Ever since this pandemic started there has been never a moment where I have actually sat back and thought about my own health. Always prioritized my patients , their well -being, answered to their queries. more importantly to their families and have given them all the moral support and care as much as  I could.

Well so I though being an ophthalmologist I would like to share with you some of my experiences and understandings about how we adapted ourselves to protect us from this deadly virus.

Why do glasses fog up?

Like we have all studied in our science classes, when warm air comes in contact with a cold surface, condensation takes place. So based on this principle, when warm breathe escapes through the top of the mask, it comes in contact with the lenses of the spectacles and can cause fogging up.

So I thought I’ll share with you some tips to reduce fogging.

  • Right fit mask

It is important to make sure your mask fits securely over the nose. In this way it will prevent warm air from escaping out of the mask into the glasses. Buy masks with a nose bridge or in case you have decided to make your own mask, you can make a better fit by sewing pipe cleaners or twist ties into the top of the mask so that they can be moulded to fit your nose better. 

  • Soap and water

All you need for this foggy glass is some soapy water and a soft cloth. In case you have special coatings on your glasses you need to check with your optician before trying out this hack so that you don’t ruin your glasses. All you need to do is wash your lenses with soapy water and remove the excess liquid. You can either air dry it or gently wipe them off with a soft cloth. Soap mainly leaves a thin film that acts as a fog barrier.

  • Glasses to seal the top

Another easy technique what you could do is, pull you mask higher on your nose, and then wear your glasses on top of that. In this way the glasses can act like a seal and shape it to you face. A secure fit will prevent the warm air from escaping through the top of the mask.

  • Use a tape.

You can use a medical or a sports tape to tape your mask down around the bridge of the nose and to the cheeks. Make sure you don’t use duct tape or tape that cannot be used for the skin. In case you have a sensitive skin make sure you test the tape beforehand to avoid any irritation.

  • Solution.

Probably you could also try using wipes and sprays that are designed to tackle foggy glasses. But before purchasing  them make sure the ingredients in them don’t t damage the protective coatings of the lens.

I am sure being a parent there is one question you  always dread but still can’t avoid it to a great extent is “ Mum /Dad can I watch some TV now please?” .Due to the current situation most of the schools have been conducting online classes and the children eventually spend almost five hours glued to their screen. Parents are in a dilemma whether allowing more screen time would have an impact on their child’s eye sight. Being an ophthalmologist I would certainly agree that spending long hours looking at your computer or tablet screen can surely have a detrimental impact on your child’s eye sight. With the educational system shifting to digital mode, parents are stuck between the demands of their children and the need to take care of their well being.

Being a practicing ophthalmologist I can tell you the number of cases of children coming to my clinic with complaints of eye strain has significantly increased. They come with complaints of blurring of vision, watering from the eyes, dryness of the eyes and even headaches. In fact I have noticed that quite a few kids unknowingly go so close to the gadgets and this causes an excessive strain on the eye muscles.

Some parents complained to me that before the lockdown we could allow our kid to play his video games or watch TV  for an hour or so but now with the online classes the child already spends quite a  number of hours looking at the screen and we certainly can’t allow him anymore screen time.  There is a constant argument on this and sometimes as parents we are helpless and have to give up. Studies have shown that over the past few months there has been a spike in the number of the children below 15 years of age who have visited an ophthalmologist for short sightedness. Excessive strain is surely the reason for reduction in eye power, weakening of the eye muscles and even dry eyes.

What I have noticed is that the blink rate has significantly reduced when you are constantly staring at the screen. Blinking is very essential as there is a circulation of the tear film which helps to keep the eye moist and nourished. When there is a decrease in the blink rate it can cause dryness of the eyes. Moreover make sure while watching you keep the gadgets at an arm’s length. This helps to reduce the eye strain. Most importantly follow the rule of 20-202-20. That is after every 20 minutes; look at something 20 feet away for 20 seconds.

Studies were recently conducted to show the side effects kids had as a result of the lockdown and it was seen that apart from short sightedness, health complications like obesity, lack of social skills, being more aggressive and violent were the other manifestations. But now because of this current situation parents, teachers as well as kids are helpless.

So as much as possible, as a parent we should try and reduce their screen time, make some time for them and engage them in some indoor activities, help them inculcate some reading habits, encourage them to do some craft work, drawing and painting,. Also encourage them to listen to some music, do some exercise. In this way they will  be healthy both physically and mentally.

 As we all know corona virus2019 also known as COVID -19 is an infection that can affect the upper and lower respiratory tract through aerosols, feces and contaminated surfaces. A potential fatal form of this disease can cause severe acute respiratory syndrome (SARS). This is due to the highly contagious RNA virus known as the SARS Coronavirus 2(SARS-CoV -2) and it has a tremendous capability of survival due to its rapid mutation rates as compared to the DNA virus.

So being a practicing ophthalmologist, I would like to share with you all the risks that we have to face while examining patients.

Ophthalmologists are certainly at a high risk due to three important factors:

  1. Presence of virus in the tear fluid.

The SARS-CoV-2 has glycoprotein on its surface and it binds to the Angiotensin Converting Enzyme 2(ACE2 ) receptors. These ACE-2 receptors are found in various parts of the human body and even on the surface of the cornea and conjunctiva and this acts as a potential source of entry point. Studies done showed that corona virus was seen in the conjunctival discharge of COVID-19 positive patients.  As an ophthalmologist there is a very high risk of the tears contaminating the fingers of the examiner as well as the instruments that have been used while examining the patients.

  •  Close encounter

Since the  doctor is in a very close proximity  as close as 20-30 cm  while examining the patient,  there is an increased risk of coming in contact with the conjunctival discharge, tears, nasal or oral secretions posing a great hazard to the ophthalmologist.  Generally most of my patients who come are elderly and have age related diseases like cataract, macula degenerations and glaucoma and they require a detailed evaluation and a longer duration of encounter thereby increasing the risk.

  • Deceiving symptoms

 Sometimes you least expect a patient who comes to you with complaints of just redness of the eye to actually be a Covid positive case. Studies have shown that conjunctivitis can be one of the first signs of COVID -19 followed by the other symptoms such as sore throat, cough, fever which may appear a little later.

 So in order to protect ourselves, the American Academy of Ophthalmology has made it mandatory that all ophthalmologists should wear a mask and an eye shield while examining patients and without fail with  those patients  who come with fever, breathlessness or any history of international travel or coming from any hotspot.

Deciding when exactly to get a cataract surgery done has always been a quite difficult task to take up.  And now the Covid -19 pandemic is posing even more questions about the timings of the cataract surgery. Should we get it right now? Is it safe to do it now? I ‘m sure many of you have gone through this phase and will certainly agree with me.

Well having a cataract is like looking through a foggy or a dusty glass. The images appear blurred, hazy and less bright. Cataracts generally develop gradually over a period of time.

So the next question is when should I do my cataract surgery? Can I wait for a few more months? If I wait will there be any further complications? Well I would say that it is all about your function level. Unless your vision is severely impaired, then there is no urgency to get the cataract surgery done.

If the loss of vision affects your safety or you find it extremely difficult to carry out your daily activities like  even walking up to the restroom , or you find it difficult to drive, read, cook or watch TV  and you are totally dependent on someone else   then you must surely not delay in getting the cataract surgery done.

It is important to get a complete examination as your ophthalmologist will be able to assess your vision, evaluate the rate at which the cataract is maturing, and monitor the intraocular pressure and even the retina. Ultimately I would like to say that careful monitoring; good communication between the patient and the doctor will usually result in a successful outcome .

Telehealth:

While telehealth has been quite successfully used in ophthalmology, I would still recommend that it is always better to meet the doctor in person before you plan for surgery. Telehealth can be useful when you want to discuss the various symptoms of cataract but before you schedule a surgery it is important to confirm that the decline in your vision is because of cataract and not due to any other cause. And also prior to doing the surgery the ophthalmologist has to thoroughly evaluate the eye and see if it is safe to operate.

Let me share with you some tips that you can try at home to delay the cataract and protect your  eyes

  • Wear sun glasses   or a hat whenever you go outside to block the harmful ultraviolet sunlight.
  • Avoid smoking.
  • Make sure you eat healthy. Incorporate green leafy vegetables, fruits and food with antioxidants.
  • Make sure any chronic disease like diabetes or high blood pressure is always kept under good control.

Wearing a mask can cause eye discomfort.

When you wear a mask most of the time the exhaled air tends to go into the eye and this generates a very uncomfortable feeling and naturally there is a tendency to touch your eyes. But if your hands are contaminated then you are certainly going to infect yourself.  So as much as possible all you could do is try and resist yourself from touching your eyes or face but more importantly wash your hands with soap for 20 seconds immediately once you come back from outside or if you have touched the door handles, food packets, vegetable or milk packets  or anything else where the germs can thrive immediately get your hands washed.

  • Can be uncomfortable.

It is also important that the mask you wear has the right fit. If it is the right fit it will prevent you from constantly touching the mask to either pull it down or push it up .But remember the mask that you wear should be snug but not tight. Tight masks can hurt your face and it gives you less room to breathe well and comfortably.  Moreover even the cloth material used can also have an impact. Cotton material is considered to have a better ventilation and traps less moisture that tends to build up while your breathing.

  • Breathing difficulty.

Like we have experienced breathing certainly becomes quite difficult when you wear a mask. And in individuals who have chronic obstructive pulmonary disease where in there is a decreased air flow, face masks are certainly intolerable and they worsen the breathlessness. And moreover a certain amount of carbon dioxide which was previously exhaled gets inhaled during each respiratory cycle.

In a lot of Covid patients that I have treated, breathing difficulty was very commonly seen. What I would like to advice is if you are suspected or a confirmed case of Covid -19 it is better to quarantine yourself from others and then remove your mask and stay comfortable. In this way neither will you be contaminating anyone nor won’t your breathing be hampered.

  • Fogging of the glass.

Normally we all exhale warm air and this dissipates into the atmosphere. But when we wear a mask , it tends to go upwards and fog our glasses and this can be extremely annoying.

I have shared some tips in one of the posts as to how we could prevent this from happening.

  • Close conversations

It is quite natural that when you wear a mask the quality and the volume of your speech gets affected and you naturally tend to come closer to the other person. But don’t forget and make sure you stay six feet away from someone while talking.

  • A false hope.

Many individuals have this notion that wearing a mask will certainly protect them from the corona virus. Well masks have to be worn mandatorily but apart from that you should also wash your hands frequently, maintain social distance and disinfect commonly touched surfaces.

  • Masks also need to be cleaned.

Masks are meant to stop the spread of germs and not spread germs themselves. Make sure your masks are clean. They need to be routinely washed depending how often you use them. Also make sure you don’t touch your eyes, nose, and mouth when you remove your masks and wash your hands immediately after removing the mask.

  • The vulnerable population

Never use cloth face masks on young children especially those below the age of 2 years or for that matter anyone who has trouble breathing or is unconscious, incapacitated or unable to remove the mask without any assistance.

  • Effect on the skin

In those individuals who have dry skin wearing a mask can be troublesome. So apply moisturizer before wearing the mask. This can prevent skin irritation when the mask constantly touches the skin.