COVID-19 and the EYE

The new coronavirus behind the pandemic causes a respiratory illness called COVID-19. Its most common symptoms are a fever, coughing, and breathing problems. Rarely, it also can cause an eye infection called conjunctivitis. Based on data so far, doctors believe that 1%-3% of people with COVID-19 will get conjunctivitis, also called pinkeye. It happens when the virus infects a tissue called conjunctiva, which covers the white part of your eye or the inside of your eyelids.

Symptoms are:

• ·         Red
• ·         Swollen
• ·         Itchy

If you have conjunctivitis, it doesn’t necessarily mean you have COVID-19. The more likely causes are the many different viruses, bacteria, chemicals, and allergens that can irritate your eyes. Many forms of conjunctivitis go away with over-the-counter treatments in about 1-2 weeks. But if you also have a fever, cough, or shortness of breath, ask your doctor what, if anything, you should do. Call before you head to a hospital or a medical center to see if it’s safe for you to visit and for any instructions for your arrival.

The new coronavirus, named SARS-CoV-2, gets passed on primarily through droplets from a cough or a sneeze. These particles most often enter through your nose or mouth as well as your eyes. It’s also possible to catch the virus if you touch a contaminated countertop, doorknob, or other surfaces. But this doesn’t seem to be the main way the virus spreads.

If you have conjunctivitis from COVID-19, you may infect others with SARS-CoV-2 if you touch your eyes and then touch people or surfaces without washing or disinfecting your hands. Avoid touching your face, especially the mucous membranes in your mouth, nose, and eyes.

How to Protect Your Eyes

Guarding your eyes — as well as your hands, nose, and mouth — can slow the spread of coronavirus. Here are some ways to you can keep your eyes safe and healthy during this coronavirus outbreak. Like everyone, be sure to wash your hands often and stay home whenever you can. If you go out, keep 6 feet away from others.

It also may be a good idea to:

Wear glasses. If you wear contact lenses, switch to glasses for a bit. That may help keep your hands away from your eyes. Also, the lenses may help protect your eyes from any respiratory droplets. If you don’t wear glasses, try sunglasses. And if you’re caring for someone ill, don safety glasses or goggles.

Stock up eye medication. Check with your insurer to see if you can refill glaucoma drops and other essential prescriptions in advance. You might be able to get a 3-month supply. Ask your doctor or pharmacist for any help.

Don’t rub your eyes. It can be a hard habit to break. Moistening drops may help ease itchiness. Wash your hands for 20 seconds before and after you do it. If you must touch your eyes, use a tissue instead of your fingers.

Expect changes to eye exams and procedures

You should wear a mask to your appointment. If you do not have a mask, one may be provided for you.

·         The clinic may ask you to wait outside, or in your car, instead of in the normal waiting room. This is to protect you, the other patients, and the office staff from possible virus exposure in crowded waiting areas.

·         The clinic is likely restricting the number of people that enter. If you do not need someone to be there with you for the actual appointment, please do not bring anyone into the building with you.

·         Your temperature may be checked on entry to the building.

·         Your eye doctor may use a special plastic breath shield on the slit lamp machine they use to look into your eyes. They will also wear a mask, and may also wear gloves, goggles or a plastic shield over their eyes.

·         Your doctor may ask you to wait to speak until after your eye exam is complete. Then they can talk with you and answer questions when they can be a safe distance from you.

You will be asked to follow certain precautions

·         If you have a cough or a fever, or have been in close contact with someone who has these symptoms, you must call your doctor’s office ahead of time and let them know. If your visit is not an emergency, you may need to stay home.

·         If you arrive sick, your doctor may ask you to return home. If you have a problem that cannot wait to be seen, you will be asked to wait in a special room away from other patients. The clinic staff and your physician may wear additional protective equipment, such as gowns and gloves.

·         If you need to cough or sneeze during your exam, move back from the slit lamp microscope machine. Bury your face in the crook of your arm or cover your face with a tissue. Wash your hands with soap and water right away.

Li Wenliang, MD, Ophthalmologist, Wuhan

The 33-year-old doctor was the first to raise the alarm about the coronavirus in late December 2019. Using the Chinese social media platform Weibo, Li attempted to warn his colleagues about a cluster of SARS-like pneumonia cases. As his posts went viral, he realized that he “would probably be punished." Within days, he was summoned by Chinese officials and forced to sign a letter accusing him of "making false comments" that had "severely disturbed the social order". A copy of that letter was later posted on Weibo.

Following the incident, Dr. Li returned to work and, unfortunately, contracted the virus from an asymptomatic glaucoma patient in early January. In several interviews with Chinese media, he said that the patient eventually developed a fever and CT scans showed an unknown virus in her lung. Soon after, he started coughing, became febrile and was hospitalized. Tests confirmed he was infected with the coronavirus on Jan. 31. Wuhan Central Hospital confirmed his death on February 7 after a series of conflicting reports about his condition.

The news of his demise has sparked a public outpouring of anger and grief. Many have hailed him a martyr and a national hero for his attempts to warn the public.

Your Child's eye during COVID Lockdown and online classes

We used to ask our children not to look at the TV or computer for long time, but now during the COVID lockout they need to sit for hours in front of the TV and computer to attend school lessons. Parents are genuinely concerned about how this prolonged viewing of the computer will affect the eyes and vision of their child.

Computer Vision Syndrome (CVS) is the term used to describe the condition commonly seen in persons working on computers for long hours. The symptoms of Computer Vision Syndrome involve not only the eyes but also the musculoskeletal system.

Eye problems consist of:

• Eye strain, Watering

• Irritation and Foreign body sensation

• Headaches or pain in and around eyes

• Blurred vision

Musculoskeletal problems consist of:

• Pain in the neck

• Pain in lower back

• Pain in the wrist

• Inability to concentrate after a while

• Disturbed sleep

Other Problems:

Uncorrected refractive errors are the single most important factors that trigger off this disorder. Hence even a small refractive error need correction. It is ideal to check your child's vision at five years of age. Thereafter it is prudent to check the eyes if the child complaints of headache, eyestrain or blurred vision.

The CVS can be reduced by adjusting the computer monitor as follows

• Sit farther away from your computer screen. A good rule is to be at least 25 inches, or roughly an arm’s length, away. 

• Adjust the height of the chair to keep the upper edge of the monitor screen below the level of your eyes so that you do not have to extend your neck or keep your eyes wide open to see the screen.

• Background should be light & letters dark. Black letters on a white background are easiest to read and least strenuous on the eyes.

• Keep the font size at least two points larger than the size you can read easily. Prefer scrolling on the screen rather than zooming down to have every thing in one view.

• Dim your screen if it’s much brighter than the rest of the light in the area. You could also adjust the room lighting so the contrast is lessened.

• Keep your screens clean. Dirty screens with fingerprints and other debris can strain your eyes even more.

• Viewing distance should be comfortable. Place monitor in such a way that there is no reflection of light on the screen. The source of light should be on your sides to avoid reflection on the screen. If a bright source of light e.g. a window is directly in front of your eyes, the glare will be highly disturbing. Some people feel comfortable working in a dimly lit room. Maintaining absolutely essential brightness is necessary to avoid straining eyes.

• If you have to work for long hours, use support for the lower back. Position your key board, mouse and monitor in such a way that the body remains in a straight posture to see as well as handle these.

• The eyes are constantly moving and accommodating while working on computers. To rest your eyes follow a 20:20:20 rule. It means that every 20 minutes take a break for 20 seconds and get up to look at a distance more than 20 feet. This will rejuvenate your eyes and make working more comfortable

• Computer glasses make working on computers comfortable and are not needed otherwise, for distance or near vision correction. Computer glasses should ideally be UV protective and have a good quality anti-reflective coating to avoid the glare.

BLUE LIGHT

Blue colour has elicited a of of interest nowadays. Blue light is the visible light spectrum with the shortest wavelength and highest energy, and similar to ultraviolet rays. The short-wavelength, high-energy light rays on the blue end of the visible light spectrum scatter more easily than other visible light rays when they strike air and water molecules in the atmosphere. The higher degree of scattering of these rays makes the cloudless sky look blue. Our eye only lets less than one percent of UV radiation from the sun to reach the retina. On the other hand, virtually all visible blue light passes through the cornea and lens and reaches the retina. Many eye care providers are concerned that the added blue light exposure from computer screens, smartphones and other digital devices might increase a person's risk of macular degeneration later in life. More research is needed, though, to determine how much natural and man-made blue light is "too much blue light" for the retina.

Because short-wavelength, high energy blue light scatters more easily than other visible light, it is not as easily focused. When you're looking at computer screens and other digital devices that emit significant amounts of blue light, this unfocused visual "noise" reduces contrast and can contribute to digital eye strain. Research has shown that lenses that block blue light with wavelengths less than 450 nm (blue-violet light) increase contrast significantly. Therefore, computer glasses with yellow-tinted lenses may increase comfort when you're viewing digital devices for extended periods of time.

White LEDs may actually emit more blue light than traditional light sources, even though the blue light might not be perceived by the user. This blue light is unlikely to pose a physical hazard to the retina. But it may stimulate the circadian clock (your internal biological clock) more than traditional light sources, keeping you awake, disrupting sleep, or having other effects on your circadian rhythm.

A lot of mobiles have got blue light filters and some spectacles lens come with blue light filter. Hence many parents enquire about effects of blue light. Blue light is of concern because it has more energy per photon of light than other colors in the visible spectrum, i.e. green or red light. Blue light, at high enough doses, is therefore more likely to cause damage when absorbed by various cells in our body. Current research shows that for normal use a person need not be too much concerned about blue light and it's effect on the eye.

DRY EYE

Tears are constantly secreted in our eyes to keep the front surface of the eye wet. This wetness of front surface is absolutely essential for clear and comfortable vision. If there is tear deficiency, it will cause dry eyes and lead to computer vision syndrome. At times of extreme concentration like studying on a computer, the blinking rate usually decreases. Humans normally blink around 15 times each minute. When staring at screens, this number decreases to a half or third that often. That can lead to dry, irritated, and tired eyes. Tears dry up faster leading to a to false dry eye state. Such cases can be helped by artificial tears, available as Eye Drops. One should also try and blink as normally as possible. A simple method is called the 20 20 20 rule.

Every 20 minutes take a break for 20 seconds by looking at an object more than 20 feet away. This gives rest to the eye muscles and helps replenish the tear film. 

OUTDOOR ACTIVITY

Some research has shown that lack of outdoor activity and sunlight exposure may cause myopia or short sight. So it is prudent that children spend atleast one hour outside and get some exposure to sunlight.