Expert Q&A: How to Protect Your Eyes and Prolong Your Vision Get Medical Advice and Patient Information

Yearly eye exams and frequent changes in your prescriptions may be part of life now. But how did your vision problems start? And what are the most effective treatments? To mark Healthy Vision Month, an ophthalmologist answers your most common questions about cataracts, nearsightedness, eye myths and more... The older we get, the more our vision fades, right? And, of course, our moms warned us that reading in dim light or sitting too close to the TV ruins our eyesight. But are these assumptions correct? “It was once simply accepted that you lose some degree of visual acuity with age,” says Uday Devgan, M.D., FACS, FRCS, a board-certified ophthalmologist at Devgan Eye Surgery and chief of ophthalmology at the University of California’s Olive View Medical Center, both in Los Angeles. “But now, thanks to surgical procedures with a high success rate and little pain or downtime, it’s possible for people to have terrific vision throughout their lives.” It’s also getting easier to protect your eyes from environmental dangers, Devgan says, whether it’s intense sunlight, a long plane flight or a ricocheting racquetball. In this exclusive interview with Lifescript, Devgan discusses how to preserve and prolong your vision. What is the single, biggest thing we can do to head off vision trouble? Wear sunglasses that block UV light. Intense exposure to UV light – such as a day spent skiing in bright sunlight – can actually burn the eye’s surface. Too much exposure to even moderate light can accelerate your chances of getting cataracts. Cataracts are very common – it’s the No. 1 surgery in the U.S., and almost everyone gets them if they live long enough – but light damage can cause cataracts at a much earlier age. What should parents know about protecting their children’s vision? An increasing number of kids are nearsighted and thus need glasses. There seems to be a loose correlation between nearsightedness and time spent indoors with computers, video games and books. In Hong Kong, 40% of children wear glasses, and the percentage is rising in the U.S., so pediatricians need to test for it earlier. There’s some debate about what age children need to begin receiving regular eye exams, but they definitely need a screening before they enter kindergarten. If their eyes are healthy, annual screenings are enough, but if the pediatrician finds a problem or you’ve noticed something seems off, such as they seem to favor one eye, take them to an ophthalmologist. Once kids have been diagnosed with a vision problem, they’ll need to see an ophthalmologist every year. What about sports injuries to the eyes? If you’re playing a high-risk sport, like racquetball, wear protective eyewear. It doesn’t have to be those goofy-looking goggles. Nike and other manufacturers are making glasses and sunglasses out of a strong bulletproof polycarbonate.They’re available at all big sports stores in different tints and styles. My kids wear them to play tennis – they look like cool sunglasses. Do diet and smoking affect vision? Oxidative damage affects the eyes just like any other organ, so a diet high in antioxidants can help keep eyes healthy. Smoking is one of the worst things for eyes. It can bring on cataracts sooner than normal and accelerate macular degeneration, the major cause of vision impairment in adults over 50. How does our health affect our vision? What diseases can cause vision change? Any disease that affects blood vessels can affect eyes, since eyes have a network of small but critical blood vessels. Both hypertension and diabetes can permanently damage vessels deep within the eye, which is why if you have either condition, it’s important to see an ophthalmologist annually. These conditions can be nipped in the bud if caught early. Are extra vitamins or minerals needed to prolong optic health? In the U.S., vitamin deficiencies are rare, so your daily multivitamin should be enough for healthy eyes. Since diseases such as macular degeneration are more common in the elderly, you sometimes see “eye health” vitamin compounds marketed toward them. These supplements won’t hurt you, but they’re usually not necessary. Is there any validity to those old wives’ tales about the dangers of reading in a dark room or sitting too close to the TV? No. Sit as close to the TV as you want. Read in a dark room. Kids have better visual function than adults and can read just fine in dim lighting. That’s one reason teenagers love to drive at night and most adults hate it. They have twice as much retinal sufficiency as we do. So when they say they can see just fine, they’re probably telling the truth. Can working at computers harm our vision? Computer use won’t hurt your long-range vision, but you can get dry eye or eyestrain if you work at your desk too long. Eyestrain is a result of focusing on something that’s 18 inches away, as opposed to looking around a room, when your focus is constantly switching between things that are near and things that are far. How does our health affect our vision? What diseases can cause vision change? Any disease that affects blood vessels can affect eyes, since eyes have a network of small but critical blood vessels. Both hypertension and diabetes can permanently damage vessels deep within the eye, which is why if you have either condition, it’s important to see an ophthalmologist annually. These conditions can be nipped in the bud if caught early. Are extra vitamins or minerals needed to prolong optic health? In the U.S., vitamin deficiencies are rare, so your daily multivitamin should be enough for healthy eyes. Since diseases such as macular degeneration are more common in the elderly, you sometimes see “eye health” vitamin compounds marketed toward them. These supplements won’t hurt you, but they’re usually not necessary. Is there any validity to those old wives’ tales about the dangers of reading in a dark room or sitting too close to the TV? No. Sit as close to the TV as you want. Read in a dark room. Kids have better visual function than adults and can read just fine in dim lighting. That’s one reason teenagers love to drive at night and most adults hate it. They have twice as much retinal sufficiency as we do. So when they say they can see just fine, they’re probably telling the truth. Can working at computers harm our vision? Computer use won’t hurt your long-range vision, but you can get dry eye or eyestrain if you work at your desk too long. Eyestrain is a result of focusing on something that’s 18 inches away, as opposed to looking around a room, when your focus is constantly switching between things that are near and things that are far. Focusing at the same depth all the time tires the muscles within the eye, so it’s smart to take a computer break of five minutes or so every hour, where you look away from the screen and walk around. What about dry eye? Is it really becoming more common? Dry eyes are the second computer-related problem. If you’re watching TV, you might look away from the screen during a commercial, and then you’ll blink and relax. But when people stare into a computer, their blink rate drops to a fraction of what it would be if they were watching TV. Less blinking means their eyes dry out. Dry eyes seem to be more common because we spend so much time indoors with processed air. Everyone’s had the experience of getting red, dry eyes on an airplane, and even an air conditioner in an office building is basically a dehumidifier. Dry eyes are also a function of age. Certain hormonal conditions such as menopause can also lead to dry eyes. Will over-the-counter eye drops for dry eyes help? Yes, if you just need it occasionally, such as during certain seasons of the year when your allergies are worse. Ninety percent of people do just fine with OTC medication, but make sure you get a brand that’s “preservative free.” Preservatives can irritate your eyes. Also, look for individual dispensers, so you’re not transferring germs into your eye along with the medicine. If the over-the-counter medication doesn’t take care of the situation, your ophthalmologist will run tests to measure tear production and, if needed, can give you prescription medication that helps your eyes make more tears. How does vision change as we age? Do we need more frequent eye exams? Even in healthy people with healthy eyes, it’s normal for vision to change over time, so after 60, you need an eye exam every year to monitor those changes. The normal cycle of vision goes like this: We have great vision when we’re young, and then about age 45, we begin to lose our near vision. That vision change is called presbyopia, and it’s fine to handle with a pair of cheap reading glasses from the pharmacy. They don’t make your eyes weaker as people sometimes think. Around age 60-65, you start getting cataracts. Exactly what are cataracts and how are they treated? There’s a lens behind the iris of the eye that is very clear when we’re children but gradually grows milkier each year. By the time people are in their 60s, it can be like looking through cloudy water. During cataract surgery, the cloudy human lens is removed and replaced with a new, clear man-made lens. This operation is usually done in less than 10 minutes with no stitches, needles, or bleeding. Recovery time is almost immediate – my patients can see the clock on the wall a few minutes after surgery. Though cataract surgery has a 99% success rate, don’t take it lightly. You’ll be seeing the world through this lens every moment for the rest of your life, so interview your surgeon and make sure you feel comfortable with his or her experience level. What vision problems should send you straight to the doctor? If you lose vision in an eye or part of an eye, get help immediately. A laundry list of things can cause a sudden loss of vision, but all are bad. Also seek immediate help for severe eye pain. How dangerous is the classic eye disease of childhood, pinkeye? Conjunctivitis, an irritation of the clear layer that covers the eyes, is highly contagious, but 99% of the time it’s not dangerous. If the discharge from the eye is watery and clear, it’s just pinkeye, the viral type of conjunctivitis and can be treated with over-the-counter medication. But if the discharge is a thick mucus, it’s bacterial conjunctivitis, and you’ll need to go to the doctor for antibiotic eye drops. What’s new in vision correction? Everyone knows about LASIK surgery, but actually that’s just one of a spectrum of ways to correct vision. Some people are opting to have cataract surgery earlier just to get the better lenses sooner. Permanent contacts can also be implanted in the eye. What do we know now about vision change that we didn't know 10 years ago? The new generation of lasers for cataract surgery is getting better and better, and so are lenses that can be implanted. Medicare pays $100 for the lens you use in standard cataract surgery, which is OK, but it’s about the quality of a $100 camera. When my mom had the surgery recently, I suggested she get one of the premium lenses, which are premium both in quality and cost, which is about $3,000. She’s in her 70s, and now she can see better than I can. For more information, visit our Vision Health Center. Are You Taking Care Of Your Eye Health? As we age, vision and eye health deteriorate. By tackling your eye health problems now, you can prevent or slow the progression of vision loss in the future. While going to regular appointments with health care providers is smart, is it enough? Should you be eating more carrots and taking health supplements?