Hand Sanitiser harming Children's Eyes

Who knew something as effective as hand sanitisers which help us avoid the spread of COVID-19 could be harming our children’s eyes?

Well during the COVID-19 pandemic we have all seen a rise in access to hand sanitisers at various public spaces. They are everywhere now; in shopping malls, schools, cafes and restaurants. The hand sanitisers which are automatic are frequently positioned at an average face height for a child of 3.5 years old. This creates opportunity for our children’s eyes to become exposed.

This could explain why eye health professionals are seeing an increase in alcohol-based hand sanitiser (ABHS) related ocular exposures in children, as reported by the French Poison Control Centre.

What we can take from this is while ABHS are a useful part of our armament against COVID-19, we should be careful with these agents around children. If the hand sanitiser is effective enough to kill a virus, it is effective enough to cause severe damage to the eye.

To limit the risks of ABHS induced ocular injuries parents are recommended to promote their children to wash their hands with soap and warm water, rather than alcohol-based agents. Also teaching your children how to correctly use sanitisers could help reduce the risks of ABHS related ocular exposures.

As with any chemical splash in the eye, it is recommended to irrigate the eye with water or saline and seek medical advice.

Primitive Reflexes and Vision Development

What are Primitive reflexes?

We enter this world with neonatal or primitive reflexes. With the purpose of assisting an infant to survive and thrive in their new environment, primitive reflexes are a set of involuntary movements that occur in response to certain stimuli. You will have encountered these when you were last in the presence of a newborn but may not have given them too much thought. Some examples;

Palmar or grasping reflex- a baby will make a strong and persistent grip around an object placed in their palm; with this reflex disappearing around 6 months.

Plantar reflex- when the sole of the foot is stroked the big toe will move upwards and outwards with the other toes also spreading outwards. This reflex may be present up to 2 years.

Spinal Galant reflex- within the first 4-6 months if a baby is stroked along either side of their spine, their body will turn to the same side.

Moro or startle reflex- as the name suggest, when an infant is startled, for instance, by a loud noise, the arms and legs will be thrown outward in response. This reflex usually disappears around 2 months of age, but may persist up to 6 months. 

Why do we care about primitive reflexes?

While the reflexes play an important role in our adaptation to the world and in our early brain development, if a baby was to retain these reflexes the maturing of the neurological system may be delayed or disrupted. This may lead to behavioural, physical or learning difficulty as the child grows.

Vision development and primitive reflexes

The remarkable thing about primitive reflexes, is the fact they begin before the baby is even born and actually assist with the birthing process. As the baby continues to grow, they are essential for development of muscle tone and posture, head control and integration of our senses. As the baby develops further these involuntary reflexes are no longer required as they are replaced with more controlled responses as the baby ‘learns’ about the world. With timely integration of the reflexes, development of gross motor skills such as crawling, standing and walking occurs. Followed by fine motor skills of holding a pen, tying shoe laces and then the even more precise muscle control of eye movements and teaming. Thus preparing the child to have the physical ability to be able to learn to read when they start school.

Retained reflexes and behavioural optometry

If the primitive reflexes are not integrated they can get in the way of vision development and learning potential. Some examples of the effects of retained reflexes;

Spinal Galant- Poor concentration, fidgeting, decreased short term memory, attention deficit, discomfort with waistbands and sitting on a chair

Moro reflex- anxiety, emotional immaturity, impulsive, sensitive to noise and sensory overload

Tonic Labyrinth reflex- Letter reversals, difficulty sequencing, motion sickness, toe-walking

Symmetrical Tonic Neck reflex- hyperactivity, poor integration of upper and lower body

Asymmetrical tonic neck reflex- Poor co-ordination, learning disabilities, association with dyslexia

What can we do about retained primitive reflexes?

It is important to revisit the stage of development that may have been disrupted; this may entail for instance teaching a child to crawl again, or being able to ‘cross – pattern’ walk and then gradually building development to an age appropriate level. Behavioural optometrists and some occupational therapists with an interest in this area will be able to assist and create a therapy program to assist the child in maximising their potential!

When should my child have an eye test?

Most of a child’s learning is done through their eyes so there is a clear link with how well a child can see and how well they may develop either academically, socially or athletically. 

Vision doesn’t just happen. In fact, when a child is born, they don’t know how to see. A child’s brain learns how to use eyes to see, just like it learns how to use legs to walk or a mouth to form words.  

Vision develops from birth, right through until the age of eight. This is known as the ‘critical period’ because if a vision deficit is corrected during this time, the eye to brain pathway is still able to adapt and allow quality vision. It is crucial during this time that the two eyes see equally in order for them to learn to work together. This allows the child to develop good binocular or 3D vision. 

Unfortunately, the longer a vision problem goes untreated, the more a child’s brain learns to accommodate that problem. For example, if one eye has blurred vision, this eye will become amblyopic or lazy- this means it will never see as well as the other eye regardless of glasses, contact lenses or surgery in their later years. 

The good news is that the majority of vision impairment in school age children is due to them simply needing a pair of glasses to correct a defocus of one or both eyes. 

Preschool kiwi kids receive a free vision screening as part of their 4 year old B4 School Check (B4SC). This entails checking distance vision and comparing the results to an expected normal level. This can be particularly useful in detecting myopia or short-sight. However, it has been postulated for some time, that kids with hyperopia or long-sight may well go undetected. Long-sighted children can often compensate for their refractive error by focusing hard to achieve clear vision, however, this can result in reduced comfort and performance with near tasks. 

The recent Welcome to School (WTS) was employed in Auckland to test the efficacy of the B4SC to detect refractive error and visual impairment by following a group of 6-7 year old children. 

Results showed the B4SC was effective at detecting all children with amblyopic risk factors, ( for example, one eye having reduced vision), however, the vision screening was shown to be ineffective at detecting significant refractive error with nearly 60% of kids in this category passing the screening! Furthermore, having passed the test, none of these children had visited an optometrist for an eye exam and therefore, they were not wearing glasses to correct their focusing error. 

As an optometrist, I understand that children with uncorrected vision conditions or eye health problems face many barriers in life. High quality eye care can break down these barriers and help enable our children to reach their highest potential. For this reason it is never too early to have their vision and eyes assessed. In fact, the New Zealand Association of Optometrists recommends that children have their eyes examined: 

• At 6 to 12 months old

• At 2 to 3 years of age

• Before starting school

• Through their school years as indicated by vision screening, school performance or as recommended by your GP or optometrist. 

It is particularly important for children to be tested at a young age if either of his/her parents required glasses as a child or teenager. 

 An eye exam is tailored to your child and their age and most kids really enjoy it – parents often comment they are surprised at how well their child has managed all the different vision checks. 

If you have any queries regarding your child’s vision don’t hesitate to contact me through our website or Facebook page. Or simply contact us to arrange an appointment.

Migraine

What is migraine?

It is a neurovascular headache, meaning it manifests as a result of complex events and interactions between both the central and peripheral nervous system and blood supply to the brain.

Migraine is often inherited and is considered the 3rd most common disabling event for those under the age of 50 years.

Symptoms of migraine

Warning stage – You may experience subtle clues that you will develop a migraine which may include neck stiffness, mood changes, constipation, fatigue, thirst or craving of sweet foods

Aura- Visual disturbance which may include light flashes, zig-zags, spots or tunnel vision. But may also cause numbness or tingling on one side of the face or body, hearing or speech disturbance, memory loss, confusion, dizziness or even fainting. The Aura usually occurs before the headache and most commonly persists for 5-20 minutes. Some people will experience the aura only; without the headache developing.

The Headache- throbbing pain, usually on one side of the head. This may be accompanied by nausea, vomiting, and sensitivity to light, sound or head movement.

Resolution & Hangover- Symptoms usually gradually fade but a ‘hangover ‘effect can persist for hours to several days. Symptoms may be similar to the early warning stage or can be the opposite, ie. If appetite was initially lost you may be incredibly hungry.

What causes migraine?

Genetics- sufferers often have a first degree relative with migraine

Sensory overload- sensitivity to light, patterns, sound and even smells

Foods and food additives- certain foods may trigger a migraine such as cheese and chocolate. MSG and some artificial sweeteners may also be implicated.

Sleep disturbance- either too much or not enough

Hormonal fluctuations

Stress or Anxiety

Physical Exertion

What you should do

First of all, if you experience regular headaches, or any significant headache event it is paramount you visit your family doctor for a thorough general health assessment and diagnosis.

A headache diary can be useful to help pinpoint any trigger to your headache.

What can help?

Medication can be prescribed to reduce the pain and even prevent events from occurring. Some patients require referral to a neurologist to help manage their symptoms.

Lifestyle changes including regular sleep, exercise and a healthy diet. Limit alcohol.

Consider an eye examination. In my experience, those with migraine, benefit from correction of even small vision imperfections. We often recommend lenses to reduce light intensity, blue-light exposure, reflection and glare indoors. Prescription sunglasses are helpful in brighter light conditions. I have also recently experienced success with a migraine patient who has found relief from light sensitivity with the new Acuvue Transition Contact Lenses. These lenses, incredibly incorporate the adaptive tint technology of traditional Transitions spectacle lenses but within a contact lens. They can even be helpful to reduce glare when night driving.

Feel free to contact us if you have any queries about your vision or light sensitivity.

Welcome to the Transitions family of light adaptive lenses

Transitions truly have a lens for every light.

In a previous blog, I discussed the new GEN 8 Transitions which react faster and go darker than ever before, along with the fashionable Style Colours which can be chosen to suit not only your frame but also the tint your eyes personally love to look through.

But what lens solutions are available for those occasions when your eyes need even more light protection?

Transitions XTRActive lenses have a slightly darker base tint- available in Grey, Brown or Graphite Green, they provide sensitive eyes with more protection indoors. These lenses will also react behind a windscreen- so ideal for people who are not able to invest in a second pair of sunglasses for driving. The XTRActive Transitions will block 50% of light to the eyes while driving, reaching a Category 2 sunglass level.

If, however, you spend a lot of your time behind the wheel, the ultimate choice would be Transitions Drivewear - this lens is not only polarised so blocks reflected glare but is also photochromatic, adapting to the different light levels you may be exposed to. It also changes colour, further adapting to lighting conditions and enhancing contrast while driving.

Last but not least is Transitions Vantage – a grey lens providing excellent protection when outdoors, as it not only darkens when outdoors but the polarisation also adapts to match the level of glare.

Remember all our Transitions lenses provide 100 percent UV protection along with blue light reduction. With your eyes being as precious as they are, it is reassuring to have so many options to protect them!

Protect your eyes in style with Transitions GEN 8

Recent survey data tells us that 9 out of 10 people are light sensitive, yet only 8 out of 10 people wear sunglasses. In a world where we are constantly exposed to necessary light; visible, ultraviolet or high energy blue light, it is nice to know there is lens technology available which adapts to our constantly changing lighting environment.

Having recently attended industry training on the new GEN 8 Transitions, I am excited how this technology works faster than ever before!

Transitions lenses are a clear lenses which respond to ultraviolet light exposure, darkening to sunglass levels when outdoors. Features of the new Transitions GEN 8 lenses;

• Activate up to 30% faster

• Darker outdoors, reaching a category 3 sunglass level

• Return to a clear state, 3 minutes faster than before

• Longer lasting performance - providing increased value for money over the lifetime of your prescription

• Provide 100% UV protection

• Filter blue light both indoors and from sunlight

The lenses are available in the iconic grey, a new aesthetically pleasing brown and the popular graphite green. In addition to the new Style colours; Amber- which provides a more vintage look to a brown lens – very popular with younger wearers, along with Emerald, Sapphire and Amethyst.

With the Style colours we have definitely seen an increase in popularity among younger wearers, with many celebrities choosing to wear their eyewear in style on the red carpet!

As a Transitions wearer, I can attest to their convenience and the fact that they are ‘right in any light’. Therefore, I have less eye fatigue and light sensitivity with the one pair, no matter what the conditions.

From an Optometrist perspective, I recommend Transitions for my patients as a way to have seamless eye protection but also to ease adaption when going from one light condition to another.

As we get older, it can take longer for our eyes to adjust, for instance if we are coming from the bright outdoors to a darker environment indoors. With Transitions lenses the eyes have less difficulty as the retina is not disabled by the blinding glare while outdoors and therefore your indoor vision is immediately more comfortable, clearer and therefore safer.

We know that 8 out of 10 Transitions wearers would happily recommend these lenses to others and with our ‘Love them or exchange them ‘guarantee, there is simply no reason not to give the latest in lens technology a go in your next pair!

COVID-19 and your eyes-what you need to know

Coronavirus and your eyes

COVID-19 is a new illness that can affect your lungs and airways. It’s caused by a type of Coronavirus. Symptoms are fever (at least 38°C), cough and shortness of breath. These symptoms may appear 2-10 days after a person has been infected.

Coronavirus can spread through the eyes

When a sick person coughs, sneezes or talks, virus particles may infect another person through their mouth, nose or eyes. Droplets of the virus may land on surfaces such as counter tops and door knobs, so it is important to wash your hands before touching your face or eating.

Coronavirus and conjunctivitis

Like any virus, COVID-19 can lead to inflammation of the eye- known as viral conjunctivitis. While it is thought to only occur in 1-3% of cases, like any conjunctivitis, it is important to practice good hygiene to avoid infecting others- so always wash your hands after touching your eyes or your tears.

Contact lenses or glasses?

If you are a contact lens wearer, you tend to touch your face and eyes more regularly so now would be a good time to wear your glasses more regularly. It would be a good idea to ensure your glasses are up to date so you can still enjoy clear vision. Furthermore, glasses or sunglasses may also add a layer of protection.

Eye drops

Ensure you have an adequate supply of eye drop medication such as glaucoma drops as it is important to continue with these drops on a daily basis and you don’t want to get caught short if you had to self-quarantine. Please don’t hesitate to phone or email us if you need a repeat prescription. Many pharmacies offer a delivery service.

Avoid eye rubbing

We all do this more often than we realise but try and become aware of this habit and avoid it whenever possible. If you need to rub your eyes, ensure your hands are washed first or use the edge of a tissue instead of your fingers.

Dry eyes and allergy can lead to more eye irritation so keep up with your dry eye drops and treatment and talk to us about prescription eye drops to control your allergy symptoms.

By taking some simple hygiene measures and being sensible if you are unwell, we can all get through this together and stay safe and healthy.

Presbyopia- vision after 40

Change- to vision after 40

Ch- ch- changes turn and face the strain.

Pretty soon you’re gonna get a little older

Time may change me

But I can’t trace time

If you know the rest of the words to this David Bowie song, chances are you are over 40! Speaking of change, an inevitable one to occur around this age is the reduced ability to see near print and objects clearly. 

If you have never required glasses or contacts to correct distance vision, this loss of near vision can be concerning and frustrating. You may feel like you have abruptly lost the ability to read that restaurant menu, your mobile phone or even the DVD screen on that last plane trip. 

In reality, your vision has been undergoing gradual change since childhood but it is only now that your eyes don’t have enough focusing power to see clearly for closer work- this is known as presbyopia. A result of the lens inside the eye losing its flexibility which allows the eye to change focus from objects that are far away to objects that are near. 

Another inevitability is that we all approach change differently. Some of us resist it, while others embrace it, or likely just gradually resign ourselves to things being different. When your vision starts to change, the unknown is scary. However, presbyopia is normal and there are several solutions to enhance your vision. 

While some people resort to cheap over the counter glasses; they are just getting by. Furthermore as we get older, we also need to look after our health. Medically speaking, from the age of 40, is when our risk increases for eye conditions like glaucoma – conditions that with early detection and treatment mean that you can maintain good vision for your lifetime. So the change in near vision focus after 40 could be said to be telling you that it’s time to see your optometrist, and start having regular eye examinations.  

People with presbyopia have several options to regain clear near vision. They include;

 Glasses; with a personalised prescription and quality lenses your vision can be as sharp as ever and depending on your lifestyle, occupation, hobbies and daily visual demands there are several lens options to ensure glasses work well for you. 

Furthermore, don’t underestimate the importance of a perfectly fitting spectacle frame. Frames are not unlike shoes: they not only have to look good but they must fit well for the glasses to work their best. Quality does feel better and will last the distance meaning you can often reuse your frame even if your prescription lenses require updating. 

Contact lenses; including multifocal to provide both clear distance and near vision simultaneously. 

Surgery; such as LASIK or other refractive surgeries

 Initially, presbyopia becomes more advanced. You may notice that you need to change your glasses or contact lens prescription more frequently than you used to. Around age 60, these changes in near vision reduce, and prescription changes should occur less often.

Presbyopia can't be prevented or cured, but most people should be able to regain clear, comfortable near vision for all of their lifestyle needs. So if it is you or someone in your family, experiencing changing vision, help them to embrace the change and book in for a comprehensive eye examination at your local optometrist. And just in case you are wondering, David Bowie’s song Changes, was released on the Hunky Dory album in 1971.