For decades, Americans have named vision loss as one of their greatest fears, second only to cancer. Some surveys have found that vision loss is even more feared than cancer. The National Eye Institute reports that 38 million Americans over the age of forty are blind, have severely reduced vision, or have an eye-related disease. Sadly, that number is on the rise. Vision loss and blindness take a significant toll beyond eyesight: the psychological impact of vision loss is colossal, and, unfortunately, loss of sight has led countless people to suicide.

These grim reminders may help elevate the significance of taking steps now to prevent vision and ocular problems from manifesting later on. Though we are not able to remove the risk of all diseases just by good preventative care, we can significantly cut the risks of some diseases linked to certain habits and behaviors.

“Must Do” #1: Get an eye examination regularly

The first and easiest step in preventative eye care is to have a comprehensive vision and ocular health examination performed at least every 1-2 years. This is critical, whether you wear eyeglasses or not.

With modern diagnostic and treatment technology, many eye diseases and conditions can be prevented or treated, but they must first be properly diagnosed. Several major eye disorders create no obvious symptoms until they are too late to treat, so you may not be aware that you have a problem. Early detection and treatment are therefore critical to good ocular health and, potentially, to preventing vision loss. One study estimated that approximately 92,700 new cases of blindness each year would have been curable or preventable through timely detection and treatment. Early glaucoma and early macular degeneration do not produce readily recognizable symptoms. However, the ocular signs of these diseases, along with examination instrumentation, allow the eye doctor to detect these threats early so that intervention may be instituted.

Seeing 20/20 on an eye chart is in no way an indication of ocular health, it is only an indication of visual health. Many people are lured into a false sense of security thinking that their eyes are healthy because they are able to read the 20/20 line on an eye chart during a vision screening. Though a visual acuity of 20/20 is a relative indicator of good ocular health, many visual disorders and blinding diseases can still be taking hold. These diseases are often well on the way to creating damage while an individual is still maintaining 20/20 vision.

The condition most notorious for this is glaucoma, a disease capable of causing irreversible blindness. Glaucoma is called “the sneak thief of sight,” and nearly half of those who have it are completely unaware of it as they are slowly losing vision. Nearly 1 in 50 Americans has glaucoma, and approximately 1 out of every 100 people has glaucoma but doesn’t know it. The risk factors for glaucoma are relatively easy for an eye doctor to detect during a comprehensive eye examination.

Children should have their first eye examination performed by an eye doctor at 6 to 12 months of age. While pediatricians screen infants and children for vision problems, they admittedly catch only a small percentage of those who have ocular health needs. The
pediatrician’s screening is not a replacement for an examination with an eye doctor.

“Must Do” #2: Take nutritional supplements

Everyone knows that proper nutrition is important for our bodies to function normally and properly, and the eyes are no exception. It will likely come as no surprise that a diet rich in fruits and vegetables is most advantageous for the eyes.

Your primary care physician and eye doctor can help you assess whether you should utilize nutritional supplements. Exercise and a healthy diet with abundant amounts of fruits and vegetables contribute to a higher quality lifestyle and a healthier body. Certain vitamins and nutrients are necessary for normal functioning of the eyes, as well as protection from various ocular diseases. Though obtaining nutrients through the diet is preferred, supplements can serve to round out an incomplete diet.

Carrots are often the first vegetable that comes to mind when thinking about eye health. Carrots are rich in beta-carotene, which the body converts to vitamin A, and proper vitamin A levels are crucial to good eye health, regardless of age and disease risk factors. However, a common misperception is that a diet rich in carrots will keep vision “perfect” and prevent the need for eyeglasses. Unfortunately, carrots will not have any effect on the need for eyeglasses or contact lenses. Nevertheless, vitamin A is still crucial since it is a required nutrient to allow our night vision to function properly, as well as possibly providing protection against macular degeneration.

“Must Do” #3: Protect your eyes from ultraviolet light

Just as dermatologists recommend using sunscreen to protect our skin from damage caused by UV light, eye protection is also imperative. There are three specific, long-term ocular health concerns regarding chronic UV exposure to the eyes. Pinguecula and pterygium—Pingueculas are the most commonly observed ocular tissue damage directly linked to excessive chronic UV exposure. A pinguecula is an overgrowth of tissue on the “whites” of the eye. They present as whitish-yellow raised areas at the 3 o’clock and 9 o’clock positions on either side of the cornea.

People living in warmer climates closer to the equator receive more UV exposure than locations further north or south, so the prevalence of pingueculas in a given population corresponds well to their distance from the equator. Elevation also plays a role in UV exposure levels, with higher elevations receiving more UV rays. Though pingueculas are fairly common and are not sight threatening, they’re known for becoming inflamed and irritated, a condition called pingueculitis. Pingueculas are often to blame for contact lens discomfort or intolerance.

Cataracts — Though a combination of multiple factors are believed to cause cataracts, UV light exposure is believed to be a contributing factor. There is a high correlation between the age of onset of cataracts to environmental and lifestyle factors contributing to higher levels of lifetime UV exposure. For decades, UV light has been thought to be a main factor in the development of cataracts, but new research and data suggests that blue light in the visible spectrum may be more to blame than UV light. Either way, good quality sunglasses are imperative in protecting the eyes from both UV and blue light.

Macular degeneration — Like cataracts, macular degeneration has multiple contributing factors, but a chronically high level of UV exposure is one of the most highly correlated factors. Steps taken early in life to guard against excessive UV rays likely reduces
the risk of this sight-threatening disease later in life.

One other health concern related to UV exposure is facial skin cancer. The eyelids are an area where skin cancers commonly occur. Because they are the body areas least protected from the sun, the face, eyelids, and arms are the most common areas for developing cancerous skin lesions due to UV exposure. Squamous cell and basal carcinomas are notorious for affecting the eyelid area. The judicious use of sunglasses, facial sunscreen, and widebrimmed hats while in the sun are effective ways of reducing the
damaging effects of UV light.

“Must Do” #4: Start a cessation program if you smoke

Everyone knows that smoking cigarettes is an unhealthy habit. Cigarettes rob the lungs of oxygen and replace it with lethal carbon monoxide. Besides the well-known association between lung cancer, emphysema, and cancers of the digestive system, cigarettes are harmful to the eyes as well. Unfortunately, the risk of developing almost any of the major ocular diseases covered in this book is much higher in smokers. Dry eyes, cataracts, macular degeneration, thyroid eye disease, and diabetic eye disease are all more
common in smokers.

Tobacco fumes irritate and inflame the conjunctiva, the clear outer layer of the eye. Smokers typically have chronically bloodshot and irritated eyes. To make matters worse, cigarettes can cause dry eye along with the other associated annoying symptoms. Among many conclusions that the large Physicians Health Study determined was a direct link between cigarette smoking and the incidence of cataracts. As tobacco fumes become absorbed into the bloodstream, the destructive ingredients are delivered to multiple body systems, including the eyes. Several other studies have linked cigarette smoking with increased risks for diabetic retinopathy, and thyroid eye disease.

Probably the most frightening association of cigarette smoking and ocular health is the link to macular degeneration. Smoking is the most preventable risk factor for developing macular degeneration. Additionally, studies (including AREDS) have shown betacarotene supplements to be beneficial in protecting against macular degeneration in patients at high risk for the disease, yet smokers are advised not to take beta-carotene supplements because they may increase their risk of lung cancer. Therefore, smokers simultaneously increase their risk of macular degeneration and disqualify themselves from the benefits of beta-carotene.

Primary Eyecare is committed to providing our patients with the best in eye care and eyewear. Contact us today to setup an appointment, or stop by one of our two locations (Barracks Road and Hollymead Town Center) to view our extensive eyewear collection of high quality brands.

Copyright © by Dr. Joe DiGirolamo