From the onset of COVID-19, the Centers for Disease Control and Prevention has warned the public that the virus could enter the body through the eyes and spread throughout the body through superficial blood vessels within the conjunctiva.
The tissue that protects the eye from dust, debris, and infection-causing microorganisms is the conjunctiva.
“The virus can cause ocular signs and symptoms, including photophobia, irritation, conjunctival injection and watery discharge,” said Dr. Danielle Richardson, who holds a bachelor of science degree in biology and a doctor of optometry degree.
Richardson, a resident of Los Angeles, shares her insights regarding eye health and the pandemic. She answered questions about the unique perspective about optometrists as essential critical infrastructure workers at the onset of the pandemic alongside doctors and hospital staff.
ML: Tell me about your role with emergency eye care due to COVID-19.
DR: In our roles, as eye doctors, we treated patients for a variety of eye emergencies during shelter in place, helping ease the burden on hospitals and emergency rooms.
Additionally, eye doctors have played a significant role in information sharing about the pandemic. Particularly because touching a surface or object that has the virus or germs on it and then touching your eyes can lead to infection.
Our office was offering emergency and urgent eye care to patients who didn’t have the virus during California’s shelter-in-place mandate, when only essential eye care, and not routine eye care, was available. This helped keep patients out of hospitals and emergency rooms, lowering the burden on hospital doctors.
Many people don’t think of calling their eye doctor in an eye emergency. Still, eye doctors can handle many eye emergencies, including injuries to the eye, sudden vision changes and more.
As far as COVID-19 and the eye, we know the virus can spread via the eye, and there can be a conjunctivitis component. Thankfully, I’ve not personally treated any patients who had COVID-19-related conjunctivitis.
ML: What have you noticed with eye patients since the pandemic outbreak?
DR: I have noticed more dry eye conditions and digital eye strain since many people are working from home or spending more time on digital devices. I’ve also noticed patients are updating their glasses and buying annual supplies of contact lenses in anticipation of extended time home for the remainder of the year.
Eyewear can look great online, but when you try them on, they might sit too low on the bridge of your nose or fit around your ears awkwardly.
ML: Tell me about glasses safety during the pandemic.
DR: Because touching a surface or object that has the virus or germs on it and then touching your eyes can lead to infection, it’s important to sanitize your glasses to prevent the potential spread of COVID-19.
First, run your glasses under warm water covering the entire frame and lenses. Use antibacterial dish soap on your fingers to wipe down all surfaces of your eyeglasses along with the lenses.
Then, rinse your glasses under warm water and dry with a lens cloth.
When you aren’t actively wearing your glasses, place them in their case. The case will help keep eyewear from being placed on other potentially contaminated surfaces or your hands.
ML: If we are encouraged not to touch our eyes, what about contact lens wearers? What should they do to stay safe?
DR: According to the American Optometric Association, contact lenses during COVID-19 are a safe and effective form of vision correction for millions of people, and you can’t contract COVID-19 from contact lenses themselves. However, you must continue to practice proper care and wear your lenses.
For contact wearers, you should always wash your hands with an oil-free soap when inserting and removing your lenses. This technique will help keep your lenses germ and smudge-free. Then, inspect and clean your lenses.
Check each lens for any scratches, tears and dust. Next, use your lens solution, not tap water, to clean and disinfect each lens separately. Repeat with your second lens. After the recommended number of routine cleanings, be sure to toss your contacts and use a fresh pair, and never share your contact lenses.
ML: What are the concerns about the extra screen time and digital eye strain due to shelter in place? What is the recommended screen time for kids, adults, or seniors?
DR: Your eyes are putting in overtime daily to focus on TV, computer and phone screens, which can contribute to repetitive eye strain and associated headaches, blurred vision and dry eyes. Try the 20-20-20 rule and give your eyes a break: Every 20 minutes, spend 20 seconds looking at something at least 20 feet away. Also, blinking more often helps to moisten your eyes, which may help reduce visual discomfort.
Additionally, practice digital distancing. Find a comfortable working distance from your screen. The distance is especially important for children since the intensity of light increases exponentially the closer our eyes are to the source. Children should hold devices as far away from their eyes as it is comfortable. Adults are encouraged to hold devices at arm’s length.
You can also adjust the lights of your devices. Turn down the brightness level or turn on the night or blue light filter mode on your device screens to reduce the amount of blue light exposure, especially during the evening hours. Additionally, as LED and CFL lighting also emit blue light, it would be a good idea to dim those at home or work if possible.
ML: Is there a recommended type of eyewear designed for computer screens that are not prescription?
DR: The benefit of visiting an eye doctor to be prescribed glasses is to ensure the glasses meet all your eye care needs and that they’re the right fit. Through an eye exam, your eye doctor will check for eye-related health issues, such as a detached retina, glaucoma or cataracts, as well as early signs of chronic health issues like diabetes and high blood pressure.
Your doctor will also confirm or update your prescription. Your vision can change over time, and you want to make sure you’re not putting your eyes through unnecessary strain. An eye doctor can ensure you receive just the right pair of lenses that support clear vision and comfort.
ML: Children returning to school has been delayed. How can parents ensure that kids can undergo eye exams during the pandemic? Why is it important?
DR: Kids have had to distance learning via a computer due to the COVID-19 pandemic and may resume this format in the fall. While school looks different these days, it’s more important now than ever that kids get comprehensive eye exams to ensure they see clearly. It is essential to know whether they’re experiencing any vision issues due to the increased screen time.
More than 10 million U.S. children suffer from undetected vision problems, even when they pass a school vision screening. These vision problems can negatively affect their school performance. And often, kids may not realize they’re experiencing vision issues simply because what they see is all they’ve ever seen. For younger children, it may also be challenging to articulate any vision issues they’re having. An eye exam goes beyond clear vision — it can play an important role in mobility and eye coordination, and the early detection of chronic diseases like diabetes.
ML: What new safety measures are in place to keep patients safe in the office during the pandemic?
DR: We want parents to feel safe bringing their kids to the eye doctor. Offices have adopted many safety precautions implementing CDC and state guidelines to mitigate the spread of COVID-19. Our staff wears PPE, including masks, gloves, and lab coats. We also received free face shields from VSP, which provide a more comfortable full-face coverage.
Many eye doctors are asking patients to fill out intake forms online before their appointment and to go to the office alone to limit the number of people in the office. Face masks are always required while in our office.
The eye frame selection process may look a little different. The frames that a patient tries on are now disinfected before being returned to the frame board.
If you or your child is feeling sick or has a fever, reschedule your appointment.
ML: How does stress affect the eyes?
DR: It’s certainly a stressful time for many reasons. Try to remember that high blood pressure and hypertension are typical results of stress and can strain your eye’s blood vessels and optic nerve. The strain could result in bleeding, difficulty seeing clearly or permanent vision loss.
Strokes often leave their victims with vision impairments, and insomnia can lead to dry and bloodshot eyes. Feelings of joy and calm are great for your health.
ML: Can you recommend eye exercises? Are there different types and what are the benefits of eye exercises?
DR: It hasn’t been proven that eye exercises improve vision; however, they can improve your eye comfort, particularly if your eyes are strained from looking at screens. Try the 20-20-20 rule to avoid digital eye strain and give your eyes a break.
Every 20 minutes, spend 20 seconds looking at something at least 20 feet away. Blinking more often helps to moisten your eyes, which may help reduce visual discomfort.
ML: If you touch your eyes out of habit or to relieve itching, how can you be sure that your eye does not become infected?
DR: Many of us touch our eyes out of habit when we’re tired or stressed or to relieve an itch. It’s especially hard to avoid touching your eyes if you wear glasses or contact lenses. If you can’t help it, wash your hands often, which lowers the risk of contracting the virus through your eyes. Try always to be aware of your hands so that you can think of ways to keep them busy when you feel the urge to rub or scratch.
ML: What is the best nutrition or vitamins for eye health at all ages: children, teens, adults and seniors?
DR: One of the best things you can do for your eyes is to eat foods that contain vitamins A, C, and E, and zinc and are low in saturated fats and sugar. Oranges, grapefruits, strawberries, papayas, green peppers, and tomatoes are all vitamin-rich. Salmon, tuna, and sardines, and other fish that includes high amounts of omega-3 fats can help decrease the risk of dry eye syndrome, high eye pressure, also known as ocular hypertension, glaucoma, and macular degeneration. Dark, leafy, green veggies like spinach, kale, and collard greens are full of lutein, which helps maintain healthy eye cells.
Avoid excess coffee and highly caffeinated beverage consumption because too much caffeine can lead to eyelid twitching. Green tea is known to be a great source of catechins, which along with other antioxidants, like vitamin C and E, zeaxanthin, and lutein, help eyes fight against various eye problems, including cataracts and age-related macular degeneration. Always drink a lot of water to stay hydrated.
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The World Health Organization offers up-to-date coronavirus advice for the public, from myth busters to how and when to wear a face mask.
Marie Y. Lemelle is the founder of www.platinumstarpr.com and a film producer. She can be reached at MarieLemelle@platinumstarpr.com. Follow her on Instagram @platinumstar.