Pay Attention to Those Eyes!

In the last year, our lives have changed to say the least, and we’ve had to adapt. We now work, study, shop, socialize almost exclusively online making computers and cellular phones a must for normal daily activities to continue. According to the American Academy of Ophthalmology, the average person who works in an office spends 1,700 hours at a computer screen per year (excluding time spent on computers and phones not relating to work!). While technology is helping in the continuance of normal daily activities for the time being, there are 2 essential sensory organs that are especially being overworked and excessively strained more than usual – our eyes!

For small organs, our eyes allow us to see and experience our environment through vision. Excessive strain and/or irritation from our environment – such as screens, excessive bright light, pollutants, extreme weather, etc. – can lead to dry eye symptoms. Burning, stinging, redness, sensitivity to light, foreign body sensation, watery eyes, itchiness, excessive eye mucous, and blurred vision are common dry eye symptoms. It may also increase the chance of developing recurrent corneal abrasions. These symptoms can make many everyday activities difficult proving just how important this subject is.

Clinical research into this prevalent condition has identified the extent of its multifactorial nature. The risk factors are numerous and include age (most prevalently begin in 30s and peak in mid to late 70s), gender (more common in women due in part to the difference in immunity and physiology related to biological sex), chronic diseases (like diabetes, asthma, smoking, environmental allergies, hypothyroidism), ocular conditions (blepharitis, ocular allergies, contact lens wear, meibomian gland dysfunction), medication use (like SSRIs, statins, antihistamines, beta blockers, oral contraceptives) and excessive time using digital screens like cell phones, tablets, computers and TV (blink rate per minute is reduced by a third to one half when we use screens, with a normal blink rate per minute of 12 to 15, leading to dry eyes since blinking moisturizes the eyes). All these can lead to a dry and vulnerable ocular surface.

It is clear just how sensitive our eyes are and how crucial now more than ever that we take steps to protect them as much as possible. Here are 5 things that can be done to show dry eyes some extra TLC:

Blue light blocking lenses

Glasses with blue light blocking lenses do exactly that – block out blue wavelength of light (short wavelengths). Blue light makes up one third of the visual spectrum and the sun is actually a natural source of it. According to the Canadian Association of Optometrists, blue light at the lower energy (470-490nm wavelength) is beneficial and helps us maintain healthy circadian rhythms (ie: the sun). Excessive usage of screens, especially in the evenings are exposing us to more synthetic blue light than ever – and this is the problematic part. Blue light from screens has been associated with: disrupting sleep (by blocking melatonin release), increasing the release of cortisol, reducing concentration, inflicting damage on the cells in our eyes, and there is emerging evidence of its negative effects on obesity and diabetes. In the past, there has been contradictory evidence on the actual effect of blue light on our physiology. But recent research conducted with blue light blocking lenses among office workers proved effective against all the above – improving sleep quality, more concentration at work and reduced eye strain while working at screens. These lenses are readily available at retailers and online. Dr. Michael Breus, PhD, “The Sleep Doctor” recommends glasses with amber lenses, not clear ones for appropriate protection. The amber lenses absorb the excessive amount of blue wavelengths allowing the less harmful long wavelengths (orange and red) to pass through. Also, it is important to note that glasses don’t block 100% of short wavelengths, but rather between 50%-80%. Dr. Breus also recommends looking for lenses that block UV-A and UV-B, developed with sleep experts and are comfortable to wear to maintain compliance. Check out naturoacademy’s blue light blocking glasses and use code WELLNSTRONG for 10% off! 

Take Regular Breaks

Taking a reprieve from staring at screens is advice most optometrists and medical professionals would recommend for reducing eye strain. The 20-20-20 Rule is an easy way to remember when to take breaks and how. The Canadian Association of Optometrists describes this rule as: every 20 minutes of screen time, take a 20 second break by looking at an object that is roughly 20 feet away. Setting a repeating alarm for 20 minutes will help be a reminder to take a break. When working indoors, a great away to focus on something roughly 20 feet away is to look out the window and stare at a tree for example, or any other still object. Remembering to blink to lubricate the eyes is also critical.

Keep Eyelids Clean

As part of daily personal hygiene practices, it is important to clean our eyelids. The accumulation of bacteria, dirt, makeup, in additional to meibomian gland dysfunction can lead to blepharitis (inflammation of the eyelids). Conditions such as rosacea and scalp dandruff can also lead to inflammation and irritation of the eyelids. This can cause burning, itching, foreign body sensation, sensitivity to light, corneal swelling, among others. To help ensure eyelids stay clean and healthy, removing all makeup at the end of the day is crucial. Whether you wear makeup or not, it is then helpful to use a gentle eyelid specific cleanser to make sure all dirt and bacteria have been effectively cleared from the eyelid. There are also antibiotic eye drops, artificial tears, medications and treatments such as Blephex that may be beneficial for those afflicted with blepharitis. Regular visits to the optometrist are key for keeping eyes and eyelids at their optimum.

NAC Supplementation

NAC (N-acetyl-cysteine) is an amino acid precursor to an antioxidant made by our liver known as glutathione. Supplemental NAC is absorbed through the GI tract, and is then utilized by the liver to convert to cysteine. Cysteine, in combination with glycine and glutamate are the three amino acids that make up glutathione. The importance of glutathione in general health cannot be underestimated. It is involved in immune system regulation, fertility, regenerating antioxidants, removing systemic toxins, and other bodily functions such as eye health, specifically dry eye. Adequate glutathione levels help ensure reactive oxygen species (ROS) do not cause oxidative stress on cells, and therefore organs, such as the eyes. Studies have shown that increased ROS activates certain genes (NLRP3) which in return activate proinflammatory pathways and cytokines (IL-1Beta) which result in eye tissue inflammation. Considering NAC or liposomal glutathione supplementation should be considered for dry eyes, including NAC eye drops. Depending on your health history and the molecular form of the supplement, the efficacy of absorption between the two can vary. For example, research has shown that oral supplementation with glutathione can have poor bioavailability and therefore absorption as it may be quickly broken down. Always consult your physician or naturopathic doctor before commencing any supplement regime to make sure it is right for you.

IPL Treatments

IPL (intense pulsed light) is a known treatment for skin conditions such as acne and rosacea. It has also found its way to the world of optometry for the treatment of dry eye caused by meibomian gland dysfunction where the glands don’t produce adequate meibum to lubricate and protect the eye. For some the dysfunction can be linked to facial rosacea (leading to ocular rosacea) and hence the crossover in treatment effectiveness. The increase in small blood vessel numbers releasing inflammatory markers that begin to damage meibomian glands and cause dry eye are part of the pathophysiology of both facial and ocular rosacea. The treatment of IPL is a quick, painless and safe one and offered by some optometrists. Its proposed mechanism is reducing the telangiectasia’s responsible for inflammatory mediators. A research study found that 93% of 78 patients reported significant improvement and satisfaction with their dry eye symptoms after IPL treatments.


References:

Abelson, M. (2016). Oxidative stress reduction for dry eye. Review of Ophthalmology. https://www.reviewofophthalmology.com/article/oxidative-stress-reduction-for-dry-eye

American Academy of Ophthalmology. (2019). Protect your eyes from too much screen time. https://www.aao.org/newsroom/news-releases/detail/protect-your-eyes-from-too-much-screen-time

Breus, M. (2019). 5 things to know before you buy blue light blocking glasses. The Sleep Doctor.

https://thesleepdoctor.com/2019/07/16/5-things-to-know-before-you-buy-blue-light-blocking-glasses/

Canadian Association of Optometrists. Blue-light: Is there a risk of harm.https://opto.ca/health-library/blue-light-is-there-a-risk-of-harm

Canadian Association of Optometrists. The 20-20-20 rule. https://opto.ca/health-library/the-20-20-20-rule

Guarana, C. et al. (2020). The effects of blue-light filtration on sleep and work outcomes. Journal of Applied Psychology (July 13 2020) PMID: 32658494

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Dr. Elaina Mansour, ND

Dr. Elaina Mansour, ND

Dr. Mansour is a naturopathic doctor licensed in Ontario. She believes that educating patients about their health is the cornerstone of helping them reach their health goals. Having interests in gastrointestinal, hormonal health, and aesthetics, Dr. Mansour is always interested in learning new techniques and staying current with new medical information and research. She graduated from The Boucher Institute of Naturopathic Medicine in Vancouver, BC in 2014.

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