The World Health Organization’s World Sight Day happens Thursday, Oct. 11, so we thought we’d check in with Dr. Christopher Starr, director of the ophthalmology residency program and the refractive surgery service at Weill Cornell Medical College, in New York City, to see what’s up with preventive eye health.
Dr. Starr referenced a recently released Bausch and Lomb survey on the state of global eye health, which demonstrated surprising results on behavior and attitudes. For instance, fifty percent of baby boomers do not have yearly eye exams, but still would rather lose their sense of taste or hearing than their vision. Of the 11,000 consumers in 11 countries and 10 U.S. cities surveyed, 83 percent of those older than 55 believe they are knowledgeable about eye health, yet 97 percent of doctor’s surveyed think patients have insufficient knowledge.
AgeBlog: What do you anticipate for baby boomers’ eye health as they age?
Dr. Starr: It’s going to be an unprecedented time for all medical specialties, but especially ophthalmology. Americans and elders worldwide tend to be wiser about eye smart behaviors than are younger people, but still most survey respondents were under the impression that if they could see well and didn’t have eye pain they didn’t need to be checked.
But there are so many things you can pick up in routine eye exams. With newer technology we can see deeper into the eye and with finer resolution. Even just looking in with the naked eye, we’re able see the body’s blood vessels, and things like hypertension, diabetes, high cholesterol. We can see certain cancers that metastasize to the eye. Blocked carotid arteries often precipitate the question, “Have you had your cholesterol, carotid arteries checked?” We can prevent major catastrophic stroke.
AgeBlog: What’s the biggest risk factor for eye disease?
Starr: Age. And the two biggest diseases are macular degeneration and cataracts. If you live long enough you will get a cataract. If you’re over 55 or 60, you will get cataracts. With boomers living longer, everyone will get cataracts. When compared to open heart surgery and brain surgery it’s a relatively risk-free operation with local anesthesia, and it’s fairly quick—10 to 30 minutes. You’re ambulatory, with no overnight stay in the hospital. When all goes well people see better the same day or the next morning.
AgeBlog: What’s the smartest eye behavior?
Starr: One of things we saw in the global health survey was protecting eyes from UV light or sunlight. It’s well known that excessive exposure to UV rays can cause cataracts to grow faster, and exacerbate macular degeneration, can cause tumors on the eyelid and melanoma. Dermatologists have done a fine job on getting people to use sunblock, but the message about the importance of sunglasses that block 100 percent of UV rays is critically important.
AgeBlog: What’s been the impact on eyes of constant computer use?
Starr: The majority of people surveyed didn’t realize that excessive computer use can damage the eye. It’s more about the habits while on the computer that matter—ergonomic things one can do to improve comfort and reduce ocular degeneration. This also pertains to cell phones and iPads—any digital device.
We call it Computer Vision Syndrome, and we’re seeing it more and more. People who look at a computer all day long will have red eyes, irritated eyes, dryness, eye fatigue, pressure in and behind eyes, trouble focusing between the computer and far away, blurred vision.
It’s from focusing at this relatively close object at eight hours at a clip and it’s taxing on muscles—they tend to give way. The redness, tearing, burning, foreign-body sensation, that’s the ocular surface drying out as the day goes on. We blink less when we’re on the computer, blinks decrease by less than 50 percent. We’re not distributing healthy, fresh tears across the eye surface, and tears evaporate quickly, creating significant dry eye.
We counsel patients on the 20-20-20 rule: When you’re on the computer, every 20 minutes look away at a distant object that’s 20 feet away, for 20 seconds. And put a bottle of artificial tears in front of your computer to use. Make sure the monitor is below eye level, similar to reading a book. That forces you to look down, creating more tears.
AgeBlog: Why don’t people get preventive eye exams?
Starr: Almost unanimously people would say that vision is the most important thing in their life, they would rather lose a limb, 10 years of life—50 percent would rather take a pay cut than lose their vision. But it’s still more likely they’ll go to dentist twice a year. I think dentists have done a far better job in getting the word out about preventive exams than have ophthalmologists.
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