Let me begin with a simple question related to our personal hygiene. How many of us brush our teeth daily? I assume most of us brush our teeth possibly twice a day, if not at least once. But let me ask you a similar question regarding ocular hygiene. How many of us consciously clean our eyelids daily?

Most of us don’t even know what eyelid hygiene entails or what a proper care regimen for our ocular structure consists of.  Some of us might have a faint memory of our optometrists or ophthalmologists taking about eyelid hygiene during a routine ocular examination, but we are so busy with our lives that we don’t have enough time to follow through.

These days, we have replaced our morning tea and newspaper with newsfeeds from Facebook, Twitter and Instagram. Moreover, throughout the day, our lives are closely intertwined with smartphones, tablets and laptops. These technological advances have made us more productive in these competitive times, but they also come at the cost of a comprise with our ocular hygiene.

Modern gadgets and ocular hygiene

Looking for long periods at mobiles and laptop screens is associated with incomplete or half blinks and infrequent blink rates, which affect the intricate structure of the eye’s tear layer which forms a protective film covering the ocular surface. This thin layer of tear film, which consists of water, mucin, lipids, lysozymes, immuno-globulins and other crucial components, forms a defence mechanism against infectious microbes, provides lubrication to the ocular surface and helps in providing crisp vision. Any compromise in the integrity of this tear layer can lead to a cascade of symptoms, including itchiness, burning sensations, grittiness and redness. This in turn exposes our bare ocular surface to infectious microbes, dry eye syndrome and meibomian gland dysfunction.

Furthermore, staring at screens for prolonged periods can also cause headaches and ocular pain due to excessive strain on the eyes’ focusing mechanism. The short wavelength blue light emitted by computer screens are also found to have an impact on our circadian rhythm, which is the biological clock that determines our sleep-wake cycles, along with hormone release, body temperature and other important bodily functions.

These are largely modern problems, having recently increased in incidence, but an important public health crisis. While these problems are more prevalent among the younger population, they are found to affect any age group, ranging from school-going children to the elderly. Even though these problems pose a serious public health issue, they can be taken care of by regularly following a simple ocular hygiene regimen.

Proper daily cleansing of eyelids is of prime importance in maintaining hygiene of the ocular surface. This can be done with clean water and commercially-available cleansing agents or baby shampoo (no-tear shampoo), which can effectively clean eyelids and lashes by removing ocular debris and moisturising the delicate surface.

There is a misconception that washing the eyes with water while keeping the eyes wide open helps in relieving dry eye-related symptoms. However, this may instead aggravate the symptoms by washing away the lipid, mucin and other important components of tear film leaving the ocular surface prone to infections. So, gentle cleaning of the eyelids and lashes must be done only with closed eyes. Clean moisturising wipes are also recommended by doctors to remove ocular surface debris and cosmetic products from the eyelids. Proper lubrication of the ocular surface with suitable tear supplements is another key factor in maintaining the normal function of the tear layer, thereby relieving symptoms related to dry eyes.

However, detailed examination of the anterior ocular surface and evaluation of signs and symptoms by optometrists or ophthalmologists are necessary prior to the use of suitable tear supplements. Furthermore, simple blink exercise can be practiced voluntarily to compensate for a reduced blink rate. It can be done by following three simple steps: blink, pause, and open— at least 20 times—while looking at screens for prolonged periods of time. This can prove effective in getting relief from symptoms immediately by resurfacing the tear layer over the ocular surface.

Also, one can wear prescription glasses with anti-reflection coating, commonly referred to as ARC glasses, to reduce the effects of annoying glare due to the reflection of light while using computers. A special coating that cuts off short wavelength blue light is also commercially available as ‘blue-cut’ lenses that reduce the deleterious effects of blue light on our delicate ocular structures.

Effects of cosmetics

Modern societal habits involve the heavy application of cosmetics to the eyelid margins, potentially introducing irritants and sources of microbial infection to the bare ocular surface. The application of cosmetic products like mascara over the eyelids are associated with meibomian gland dysfunction as these cosmetic products plug the openings of the meibomian glands located at the eyelid margins, thereby resulting in burning sensations, grittiness and dryness. Cosmetic products are also a heavy risk factor for ocular allergies. Hence, proper care of eyes must be taken while using cosmetics.

First, hypo-allergic cosmetic products that suit particular types of skin must be selected. Further, cosmetics must be properly wiped off and eyelids must be cleansed properly at the end of day to reduce any risk of allergy or infection.

Healthy contact lens wear

The use of contact lenses is popular for refractive correction as well as for cosmetic purposes. The increasing popularity of contact lenses also comes with the increased risk of ocular infection and ocular allergy. To reduce this risk of contamination, a contact lens care and maintenance regimen, which includes proper cleaning, rinsing and disinfecting, must be followed closely. Further, weekly enzymatic cleaning is also essential to reduce the accumulation of deposits over the contact lens surface. Contact lens storage cases and cleaning solutions also need to be maintained properly. Additionally, wearing goggles over your contact lenses while outdoors can prove to be simple yet very effective solution to keeping your contact lenses clean from the dust and dirt of polluted air. If you are a contact lens wearer, you must definitely keep in touch with your optometrist to keep your contact lenses clean and well maintained. After all, they have important roles in your daily life.

Effect of pollution

The insurmountable amounts of environmental pollution greatly increase the risk of ocular infections and allergies. Cases of ocular infections and allergies pile up day-by-day and infectious microbial agents are becoming more drug resistant requiring more potent drugs to treat conditions. Incidences of the entry of flecks of dust and sand particles into the eyes have also increased significantly.

Exposure of ultraviolet radiations on our bare ocular surface also poses a major threat to people who spend significant periods of time outdoors. In order to tackle these conditions, one should always wear UV protective glasses to keep their eyes safe from dust, dirt and harmful radiation. Also, proper ocular hygiene must be maintained by cleansing the eyelids along with adequate ocular lubrication.

Occupational hazards

We often tend to ignore the harmful effects of professional hazards on our delicate eyes. Hazards due to pesticides and insecticides in agriculture, harmful chemical fumes and toxins in industries, ultraviolet radiation in arc welding, and radiation hazards in recreational sports like skiing, snow sports and cycling are often ignored. And when a visit to the optometrist or ophthalmologist is finally paid, there has already been irreversible damage to our ocular structure.

There are many safety eye-wears with face-form shapes that completely cover our eyes according to our facial contours and protect our eyes from harmful chemicals and fumes. There are many arc welders who do not apply proper protection due to poor perception of potential risk or even vanity. However, ocular safety measures are a must for preventing eye injuries due to potentially harmful ultraviolet radiation while welding. Welders must wear special UV protection goggles or safety glasses with side shields that comply with the protocol of the American National Standards Institute (ANSI Z87.1) under the welding helmets.

If in doubt regarding any ocular problems or a worsening of symptoms, one should always visit the nearest eye care centre and seek professional care from an optometrist or ophthalmologist. Also, having one’s eyes examined on regular intervals of three-six months forms an integral part of maintaining proper ocular health.

- Kandel is an optometrist at the Institute of Medicine