD) affects the central point of the retina and in turn, the central point if your vision. This central point in your vision is critical for fine detailed tasks such as reading, recognising faces and even driving. In a lot of cases, this loss of vision is permanent! Multiple studies have linked smoking to an increased chance of developing macular degeneration, with the figure showing between 3 and 5.5 times more likely to develop it if you smoke.

AMD destroys your central vision, making faces and words hard to see

Many people with macular degeneration are not able to drive – would you be happy to give up your driving licence in order to keep smoking? It is not all bad news though, as this risk factor is controllable – meaning you can cut your chance of developing macular degeneration if you stop smoking, even if you have smoked for years.

Uveitis

Uveitis is an inflammation of the eye’s middle layer. This is a serious ocular disease that can be very painful and result in vision loss. Uveitis damages vital structures in the eye (including the iris, choroid and retina) leading to vision loss. Multiple studies have shown that the chances of developing uveitis as a smoker is double that of a non-smoker.

Smoking doubles your risk of developing uveitis - be warned!

Diabetic Retinopathy

The damage that diabetes does to your body is widespread, but a great deal of damage occurs to the retina.  The changes to the retinal blood vessels due to diabetes can cause vision loss, through haemorrhaging across the retina, scarring and even lead to total vision loss through a retinal detachment. Studies have shown that smokers have twice the risk of developing diabetes than non-smokers. Moreover, a link has been found between the progression of diabetic retinopathy in smokers, with smokers more likely to have a complication due to diabetic retinopathy than non-smokers.

How the world may appear with diabetic retinopathy

Childhood Eye Disease

Smoking involves taking in harmful toxins as you breathe. If you are pregnant, the toxins pass on to the developing foetus via the placenta and can harm the unborn child.  This can cause them to have birth defects and other general health complaints. The unborn child’s eyes may also be affected, causing strabismus (an eye turn), underdevelopment of the optic nerve and, due to the likelihood of a premature birth through smoking, retinopathy of prematurity.

Smoking during pregnancy can cause damage to a child's eyes

Read Enough to Stop?

The ability to stop smoking ultimately lies in your hands, but I understand that it is not an easy journey to make. Quitting at any time will lower your risks of developing many sight-threatening conditions, as well as help you lead a healthier lifestyle. If any of these points have raised concerns about your health and vision, then be sure to mention it at your next doctor or optometrist's appointment, where they will able to signpost or arrange a plan to help you stop. 

More about the Government's plans to help you stop smoking can be found here: 
https://www.gov.uk/government/publications/health-matters-smoking-and-quitting-in-england/smoking-and-quitting-in-england

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Prototype Smart-Cane to Aid Visually-Impaired

The white cane has long been a symbol and a great partner for those with visual impairments, but the overall design and function has not seen much change in its many years of existence. One PhD, from Manchester University's School of Electrical and Electronic Engineering has designed a prototype upgrade to improve the cane and its functionality.

Vasileious Tsormpatzoudis was inspired by his mother, whom he explains has retinitis pigmentosa (a progressive, hereditary disease that affects vision), to design an upgrade to the cane that is both useful and affordable.

His upgrade, known presently as "mySmartCane", is made using some sensors and 3D-printed plastic. The product fits at the end of the white cane and uses ultrasound to detect the environment around it, feeding the information back audibly to alert the user of any approaching obstacles. In simple terms, it works in a very similar way to a car's parking sensor.

The additional benefits of this design are that the cane can detect objects further away from the user (providing more time to adjust their course) as well as providing the information without having to actually collide the cane with the obstacle.  Far from being the finished article, this prototype has a lot to offer the visually impaired and may further technologies in this area. 

Source: Phys.org

Lutein-Rich Diet and Supplements Lead to Crystalline Macular Crystals

It has been reported in the JAMA Ophthalmology journal that a lady was seen in a medical retina clinic for an examination due to "foveal sparkles" on her fundus examination. Case history reported that she had been taking a 20 mg lutein supplement for approximately 8 years on top of her lutein rich diet, which included a daily kale, spinach, avocado and broccoli smoothie. 

Although asymptomatic and with visual acuities of 6/6, the fundus displayed sparkling round and yellow crystalline deposits in the inner layers of of her foveal retina. It did find that after removing the supplement, but keeping her eye-healthy diet, that the crystals resolved after 7 months. 

With many optometrist practices now stocking supplements and the emphasis on dietary eye-health high, optometrists need to be aware of what to recommend and when. The guidance from the Age-Related Eye Disease Study 2 recommending AMD patients take 10 mg of lutein daily, care must be taken to ensure the patient does not exceed this limit regularly. It is also a case of ensuring that supplements are recommended in those patients that actually require them.

Source: JAMA Ophthalmology

ECHoES Trial Reveals Potential to Reduce nAMD workload in Hospitals

The Effectiveness of Community vs Hospital Eye Service (ECHoES) for follow ups of dormant neovascular age-related macular degeneration reveals that community optometrists have the potential to reduce the workload of the hospital eye service in this highly populated area of secondary care. 

The virtual study by Reeves et al. showed that the decision making between experienced ophthalmologists and trained optometrists was very similar, although optometrists were more cautious in their decision making.  The number of sight-threatening mistakes were similar between both optometrists and ophthalmologists.

This study shows that there is a huge untapped potential for community optometrists to reduce the workload in the macular degeneration clinics and allow for the every increasing demand for such services. 

The full article can be accessed by clicking HERE.

Source: British Medical Journal Open

Reeves BC, Scott LJ, Taylor J, Harding SP, Peto T, Muldrew A, and Hogg RE et al. (2016). Effectiveness of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual non-inferiority trial. British Medical Journal Open 6:e010685

New Samsung Galaxy S8 to have Iris Scanner

From browsing the web, I have discovered that the Samsung brand of Galaxy phones will continue to produced and with the next model, the Samsung Galaxy S8 to feature an iris scanner. 

It is believed that the inclusion of the scanner is to compensate the original lens suppliers who produced the scanners for the short-lived Samsung Galaxy Note 7, which had numerous safety issues.  

Security features of an iris scanner are again showing how eyes are being incorporated in upcoming technology.  I am sure it won't be long before research is to be conducted into the safety of repeated use of iris and retinal scanning software.

Source: The Korea Herald

Astigmatism Alters with Cycloplegia

A study by Asharlous et al., published in the Journal of Current Ophthalmology, showed a significant difference between prescription pre- and post- cycloplegia.  The prescriptions were taken from 375 eyes before and after a drop of 1% cyclopentolate was added and a period of 30 minutes waited to allow for the cycloplegia to take effect.

The cycloplegia seems to only significantly affect "with-the-rule" and "against-the-rule", with little effect on the oblique astigmatisms. It also mainly affects hyperopic patients. How much clinical use this information will provide is yet to be seen, with further study into this effect required.

Read more on the article by clicking HERE.