Eye Health in the Outdoors

Amongst my favorite memories as a child, there is one particularly cherished of which only a small vestige remains. I was no older than age seven when I conferred to do everything in my power to make my great-grandfather, whose age had just surpassed ninety at the time, happy: He had lost his wife in the springtime many years prior, and as memories often do, his sadness awakened in temporal fashion, with the melting snow and brightening sun. For hours, in hopes of drawing a smile, I danced around the front lawn while he sat on the staircase, cane in hand. With the dirt covered hands of a child who pays no mind to what is clean or proper, in concentrated effort, I climbed into his lap, legs swinging below, and placed flowers in a crown-formation atop his still jet-black hair. The kind man that he was, he slouched down to ease his head for my short arms’ reach. As my hand looped below, a flower meant for his crown accidentally swatted into his eye. Though shrapnel from an exploding bomb in the Second World War would cost him the privilege of two seeing eyes, of all chance, I had the misfortune of poking “the good one”. As he rubbed hastily, instead of a smile, I had inadvertently drawn a tear.

“When a person is poked in the eye, watering is a common response,” says Dr. James Stoyan, head optometrist at Stoyan’s Optical, easing my childhood worry as I recall my memory in conversation with him. He pauses for a moment; then, with the depth and clarity that only an optometrist of his lofty expertise and distinguished experiential stature could achieve, he details exactly what to do should a similar situation ever arise, noting from his lengthy practice that most of us — myself included — are completely unaware of proper protocol: “In a surface injury, a poke doesn’t penetrate the cornea (a protective layer of tissue on that covers the iris, the coloured part of the eye, among other mechanisms integral to our ability to see). The cornea has five layers and if an injury goes past the second layer, I might tell my patient to use artificial tear drops and cover it, and it should get better.” A common mistake, says Dr. Stoyan, is rubbing eyes after an injury, which can worsen potential cuts by causing ‘corneal abrasions’. If the cut becomes penetrating, however, which sometimes occurs through rubbing, “infection might set in and without the use of a steroid, antibiotic or antiviral, blindness can occur.” And with that, he answers my ever-lasting question of why my great-grandfather, now deceased, went blind after the shard of metal entered his eye: “Nowadays, if a flake of stainless steel enters the eye, doctors might choose to leave it in because it doesn’t rust. Other substances, however, can badly damage the eye, through infection or rust, so I always recommend safety goggles if welding or for certain outdoor activities.” 

Being cautious about what enters our eyes in the outdoors is not only privy to shards of metal, however, but everyday substances such as grass, trees, and sand: “Grass and trees have the potential of giving you a fungal infection if they enter the eye. If so, you’ll have to be treated with an anti-fungal. If it’s sand or dirt in the eye, you might get a viral or bacterial infection. If [a substance enters the eye], the first thing you should do to prevent infection is to wash the eye out thoroughly in cold water immediately and continuously for 10 minutes. After that, you have hopefully washed out all of the pathogens, but to be extra safe, if the eye still looks red or the patient feels something, see an optometrist or ophthalmologist.”

Though Dr. Stoyan recommends thoroughly washing one’s eyes with water, he cautions not to keep our eyes open underwater for too long, particularly if spending the summer months in swimming pools:

“The tears of our eyes have a pH of 7.3 or 7.4 out of 14. If you put water in your eyes, which is slightly more acidic [meaning the pH, a measurement of acidity, is less than 7.3], it burns a bit. A small amount of acid is put in swimming pools to keep them clean, and if you’re in there long enough, your cornea swells and you may feel burning. It’s best to wear under-water goggles if you swim repeatedly, because it would otherwise be constant exposure to acid in the eyes.”

While mild exposure to swimming with our eyes open rarely cause long-lasting damage, Dr. Stoyan warns it’s bathing of another variety which is the source of major harm to our vision: Sunbathing.

“Years ago, when I was a kid, we didn’t wear sunglasses; no one suggested it. Now, we suggest that all kids wear them because for those who didn’t and are now turning 60, we are seeing the development of cataracts. When a child wears sunglasses, they may age to 80 or more without cataracts or retinal damage.”

Why does sun exposure increase the damage to our eyes? The optimal amount of light intensity for our eyes (measured in units called foot-candles) is 150-200 foot-candles. In retail environments, such as shopping malls, the light intensity soars up to 1,000 foot-candles, which tends to make everything look brighter and therefore much more aesthetically pleasing. On a cloudy day outside, the light intensity is roughly 3,000 foot-candles, but in broad daylight, it can go as high as 12,000 foot-candles, nearly six times more than what knowledgeable specialists like Dr. Stoyan would consider optimal intensity for our eyes. To further complicate matters, the infamous ‘UV radiation’ is strongest in summer months (May to August) which can not only cause skin cancer, as dermatologists often warn, but also damage eyes, causing cataracts, macular degeneration and even solar burn – literally, a sunburn inside the eye.

“I had one patient who had his vision reduced after the solar eclipse because he was looking at it for more than 10 seconds… This caused what is known as ‘solar burn’, which left a scar in the back of his eye, permanently reducing his vision,” Dr. Stoyan recalls. “We’re told not to look at the sun, but we still do because of a false idea that sun-gazing is healthy for our eyes, but this isn’t the case.”

So, how do we protect our vision from the damaging effects of the sun? Besides seeing a qualified optometrist for eye tests (Dr. Stoyan recommends once a year for children, every two years for adults aged 20-40, and yearly checks thereafter), wearing appropriate protection can make all the difference:

“When you put sunglasses on, your pupils (the opening of the centre of our eye in which light enters) dilate to allow more light in, to produce a better image. When sunglasses do not contain UV protection, the UV radiation has even greater exposure to the naked eye through the dilated pupils, producing damage.” In other words, wearing sunglasses without UV protection would be the equivalent of your bare skin burning in the sun for hours on-end, with no sunscreen in sight. Though all sunglasses must have UV protection as mandated by Canadian law, Dr. Stoyan notes “the difference between the sunglasses you can buy at drug marts and convenience or retail stores versus Stoyan’s Optical is in the lens. Cheaper sunglasses use one UV coating, but better quality sunglasses can use up to 14 coatings. The quality of the cheaper glasses won’t cut out the UV as well as better quality glasses and won’t produce a clear image.” The lesson here is to get into the habit of wearing high quality sunglasses, preferably purchased from a store staffed with certified opticians like Stoyan’s Optical, whom you know and trust, and, of course, wearing your sunglasses whenever outdoors.

Dr. Stoyan also recommends an unlikely source of keeping eyes healthy: Exercise. Proven by scientific research to prevent the degeneration of neural cells in the retina (which cause a condition known as ‘macular degeneration’), there may be no better way to spend the outdoors than getting eye healthy by dancing around your own front lawn.

Dr. Stoyan’s Quick Tips for Eye Health

• Get regular eye examinations by a qualified and certified Optometrist.

• Invest in high quality sunglasses, with help from a trusted Optician, and wear them as often as possible.

• Get children into a habit of wearing sunglasses early.

• If a substance enters your eye, wash it in cold water for 10 minutes, avoiding rubbing. If it is still red or painful thereafter, see an optometrist, ophthalmologist or go to the hospital.

• If macular degeneration runs in your family, wear sunglasses, take vitamins, (particularly lutein and zeazanthin), and exercise.

Written By: Mariana Bockarova 

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