Bright Winter Eyes

Protecting our eyes in the winter is essential for preventing short and long term problems.
Eye dryness is very common, especially on cold brisk days. Finding comfort near a warm toasty heater or fireplace can dry the eye surface too. Maintain good eyelid hygiene, stay hydrated and use artificial tears to control mild dry eye symptoms.

iStock_000023582367SmallSunglasses are important for preventing keratitis (a burn on the cornea surface) and aging effects such as cataracts, pinguecula and macular degeneration. Snow-blindness or keratitis is a painful corneal condition that can occur when the outermost layers of the cornea are damaged (like a sunburn). Damage can occur in as little as an hour of exposure to ultraviolet radiation, the risk is intensified at higher altitude.

Damage to the eye doesn’t stop on the surface. Cumulative ultraviolet exposure damages the lens of the eye causing cataract formation. Research has also found that UV radiation contributes to macular degeneration.

Wearing good UV blocking sunglasses protects all layers of the eye. The UV radiation reflected off of water and snowUV and sunglasses is dangerous too.

Don’t hang-up your sunglasses because it is winter, year-round UV protection is a proactive way to promote good eye health and clear vision for adults and children.


I See Smoke

A google search looking for “what’s in a cigarette?” produced the list below. Most of the products containing these ingredients earn a special danger or poison label. The substances are not listed on a pack of cigarettes.

Here are a few of the chemicals in tobacco smoke and the other places you can find them (list from the American Lung Association):

Acetone – found in nail polish remover
Acetic Acid – an ingredient in hair dye
Ammonia – a common household cleaner
Arsenic – used in rat poison
Benzene – found in rubber cement
Butane – used in lighter fluid
Cadmium – active component in battery acid
Carbon Monoxide – released in car exhaust fumes
Formaldehyde – embalming fluid
Hexamine – found in barbecue lighter fluid
Lead – used in batteries
Naphthalene – an ingredient in mothballs
Methanol – a main component in rocket fuel
Nicotine – used as insecticide
Tar – material for paving roads
Toluene – used to manufacture paint

How naive am I? I thought all the danger in cigarettes came from the nicotine in the tobacco leaves. I couldn’t understand where all the poisons and toxins on the above list came from. Further googling introduced me to the “additives” in cigarettes. Chemicals are added to the tobacco to flavor and fragrance the cigarette “brand”. There are additives for improving texture and holding the leaves together. I can only assume that burning the tobacco and additives creates more toxins.



Crying man with cigarette So what does this have to do with eyeballs? Unfortunately smoking contributes to many ocular conditions such as cataracts, macular degeneration, dry eye disease, diabetic retinopathy and retinal vascular occlusions. Fortunately if you quit inhaling the toxic chemicals, the risk of related ocular diseases is nearly extinguished to the non-smoker level.


Sun Protection

Most of us take precautions to protect our skin from the damaging sun radiation by putting on a hat and applying sunscreen.
A significantly smaller percentage of people put on sunglasses to protect the eyes from the same ultraviolet risks. Besides glare and discomfort from the brightness, the ultraviolet (UV) rays from the sun cause premature aging to the skin around the eye and the structures of the eye. In fact, the sun is the greatest environmental factor contributing to cataract formation.

SUNGLASSES provide a barrier to other eye irritants as well. Wearing sunglasses protects the eyes from wind, dust, pollen and debris. This is particularly beneficial for sports like cycling and running. maui jim 2016
COMFORT from good quality sunglasses is attributed to reducing glare and eliminating squinting. Glare can be direct from the light source or indirected (reflected). Reflected glare is eliminated best with polarized lenses. Polarized lenses are especially helpful for watersports, fishing and on the snow, skiing and snowboarding.
QUALITY SUNGLASSES will protect against all UV wavelengths (A,B and high energy wavelengths). The lenses will be centered and have clearer optics than the sunglasses you find at the grocery store and gas stations. A premium sunglass frame is comfortable, fits well and is durable. It is also resistant to corrosion, tarnish, peeling and chipping.

Long-Term UV damage cannot be repaired. It is cumulative. Protect your eyes today, wear quality sunglasses.
And don’t forget the kids, they are more susceptible to UV damage than adults.


How Does Diabetes Damage Your Eyes?

November is Diabetes Awareness month. High amounts of blood sugar can harm the internal structures of the eye. Below are some of the things that diabetes can do to the eyes.

  • Blurry or Double Vision. Fluctuating blood sugar and fluctuating vision are connected. A change in glucose levels affects the eye’s ability to maintain sharp focus. It may take several months after your blood sugar is well controlled for your vision to stabilize.


  • Diabetic Retinopathy. The leading cause of diabetes-related vision loss is diabetic Diabetic Retinopathy retinopathy. This condition damages the network of blood vessels supplying the retina with blood and oxygen. It also causes abnormal growth of blood vessels on the retina. When these vessels leak they damage  the retina causing permanent vision loss.
  • (the picture on the left is an example of fluid and blood leakage in diabetic retinopathy.)



  • Cataracts. People with diabetes have a much greater risk of developing cataracts and at an earlier age. A cataract is clouding of the eye’s natural lens and results in glare and obscured vision.
  • Glaucoma. Diabetes also increases your risk of developing glaucoma. This condition results from an increase in fluid pressure inside the eyeball, which causes damage to the retina and optic nerve. If untreated, glaucoma leads to gradual but permanent vision loss.

Actions to take right now include the following: Eating sensibly, the American Diabetes Association recommends filling half your plate with vegetables, a quarter of the plate should be lean protein and the rest a carbohydrate. Make time for 30 minutes of exercise everyday. Take your medicine as prescribed and know your blood sugar level.

Preventing diabetes is the best way to avoid diabetic damage to the eyes, but if you already have diabetes, regular eye examinations can prevent permanent damage to the eye due to elevated blood sugar.



Too Much Sun can be Dangerous for Eyes

Corneal Sunburn

If the eyes are exposed to excessive amount of Ultraviolet (UV) radiation over a short period of time, “sunburn” called photokeratitis can occur on the surface of the eye (the cornea). This condition Sun and the Eyes may be painful and includes symptoms such as red eyes, a foreign-body sensation or gritty feeling in the eyes, blurry vision, excessive tearing and extreme sensitivity to light. Photokeratitis is also called snowblindness because it occurs often when enjoying winter sports where the light is reflected from the snow. It is usually temporary and rarely causes permanent damage, but can take days to heal.
 Premature Aging
Ongoing exposure to UV radiation, however, can cause serious harm to the eyes and age them prematurely. Research has shown that exposure to small amounts of UV radiation over time increases the chance of developing cataracts, macular degeneration and eye cancer.

Whether it’s cloudy or sunny, summer or winter protect your eyes from the sun’s rays in order to decrease the risk of eye diseases and disorders.
A good rule of thumb to follow is to wear sunglasses, glasses or contact lenses with UV protection, apply sunscreen and wear a hat to protect the eyes and tissues around them.
And don’t forget your children, their eyes are more susceptible to damage from UV.
A good way to monitor eye health, maintain good vision and keep up-to-date on the latest UV protection is by scheduling yearly comprehensive eye exams.


Do you have Cataracts?

June is cataract awareness month.


Here are some of the clues that you might have cataracts?

  • Vision is cloudy or blurred
  • Vision is discolored
  • Vision is impaired at night and there is more glare
  • Vision is double in one eye

A cataract is the clouding of the lens of the eye. The proteins in the lens discolor and clump causing blurry and obscured vision. Age is the leading cause, but certain medications can speed up the process also. Two contributing factors that you can control are protecting your eyes from UV damage by wearing sunglasses, and to stop smoking.

For more details about cataracts click here.


Cataract Myths Busted

There are many myths about cataracts, here are the facts:

  • Cataracts cause blindness. While it is true that cataracts can cause severe vision loss and even blindness if left untreated, in most cases vision can be fully restored by cataract surgery. In fact, people who have needed prescription eyeglasses most of their life often see better without glasses after cataract surgery. cataract
  • Only older people get cataracts. Though the risk for the most common type of cataract increases as we get older, cataracts can occur at any age – even among children. Cataracts developing at an early age can be caused by heredity, certain diseases, medications or eye injuries.
  • A cataract is a film that grows on the front of the eye. Actually, a cataract is the clouding of the lens inside the eye that is located behind the iris (colored part of the eye) and the pupil. The eye’s natural lens consists primarily of water and protein. When something affects the normal arrangement of protein in the lens, the lens becomes cloudy and causes blurry vision.
  • There is nothing you can do to prevent cataracts. You may not be able to prevent some types of cataracts – such as those caused by an eye injury – but you can reduce your risk of some of the more common types by choosing a healthful diet, protecting your eyes from the sun’s UV rays, exercising regularly, maintaining a healthy weight and avoiding smoking.
  • Cataracts have to be fully developed or “ripe” before they can be removed. Cataracts can be removed at any stage. The best time to remove the cloudy crystalline lens (cataract) is when the vision is compromising your quality of life. This includes the inability to drive at night due to excessive glare.
  • Cataract surgery is dangerous. Modern cataract surgery is one of the safest operations performed today. More than 95% of cataract procedures are successful and fewer than 5% of patients have complications such as inflammation, bleeding, infection and retinal detachment, according to the Prevent Blindness America. In most cases, no stitches are required and it’s safe to return to work after a day of rest.

To read more about cataract, click here.


Eye Damage from the Sun

How does UV affect the eyes?

One of the most common conditions I see due to UV radiation is pinguecula. This is a raised nodule that appears on the white of the eye. It can become inflamed, discolored, and dry with chronic sun exposure.


Pterygium is a similar condition to pinguecula, but is grows onto the cornea (the clear part of the eye). Pterygia can grow and affect the vision. Removal is possible, but there is a high recurrence rate.

Photokeratitis is like a sunburn on the cornea, also known as “snow blindness.” Photokeratitis is directly attributed to environmental UV radiation exposure and generally occurs 8 to 24 hours after being in the sun. It is more typical in individuals who have not used sunglasses or hats. The primary symptoms include photophobia (extreme sensitivity to light) and pain.

One of the causes of cataracts is UV exposure. The crystalline lens is made up of proteins. These proteins can be altered or denatured by exposure to UVB or UVC radiation.

Age Related Macular Degeneration (ARMD) is another eye condition associated with UV exposure. The worldwide prevalence rate of ARMD resulting in impairment and blindness is 8.7%, making it one of the most common causes of blindness in patients over age 60. Studies have shown that many individuals with macular degeneration have had greater UV exposure over their lifetime.

Skin Cancers can present on and around the eyelids. Removal and excision is complicated by the importance of proper blinking and eyelid closure. Malignant melanoma can appear in the choroid (under the retina), the iris (colored part) and the conjunctiva (white of the eye). These tumors can be very aggressive. In fact, malignant melanomas of the choroid are the most common intraocular malignancy.

UV Radiation

To read more about how the eyes are effected by UV Radiation click here.


Ripe Cataracts

I occasionally have patients ask if their cataract is “ripe.” There is some misunderstanding, cataracts don’t ripen. The crystalline lens does change and causes vision problems. To read more about what a cataract is click here.
Cataracts can be removed whenever the patient and surgeon agree that they should be removed. Generally, the best time to remove the cloudy crystalline lens (AKA cataract) is when the vision is compromising your quality of life. This includes the inability to drive at night due to excessive glare. Other causes of blurry vision must be explored before cataract surgery. Macular degeneration can reduce the quality of vision, especially for reading. Removing cataracts will not improve the clarity in this case.


Maintaining Clear Vision

Age-related eye diseases such as macular degeneration and cataracts commonly cause impaired vision and blindness in older adults. But lifestyle changes, including good nutrition, could help delay or prevent certain eye problems.
Besides adopting a healthy diet, you also can protect your eyes by avoiding intense ultraviolet (UV) light, quitting smoking and getting regular checkups that may help detect chronic diseases contributing to eye problems. Diabetes, for example, increases your risk for age-related eye diseases and may cause diabetic retinopathy.
Regular eye exams, too, are essential for maintaining eye health as you grow older. If eye problems and chronic diseases are detected early enough, appropriate treatment may prevent permanent vision loss.