There are some things you'd rather not see.
Like whatever just squished under your shoe while walking in the park. Or when the thing that you thought was an extra thick boot lace moved of its own volition. Or the man crossing the street showing the world his Kermit the Frog boxers as his belt and jeans slip southward.
For everything you'd rather not see, there's at least another thing you do want to see.
Like the last of the snake that you thought was a boot lace. Or your indoor cat waiting on your porch after his latest Houdini trick. Or two more chocolate peanut butter cookies in the package when you desperately need chocolate.
Thankfully, we can protect our eyesight by slipping on a pair of safety glasses. When is the right time to take this precaution?
"All the time," Alison Granier, an ophthalmologist at the North Idaho Eye Institute says. "I'm biased because I see the worst of the worst, but I would probably have my children or my loved ones in protective eyewear for everything if it were up to me."
On the Injured List
"I've seen everything go into an eye. Hangers, Barbie legs, pencils, knives, golf balls, air soft pellets," Granier says.
One of the worst injuries Granier has encountered was a patient who had a circular saw blade penetrate through his eye and into the front of his brain. Somehow the man resisted any urge to pull the blade out himself. The patient survived the injury, but not only was his eye affected, he also ended up with "significant neurological dysfunction."
Sara Edmons, an optometrist at Eye Consultants in Spokane, has also seen her share of objects vs. eyeballs. Like a high school student with a pencil in his eye (because the teens were throwing pencils at each other). The pencil penetrated the student's lens (behind the iris, the colored part of the eye) and displaced it, leading to permanent vision loss.
So, danger lies not just in what you're doing, but also what the person next to you is up to, notes Granier. This is true for work and for recreational activities like skiing, hiking, riding an ATV and gardening.
"I've seen a surprising number of plants go into corneas when people are pruning," Granier says.
Another situation to consider wearing safety glasses is for sports that involve balls — like tennis, volleyball, pickleball, etc. — according Edmons. "When my brother was in high school, he got elbowed in the eye in a basketball game, and he ended up bleeding in his eye," and missing a week of school. Edmons also recommends wearing safety glasses in any dusty, dirty environment.
For people who already have impaired vision loss in one or both eyes, it's especially crucial to wear eye protection.
Granier sums it up: "Realistically, you should have protective eye wear on whenever you're doing anything that involves unpredictable movement patterns, unpredictable obstacles or machinery, or any kind of industrial application if you work in a welding shop, auto shop, mechanic, etc."
Extent of Injuries
Let's start with minor problems.
Granier says some superficial eye injuries include scratches and/or foreign bodies that can be treated in a doctor's office by removal of the object and antibiotic eye drops. (Note that eye infection can be serious, destroying vision in as little as 48 to 72 hours.)
Significant, though usually temporary, vision impairment can arise from a superficial trauma, say from being struck by an airsoft pellet or in fist fight, when bleeding in the anterior portion of the eye gets stuck between the iris and the cornea. Termed hyphema, it's most often found in kids and young adults, and if treated quickly and appropriately, it results in full vision restoration.
One alarming, but not usually serious ailment is a broken blood vessel, a bloody area that develops in the white part of the eye. The causes are varied and can be something as innocuous as rubbing your eye, sneezing, coughing or taking a blood thinner (like an aspirin to treat a headache).
"They look really bad, and they always make people very nervous, but oftentimes they usually are not of much concern," Granier says.
If you do have a broken blood vessel and it's accompanied with discomfort, vision changes or a sudden light sensitivity, it's best to get it checked, she cautions.
Things can get much worse if you choose to forgo the safety gear (or temporarily remove it at the wrong moment). One of the most serious scenarios is a ruptured globe. This is when an object (like a saw blade) penetrates or perforates the eye.
This requires surgery and the possible long-term complications include low or elevated eye pressure and scarring. Depending on where the object entered the eyeball, a patient's eye may never function the same way again.
"If (an object) enters your iris or your lens, which are the structures that lie behind your cornea, that can be very devastating. If you have an object that either goes all the way through to the back or exits the back of the eye in the retina, that causes a much, much more complicated injury," Granier says. "They're much more likely to cause a level of blindness or visual impairment."
Retinal detachment is another serious situation.
"Retina is like the film of the camera," Edmons says. "If the retina detaches from the back of the eye you lose vision where that retina has been detached."
A detached retina requires surgery, and the sooner you are seen by a doctor, the better your possible outcome.
"If you come in right away, within a day or two of it happening, and we get [it] fixed, we can frequently get vision back to normal, but if it's ignored and the patient waits several weeks before they come in and it is something as serious as a retinal detachment, the retina starts to die," Edmons says.
"Even if we get it reattached it's lost that blood flow, it's not going to regenerate, and patients may always have — depending on the severity of detachment — some peripheral vision loss if it was just the peripheral part of the retina that was detached. So it's important to get in right away."
Raise Your Glasses
If you're now convinced eye protection is a good idea, Edmons and Granier recommend polycarbonate safety glasses because the material won't shatter if it's hit with an object moving at high speed. And no, regular prescription or even sunglasses don't offer enough protection. You need safety glasses that have peripheral protection and are formed to your face so nothing can slip behind the glasses and enter your eye.
(Plastic protective glasses aren't recommended by Edmons unless it's to protect your eyes from chemicals you're working with, like bleach.)
Polycarbonate safety glasses that can fit around your prescription glasses are available, and you can even order a pair that contains your prescription.
"Most opticals in our area are comfortable helping you custom order. Oftentimes there's also an insurance benefit for that if you talk to your employer or look at your vision insurance. Insurance companies like to prevent eye injuries because they are costly," Granier says. "Make [eye protection] a conscious effort in your day to day life, and especially at the times when you wouldn't expect or anticipate it, because those seem to be the injuries that sneak up on us."
Vision for the Future
There are nutrients shown to benefit eye health, including antioxidants (like vitamins A, E and C, as well as zinc and lutein). So include them in your diet, optimally through eating foods like kale, spinach, collard and beet greens as well as blueberries and blackberries, or if you can't do that, supplements may help.
"There can be a lot of expense and false advertising in some supplements that are purported to support eye health. More than they actually have evidence," ophthalmologist Alison Granier says. "Most of those things aren't necessarily dangerous, but I have seen vulnerable populations spend a lot of money on supplements that are probably not effective."
"Fish oil is good for the eyes, so eat fish several times a week," optometrist Sara Edmons says. "If you don't like fish, you can take a fish oil supplement."
General health for your entire body is also important for your eye health. "The more diseases we have, the more likely you're going to have eye diseases," Edmons cautions.
Shades On
While you may wear sunglasses more for your comfort in bright or intense light, sunglasses also help avoid sunburn of the eyes and eyelids. Eyelids account for about 10 percent of all skin cancers, mostly because no one is chancing rubbing sunscreen in their eyes. Meanwhile, "Somebody's out in the sun, they can get a sunburn on their cornea," says optometrist Sara Edmons of Eye Consultants in Spokane. "Also chronic exposure to ultraviolet light is going to speed up cataract formation, a yellowing, clouding to the lens of the eye."
If you're lucky to celebrate a large number of birthdays, you're eventually going to develop cataracts, but "if you don't wear sunglasses and you live outdoors, you're going to get cataracts much younger in life," Edmons says.
The best kind of protection is from sunglasses with a sticker stating "100% UVA and UVB protection." The tint and darkness of sunglasses is a personal preference. People with lighter colored eyes are usually more sensitive to light and may prefer darker sunglasses. Polarized lenses are nice if you're light sensitive or need glare reduction, like for boating or skiing.
Edmons recommends children form the habit of wearing sunglasses at a young age. She had her own son sporting shades at 6 months old. While he initially pulled them off, over and over again, she kept putting them back, and eventually he stopped resisting.
Dry Itchy Eyes
Lots of things can cause dry itchy eyes and teasing out the exact cause may take time. Eyes may get itchy due to allergies.
Pataday and Lastacaft are the over-the-counter brands of allergy eye drops that ophthalmologist Alison Granier of the North Idaho Eye Institute suggests patients use. Wearing sunglasses can help minimize the allergens in your eyes, as can keeping windows closed at night in allergy seasons. Showering in the evening, including washing your hair and eyelids, can help remove any pollen lingering from the day. Oral allergy medication may also help.
Staring into a computer screen for most of the day can lead to dry eyes, which can be helped by using lubricating drops or by simply trying to blink more frequently. "The only way those tears get spread over the surface of the eye is to blink," optometrist Sara Edmons says.
Other dry eye treatments involve increasing tear production or preventing tears from evaporating, and even plugging tear ducts so the tears in the eyes stick around longer.
