Dettloff family with their giant snowman

Ten Tips For Good Vision In 2011

by Marcia Dettloff, OD on January 17, 2011

I had to find an excuse to post a picture of the awesome 10 foot 1 inch tall snowman our family made after the Christmas snowstorm so how about one tip for each foot?  I’m still catching up from my vacation and the holidays so this is a little late but maybe it will act as a booster for those “get healthy” New Year’s resolutions that are fading fast.

1.) Get an eye exam

If you haven’t had an eye exam in a while (or ever!), get one. You don’t know what you don’t know about your eyes.  There’s a lot more to good vision and eye health than being able to see the road signs or read a menu.  Eye diseases such as glaucoma can be asymptomatic until late into the disease.  Many other health problems such as diabetes, high blood pressure and thyroid disease may be seen in your eyes.

2.) Eat your colored fruits and vegetables.

In addition to benefiting your general health, they have vitamins, minerals and other  nutrients that have been shown to protect your eyes against macular degeneration (the leading cause of blindness in people over 65) and cataracts. These nutrients have a very complex relationship with each other. By obtaining them naturally through your diet, you are more likely to get the proper variety and balance of nutrients and they will be absorbed more efficiently than eating junk food and trying to make up for it with supplements.

3.) Get some sunshine

Vitamin D is produced in your skin when exposed to UVB radiation. Then it turns into a hormone that affects thousands of genes in your body.  Most people can produce up to 1000 of units of Vitamin D a minute IF they are outdoors when their shadow is shorter than they are and their arms and legs exposed (without sunscreen). If you can’t get outside under those conditions, then you should supplement with Vitamin D3.  See my Vitamin D handout for more information.

Recent studies have also shown that kids that are outdoors an average of two hours a day are less likely to develop myopia.  Whether it’s the increased Vitamin D, the break from near work or some other factor has yet to be determined.  Regardless, getting off the couch or away from the computer and running around outside is good exercise and we can all use more of that.

4.) Protect your eyes from UV

Exposure to UV radiation increases your risk for cataracts, macular degeneration and pingueculas/pterygia.  While tinted and polarized lenses can improve comfort or visual performance outdoors, you can get UV protection with clear lenses.  Many lens materials naturally block UV rays but traditional plastic lenses need to be specially treated to block UV.  Don’t forget about the light that gets in around the edge of the UV protected lenses, especially with the small frames styles that are popular today.  Since most UV comes from above, wearing a wide-brimmed hat will help block that UV if you don’t have sunglasses with a good wrap design to provide full coverage.

5.) Stop smoking

If lung cancer, emphysema, yellow fingernails and bad breath aren’t enough of a deterrent, how about up to 8x increased risk of macular degeneration, 3x risk of cataracts, acceleration of diabetic eye disease or an increased risk of strabismus (eye turn) in children of mothers who smoked while pregnant?   The constant smoke floating in the eyes is more likely to cause dry eyes and pingueculas which are unsightly growths on the white of the eyes between the lids.

If you’ve tried to quit in the past and were unsuccessful, try, try again.  There are many more options available to help you quit than there were just a few years ago.  Check out Smokefree.gov or this CDC site with links to resources to help you quit.

6.) Take regular breaks from near work.

Whether sewing, reading a book or working at the computer, give your eyes a break every 20-30 minutes.  Get up and walk around, maybe get a drink of water (you’re probably dehydrated anyway). Just as it’s uncomfortable for you to sit in the same position for long periods of time, it’s uncomfortable for your eyes to be focused in the same place for long periods of time.  Some people suggest the 20-20-20 rule. Every 20 minutes take 20 seconds to look at something 20 feet away.  At a minimum, try to change your focus from distance to near several times and look at the 4 corners of the room.  Dejal Time Out for Mac and Workrave for Windows are freeware programs that will remind you to take a break.

7.) Don’t hold your reading too close

The closer you hold your reading, the more effort it takes to focus and converge your eyes.  If you make a fist and hold it up to your chin, you shouldn’t hold your reading any closer than your elbow.  This is called the Harmon distance.  In addition to the greater potential for eye strain, studies have shown that kids that hold their reading closer than the Harmon distance are more likely to become myopic.

8.) Wash your hands frequently…

and keep them away from your eyes!  Your hands bring extra bacteria or viruses to your eyes where they can cause eye irritation, conjunctivitis, blepharitis or other infection.  You can have an infection without having red, goopey eyes.   If you’ve got hard, yellow “sleep” or “sand” in the corners of your eyes when you wake up, that’s most likely dried pus from a chronic, low grade, bacterial infection in the oils glands of the lids.

9.) Eat fatty cold water fish like tuna, salmon, mackerel 2-3 times per week

They are rich in the Omega 3 essential fatty acids EPA and DHA that are necessary for proper brain development and function and have many health benefits.  In your eyes, Omega 3s improve your tear film by changing the oils that you produce and increasing the watery layer of your tears and may be  protective against macular degeneration.

Omega 3s could be the subject of an entire blog post of it’s own but let me make some quick comments.

While getting Omega 3s in your diet is preferable to taking fish oil supplements, be sure to check the quality of the fish.  The fish that are high in Omega 3 are also at risk for heavy metal contamination (which have not been found in fish oil supplements).  Also,  be aware that farmed fish that are fed a grain diet will not provide Omega 3s.

Fish oil is a far better source of Omega 3 than flax.  Fish oil provdies EPA and DHA directly while flax provide ALA which has to be converted to the beneficial EPA and DHA.  Unfortunately, it’s conversion is not very efficient or predictable.  Some recent studies have also shown a possible link between higher intake of ALA and increased risk of prostate cancer and other medical problems.

Both Omega 3 and Omega 6 are essential fattys acids, but we need them in the proper balance and amount.  It is just as important to decrease Omega 6 (found in meat, dairy products and also in most of the oils used in processed foods such as corn, safflower, sunflower and cottonseed oil) in our diet as it is to increase our Omega 3.

For more information, check out these excellent articles on Omega 3 and Omega 6 EFAs on the  University of Maryland Medical Center website.

10.) Get the Varicella Zoster  vaccine if you are over age 60

Varicella Zoster is the virus that causes chicken pox and it stays in your body, hiding in the nerves.  With age, the immune system generally weakens and the virus can be reactivated, causing a painful rash commonly known as shingles.  Up to 30% of the population will develop shingles at some point in their life. If the eye is involved,  vision loss can occur due to corneal scarring,  ocular inflammation, glaucoma and cataracts.

According to this blog post at the NY Times, while an excellent vaccine is available for seniors, few are getting vaccinated.  Having treated patients with shingles I can tell you it can be a miserable experience.  I encourage you to read this FDA FAQ on the vaccine and discuss vaccination with your doctor.

If you choose not to get vaccinated, be aware of the signs and symptoms of shingles and be sure to seek immediate medical attention if you develop pain or a rash in a band on one side of your body.  There are inexpensive anti-viral medications that can treat it and minimize the risk of post-herpetic neuralgia and other long-term complications but they are most effective if started within 72 hours after the rash appears.   If there is any involvement around the eyes or nose, be sure to have your eyes examined too.

That should give you plenty of things to work on for  2011.    Have a Happy and Healthy New Year!

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{ 1 comment… read it below or add one }

1 Nathan Bonilla-Warford January 18, 2011 at 2:03 am

Great job pulling all this info together. Especially the relevant links.

Sadly, here in Florida we can’t make a snowman, but maybe I’ll post a picture of a sandcastle! :)

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