What You Probably Don’t Know About Caring for Eyes

Date aired: October 15, 2007

Guest #1 – Dr. Marguerite McDonald (New York, NY), Ophthalmologist, refractive eye surgeon and LASIK pioneer.

“What You Probably Don’t Know About Caring for Eyes”

Sharon (paraphrased): I’m talking to the National Safety Congress convention in Chicago. My guest, via telephone from New York, is my good friend, Dr. Marguerite McDonald, a refractive eye surgeon and Clinical Professor of Ophthalmology at New York University. She is also Adjunct Professor of Ophthalmology at Tulane University in New Orleans and affiliated with several New York City eye clinics. Dr. McDonald, how did you become interested in eyes?

Dr. Marguerite McDonald (paraphrased): I was severely visually impaired as a child and never saw my mother’s entire face until I was five. It was like a revelation. From that day on, I was fascinated by eyes, and by the ability of doctors to change lives (my father was a doctor). Years later, as an ophthalmologist, I became interested in refractive surgery as a way to permanently repair vision. I participated in the development of laser eye surgery and I was honored to have performed the very first laser eye surgery, in New Orleans, in 1987.

S: What was wrong with your eyes?

M: I was extremely nearsighted. To see something clearly, I had to get within an inch so I rarely saw the whole object. However, I was also extremely bright so I was able to compensate. My parents never knew about my vision problem until I was five.

S: How did they find out?

M: I was in a shopping mall and fell into a pool that I didn’t see and nearly drowned. I was rescued by a passerby. My parents were dumbfounded that I hadn’t seen the pool, and immediately had my eyes tested. That’s then I got glasses and saw my parents entire faces for the first time.

S: I’ve always felt that eyes are the most important organ in relating to the outside world. And yet there is much less education available on eye care than with most other health areas.

M: I totally agree. So does the American Academy of Ophthalmology, which has been conducting its “EyeSmart” campaign. Studies show that Americans know virtually nothing about vision care. Even if you have perfect vision and no history of eye problems, the Academy recommends a dilated eye exam at age 40.

S: What should a parent with a new baby look for regarding vision care?

M: Actually, the better hospitals routinely test infant vision. If there are no problems, they probably won’t mention it. All babies should have a pediatric eye exam, however, because with conditions such as lazy eye, pediatric cataract (present in one birth in 50) or glaucoma, the earlier they are caught, the easier they are to correct. These conditions all cause the eye to send incorrect messages to the brain. Eventually, the brain begins ignoring messages from the bad eye. That’s when correction becomes really difficult.

S: Could you talk more about how the eyes communicate with the brain?

M: Technically, the retina is part of the brain. Eye-to-brain pathways begin developing immediately after birth and it is critical that the baby’s eyes send correct messages.

S: Do infants ever have dry eye symptoms?

M: Rarely. And it is extremely difficult to detect. However, common pediatric medications for asthma and coughs are very dehydrating. In adults, of course, it is estimated that 40,000,000 people suffer from serious, chronic dry eye.

S: What do you recommend for school children with eye complaints?

M: Most schools have vision screening programs. They are able to detect poor vision because all you need is a simple eye chart. Diseases such as dry eye or glaucoma are much harder to detect.

S: Do you have any recommendations about vision and computers?

M: The average blink rate is 20 times per minute. When working at a computer, the rate drops to three times per minute. This can cause situational dry eye even if your vision is perfect.

S: Have you encountered computer vision syndrome?

M: Frequently. Symptoms are drowsiness, eyes that burn or itch, and blurred vision. Fluctuating vision is also a symptom, where you strain and blink to pull your vision into focus.

S: Have you been approached by companies who have many computer operators?

M: A few times, mostly by middle-sized companies. My primary recommendation is that they move the desk chair up or the computer down so there is a 15-20 degree angle between the eye and the screen, with the screen lower. That way, eyelids are partially closed when viewing the screen. I also recommend taking a break every 45 minutes, preferably spent looking at far objects. Also, artificial tears and Nature’s Tears EyeMist can be a big help.

S: Are there other vision related occupational health hazards?

M: Dry eye greatly affects night driving. Visual acuity drops and the risk of accident is greater.

S: Could you go over the symptoms again?

M: Redness, fluctuating vision, slight itching, drowsiness, the need to press down on your eyelids. Excessive tearing can also be a symptom. Eyes are usually OK in the morning but as they get dryer during the day, tiny ulcerations develop on the cornea, which causes reflex tearing. The tearing often goes away after ten minutes. Reflex tears protect eyes from infection and improve vision but it is far better if your regular baseline tears do this.

S: Could you talk about nutrition and eye health?

M: Sure. Eat lots of dark green leafy vegetables and dark fruits such as blueberries. Also cold water fish and flaxseed oil. These are all excellent for eye health. As a bonus, they are also all rich in antioxidants for heart health.

S: What is the latest in refractive surgery?

M: Laser eye surgery is now in its 20th year and LASIK has evolved into “All-Laser LASIK,” which is simpler and safer than ever. The vast majority of patients recover instantly. The procedure improves night vision and usually makes your vision better without glasses than it was with glasses. All-Laser LASIK is the first refractive surgery approved for American astronauts.

S: Good vision is also crucial to US troops so the procedure could save lives.

M: Definitely. There have also been exciting advances in interocular lens implants, that improve both far and near vision. The new lenses, which go by a number of names (such as “Re-Zoom”), decrease the need for reading glasses by 90%. They are in focus at all distances and under all lighting conditions. They are often implanted during cataract surgery but they don’t have to be. You can also go in for a LASIK “touch-up” if your vision still isn’t perfect. Unfortunately, most insurance still won’t pay for these procedures.

S: Tell us about your experience with hurricane Katrina, in New Orleans.

M: As a professor at Tulane University, I was in the middle of the hurricane. Unfortunately, the city’s population dropped so drastically afterwards, that I couldn’t keep up my practice. That’s why I moved to NYU, although I still lecture at Tulane.

S: Thank you so much, Dr. McDonald. My next guest is naturalist Art Bernstein. You’ll recall that two week ago, Art told us about Lake Baikal, in Russia, the world’s deepest lake. This week, he’s going to talk about the world’s ten deepest lakes, their ecological importance and their preservation.

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