EYE CARE AT WORK, HOME AND PLAY
"I care"

A Precious Gift

Most of us take our eyesight for granted.  We rarely realise how much we depend on our ability to see until an injury or changes in our vision remind us that our eyes are not only marvellous, but irreplaceable.  Most eye injuries can be prevented and most eye problems can be successfully treated if diagnosed early.  The key to preserving your gift of sight is eye care - having routine eye examinations as needed, taking simple precautions to avoid eye injuries, and learning first aid in case an eye injury should occur.  Saying "I care" is the first step of all.

Preschool Years
Eye problems during early childhood may be hard for parents or teachers to detect because children naturally assume their vision is normal.  One in every 20 children between the ages of 3 and 6 has an eye problem, such as "lazy eye" (amblyopia), poorly aligned or "crossed eyes" ( strabismus) or poor vision.  Your preschooler's eyes should be checked before age 6 because some problems can result in poor vision if not diagnosed and corrected early.

Young Adult Years
Periodic vision checks during the teenage and young adult years may be recommended by your eye doctor.  A vision problem, such as nearsightedness (myopia), is common during the pre-teen and teenage years and it may lead to difficulty with schoolwork because of the inability to see well at distance.

"After 35"
As they enter middle age, most people begin to experience difficulty with reading and close work, a condition know as presbyopia.  More serious is the fact that glaucoma, a leading cause of blindness, is more prevalent in people over 35 and may not have any early symptoms.  A routine examination to check for glaucoma, presbyopia and other problems will increase the chance for successful treatment of these conditions.

"Over 50"
Usually our eyes give us many years of good service, often with nothing more than the help of reading glasses.  But in later years, as part of the normal aging process, the lens of the eye may become clouded.  This common problem is called cataracts.  Although cataracts are still a major cause of poor vision today, surgical correction is very successful in restoring good vision.

Eye Safety is a Good Idea
90% of all eye injuries are clearly preventable by taking simple protective measures, such as wearing safety glasses when needed.  Keep all sharp objects out of the reach of babies and toddlers.  Teach your children the basics of injury prevention.  Adults should also learn to take special precautions when necessary in potentially hazardous situations.

Whether at work, home or play, protecting your eyes and knowing what to do if an injury should occur may save your sight!

How Your Eye Works

The eye works basically like a camera.  Light enters through a small hole, the pupil, which is like the lens opening of a camera.  The image is then focused onto the retina by the eye's lens, just as the camera's lens registers an image onto film.  The coloured ring of the eye, the iris, controls the amount of light allowed into the eye.  It automatically opens (dilates) or closes (constricts) the pupil when the light around you changes.

The human eye is, of course, more complex than a camera.  The outside of the eye is covered by a tough, white sheath called the sclera. The front part of the eye is the cornea, a clear covering that allows light to enter.  Muscles inside the eye automatically change the shape of the lens to focus light on the retina.  This delicate sheet of light-sensitive nerve tissue collects and transmits visual images to the brain via the optic nerve.

The lens, iris and cornea are nourished by a special, clear fluid.  This fluid flows through the pupil and is absorbed through channels in front of the iris.  The delicate balance between fluid production and absorption controls pressure within the eye.

Normal Refraction
As light enters the eye, it is bent (refracted) by the cornea and lens to focus an image on the retina.  The lens automatically changes shape to adjust the focus for near or far objects.  A flexible lens and a normally shaped eyeball and cornea are necessary for clear vision.  The eye is rarely perfect, however, which is why over half of the USA population uses corrective lenses.

Nearsightedness (myopia)
This means  that you can see near objects more clearly than those at a distance when the eyeball is too long, light rays from distant objects meet and focus before they reach the retina.  The result is blurred vision. 
Correction: concave lenses, which are thinner in the centre than at the edges, spread the light rays outward so that the image is focused clearly on the retina.

Farsightedness (hyperopia)
This means that your eye's lens can bring distant objects into focus more easily than near ones, although many farsighted people have difficulty with both.  When the eyeball is too short, light rays do not meet in focus by the time they reach the retina.  The result is blurred vision.  Although slight farsightedness is usually not a problem, a more pronounced condition can cause blurring or eye-strain with close work.
Correction: Convex lenses, which are thicker in the centre than at the edges, bend the light rays inward so that the image is focused clearly on the retina.

Astigmatism
This condition blurs objects viewed at all distances because the shape of the cornea is not uniform. 
Correction: special lenses are used to compensate for the curve of the cornea.

Presbyopia
This means that, with the normal process of ageing, the eye's lens gradually becomes less flexible and may be unable to focus on near objects.
Correction: convex lenses, which are thicker in the centre than at the edges, or bifocals are used to help with reading and close work.

Eye Examinations

An eye examination at key times in your life is important not only to diagnose and correct refractive problems, but also to check for certain eye conditions that may have no noticeable symptoms.

Medical history
It is essential for your doctor to know your medical history.  You will be asked about any current or previous eye problems that you may have, and also about your general health.  Your doctor will look for potential problems that your medical history may suggest, especially if anyone in your family has had glaucoma, blindness or cataracts, among other conditions.

Preschool examination
Because very young children are unable to recognise whether or not they have a vision problem, an early professional eye examination is crucial.  Early diagnosis and correction of problems, such as amblyopia or strabismus, is essential to preserve your child's vision.

Amblyopia test
Various eye problems can result in a child's learning to depend primarily on one eye.  The other eye may then become a "lazy eye" (amblyopia).  This condition can be detected by quick screening tests even before the child can read.  Often the child will be asked to "read" an E chart by pointing in the same direction as the various E's.  If amblyopia is discovered early in life, preferably before age 6, the condition can often be corrected. 

Strabismus test
Strabismus is a condition where the eyes are not straight.  Strabismus can be detected by covering one eye at a time and having the child follow a moving light or toy.  Because strabismus can lead to amblyopia if it is not corrected early, this test is extremely important.

If your doctor suspects that your child may have a vision problem, additional tests may be performed.  Sometimes it may be necessary to use eye drops that relax the child's strong near-focusing muscles in order to get accurate test results.  Glasses, patching, eye exercises, or a combination may be prescribed to correct vision or to help your child learn to use both eyes together properly.  For correction of strabismus, surgery is frequently necessary.

Adult examination
Routine adult eye examinations should start during the teenage or young adult years and be repeated as recommended by the doctor throughout your life.

Vision test
Your vision will be checked with the use of a refractor (or phoropter) and a retinoscope.  The retinoscope shines a light through the refractor onto the retina, allowing your doctor to estimate each eye's refractive error and the correction needed.  You will then be asked to read a chart of letters or numbers while you look through the refractor.  Although many of the characters on the chart may appear blurred at first, your doctor will change the refractor' lenses until you can see the images clearly.  Don't worry about giving the "wrong" answer when reading the chart - your responses just help your doctor "fine tune" the diagnosis reached with the refractor and retinoscope.  After your vision is checked, your doctor uses special instruments to examine the various parts inside your eye, often with the use of eye drops to dilate the pupils.

Slit lamp
A slit lamp is a microscope that magnifies and illuminates the surfaces of the cornea, iris and lens, and aids the doctor in locating conditions such as cataracts and corneal problems.

Ophthalmoscope
An ophthalmoscope magnifies and illuminates the deeper structures of the eye and allows the doctor to examine the retina for possible problems.  Because the retina is the only place in the body where the nerves and blood vessels are directly visible, your eye is a window into your body, where signs of many diseases, such as diabetes, hardening of the arteries (arteriosclerosis) or hypertension can be detected.

Glaucoma test
In glaucoma, the channels that absorb the fluid inside your eye become blocked, causing an increase of pressure inside the eye.  There are two types of glaucoma - one where the pressure builds very gradually without symptoms, the other (acute) where the increase is rapid and painful.  Both types can damage the optic nerve and cause vision loss.  A tonometer painlessly and delicately presses on the eye, or blows a puff of air at the eye, to check the pressure.  Depending on the method used, anaesthetic eye drops may be applied first.  This test is particularly important for those over 35, because glaucoma usually begins during middle age.

After the examination, your doctor will prescribe corrective lenses if necessary, and you may have a choice between glasses or contact lenses.  You will also be told how soon you should have another eye examination.  If it is necessary, additional testing or treatment may be suggested.
   
Corrective Lenses

If you need corrective lenses, your ophthalmologist or optometrist can help you pick the ones best for you, depending on the nature of your vision problem.  There are two kinds of corrective lenses available: eyeglasses and contact lenses, which are thin plastic discs that rest directly on the cornea on a film of tear fluid.  If you have a choice, the following comparison between glasses and contact lenses may help you decide.

Glasses:
Good correction for almost all vision problems
Limited peripheral vision with strong prescriptions
Easy to get used to - more practical for many people, including young children
Less expensive and sturdier than contact lenses
Can fog up or get in the way
Easy to care for

Contact lenses:
Better correction for certain eye conditions, but not suitable for others
Excellent peripheral vision
With hard lenses, wearing time must be built up gradually - strong motivation required for successful use
More expensive and easier to damage and lose
More convenient for all-day wear
Require special care

Not only is there often a choice between glasses and contact lenses, you may have a choice between hard and soft contacts.  If you choose soft contacts, daily wear or extended wear lenses are available.

Hard lenses are less expensive, less fragile, and can offer sharper vision than soft lenses.

Soft lenses are immediately more comfortable, easier to alternate with glasses, less apt to "pop" out, but take more care in cleaning and storing if you have daily wear lenses.  Extended wear lenses can be worn for long periods of time without removal.  Eye drops keep them clean.

Check with your doctor for a recommendation.  Remember that corrective lenses of any kind generally do not strengthen or weaken your eyes.  They simply improve your vision while they are worn.

Safety Glasses

Whether at work, home or play, most eye injuries can be prevented by wearing specially designed protective eye gear.  The impact-resistant lenses of your sunglasses or prescription glasses are not adequate protection. Even though industrial hazards are now well publicised, learning to be aware of eye dangers elsewhere and wearing the appropriate safety gear when needed is important to protect your eyesight.

At Work
It is important to use the right eye gear for the job, to protect you from:
Flying particles or sparks from power equipment and other tools
Harsh chemicals, fumes or airborne particles
Intense light rays

At Home
Safety goggles, which are available at most hardware stores, should be used when working in the house, yard or home workshop to protect you from:
Flying objects
Harsh sprays and fumes
Cuts and penetration of the eye

At Play
Eye injuries caused by recreational activities are becoming more common.  Use safety gear especially designed for your activity, available at sporting goods stores, to protect against:
"Snow blindness"
Sunlamp radiation
Fast-moving balls

Remember - better broken goggles than an injured eye!  Unworn glasses cannot prevent eye injuries.

Foreign Bodies

Getting something in the eye is the most common eye problem.  Foreign bodies can range from minor irritants like dust and dirt, to pieces of metal that can penetrate the eyeball.

The eye has a number of natural protective mechanisms.  It is recessed in a bony socket.  The eyelids and eyelashes can deflect particles with their quick blinking reflex.  Tears, which increase with eye irritation, can wash away most minor particles.  A clear membrane called the conjunctiva covers a portion of the front of the eye and prevents any particles that might enter from getting behind the eyeball.

Unfortunately, the eye's defenses are not always enough. Wearing protective eye gear when needed can help guard your eyes from foreign bodies.

Embedded Objects
If something penetrates your eye, try to remain still.  Do not attempt to remove the object.  Do not rub, press on or wash the eye, even to stop bleeding - you might cause more damage.  Loosely cover the eye and go to the nearest emergency room immediately.  Knowing the nature of the embedded object will help your doctor treat you.  If possible, bring a sample or description of the object with you.

First Aid
Do not try to remove a particle from your eye unless you are sure it is just a minor irritant like dust or dirt.  If there is any doubt, seek medical attention.
Do not rub your eyes or use dirty fingers to remove foreign bodies.
Small particles can often be dislodged by pulling the upper eyelid out and down over the lower lid.
If you can see a particle floating on your eye, you can try to remove it with the corner of a clean handkerchief. 
By spreading your eye open with thumb and forefinger, and gently washing with tap water, you can often flush a particle out.

Warning!
If these simple self-help measures don't work, if irritation or pain persists or if you later see something unusual on your eye, call your ophthalmologist for help.

Chemical Burns

Many household and industrial chemicals are extremely hazardous and can burn the eye's delicate tissues in a few seconds.  Tight-fitting goggles are essential when working with dangerous chemicals and goggle ventilation should be matched to the form of chemical being used.

On the job, put you goggles on before handling strong acids or alkalis.  Know where taps  or eyewash fountains are located.  If you work with harsh chemicals or fumes, contact lenses should not be worn without protective goggles because these substances can be absorbed by contact lenses and damage the eyes.

At home, before using oven cleaner or other harsh sprays, check which way the nozzle is pointed.  Keep windows open for good ventilation and use goggles if extensive spraying is necessary.  Make sure to keep all chemicals out of the reach of children.

First Aid
Immediately flush your eye with the first available water - seconds count!
Don't waste time looking for antidotes.
Spread eyelids open with thumb and forefinger, or pull lower lid down to help get water in.
Use a gentle flow of water from a tap or eyewash fountain - wash the eye, 15 minutes for acids and 30 minutes for alkalis (when in doubt, wash longer).
Get medical help!

Warning!
Chemical burns are true emergencies.  If you don't get water into the eye within seconds, permanent damage may occur.  You should go to the nearest emergency room immediately after washing the eye thoroughly.  Knowing the nature of the chemical will help the doctor treat you.  If possible, bring a sample or description of the chemical with you.

Light Burns

Certain kinds of light can cause eye burns unless you use appropriate eye protection.  Intense radiation from welding, sunlamps and sunlight that is reflected by snow can cause painful burns to the cornea.  Looking directly at the sun can burn the retina.  Both types of light burn are potentially serious and should be avoided.

Do not look at the arc of a welding torch.  Welders must wear eye protection specifically designed for their work.  Others nearby should wear tinted eye gear or turn completely away from the arc of the welding torch so that there's no chance of an eye burn.

Always wear special eye shades or smoked glass goggles, not sunglasses, when you use a sunlamp.  Remember the lamp's intense ultraviolet rays can burn your eyes, even if you are lying on your stomach.

Reflected sunlight or glare can damage the eyes.  People who are out in the snow should wear tinted glasses or goggles to protect against "snow blindness."

First Aid
The effects of a corneal light burn will not be felt until 6 to 12 hours after exposure.  Symptoms include the feeling of having sand in the eyes, pain, blurred vision and an unusual sensitivity to light.  If this happens, keep you eyes closed and call your doctor.  Corneal burns will usually heal in a few days.

Warning!
Looking directly at the sun or a solar eclipse is dangerous because the eye's lens magnifies the sun's rays and can burn a hole in the retina.  Severe retinal burns do not heal and cause permanent loss of vision.  Most methods currently used to view an eclipse are dangerous.  If you want to follow an eclipse, ask your doctor for advice.

Other Eye Injuries

Bruises (black eyes)
A blow to the area around the eye may produce bleeding in or under the skin, causing a bruise or "black eye."  Because the eye is recessed in a bony socket, most blows normally do not affect the eye itself.  An icepack can help reduce swelling, and in a week or so, as the blood is absorbed, a black eye will fade and disappear.

Warning!
If double vision, vision loss, blurred vision or any increasing or persistent pain accompanies a black eye, see a doctor as soon as possible.

Severe Blows to the Eye
If there is any doubt about the severity of a blow around or directly to your eye, don't take a chance with your eyesight - call your doctor or go to the nearest emergency room at once.  Do not rub, wash or apply pressure to the eye.  Cover it loosely and get medical attention quickly.

Cuts
Although a superficial scratch around the eyes can be treated with a bandage like an minor cut, a deep cut of the eyelid or especially of the eye itself should receive medical attention at once.  Do not apply pressure to stop the bleeding as this may cause additional damage.  Do not rub or wash the eye.  Loosely cover the wound and go to the nearest emergency room immediately.  If possible, bring the object or materials that caused the injury with you.

Eye Care Tips

Over-the-counter eye drops and solutions, although generally harmless, are quite unnecessary for healthy eyes and overuse can lead to dependency.  Your own tears are usually all that is needed to wash and soothe your eyes.

Do not share eye cosmetics because they can spread eye infections.

A one-eyed person should consider wearing impact-resistant glasses, even if there is no vision problem, to protect against a potentially blinding eye injury.

You cannot damage your eyes by using them, but eye discomfort may result after prolonged close work because eye muscles get tired.  Using good light and reading glasses can help prevent eyestrain.

How to Use Prescribed Eye Medications
Always read the label first and follow directions exactly.  The "bombs away" approach usually misses the mark when applying eye medicine.  Try this method instead:

Pull down your lower lid.
Using a mirror, apply the drops or ointment inside the lower lid, keeping the container from touching your eye.
Release the lid - it will spread the medication evenly over your whole eye.

Eye Warning Signs
The following warning signs may indicate eye problems that require quick medical attention:

Persistent pain or unusual sensitivity to light
Seeing rainbows or halos around lights
Persistently seeing "flashing lights"
Loss, blurring or any change in vision

Questions and Answers

What is meant by 20/20 vision?
20/20 vision means that you can see well enough at a distance of 20 feet to be considered as having "normal" vision. On the other hand, an eye with vision reduced to 20/40, for example, must move up to 20 feet to see clearly what an eye with "normal" vision can see at 40 feet.  Vision may or may not be the same in both eyes.

What is astigmatism?
Astigmatism results from an irregularly shaped cornea.  A normal cornea is shaped much like a basketball - the vertical curve is the same as the horizontal curve.  With astigmatism, the cornea is shaped more like a football, with one curve being different from the other.  Vision is blurred because the vertical and horizontal aspects of an image do not focus together.  Either glasses or hard contact lenses can be used to bring the two planes together into focus on the retina.

What does presbyopia mean?
Presbyopia, a normal process of ageing, results in the gradual hardening of the eye's lens (presby = old; opia = sight).  Although during childhood the eye's lens is able to focus easily on very close objects, after age 35, the lens loses flexibility and the nearest point of focus moves farther and farther away, making reading and close work increasingly difficult.


Until an injury or a change in vision makes us aware of the act of seeing, most of us take our eyesight for granted.  Eye care begins by saying "I care" and can help us preserve the precious gift of sight.