What You Need to Know About the Eyes
14 min read
Many of us don’t give our eyes a second thought until they hurt or our vision changes—and then, wow, it’s hard to think about anything else! Consider this your get-ready guide to eye issues so that when one crops up, you’ll know exactly what to do. Let’s take a closer look.
Quick eye health facts to know
1. There’s a safe way to remove a bit of debris from your eye.
Don’t stick your finger in your eye or force yourself to cry in an attempt to remove an eyelash or a fleck of dirt. If blinking and your natural tears don’t take care of it, you need to step up your efforts, says Raman Bhakhri, O.D., an associate professor at the Illinois College of Optometry in Chicago. That’s especially true if you’re experiencing heavy tearing, redness, or light sensitivity. Immediately flush the eye with medical-grade eyewash (a sterile saline solution found at drugstores) if you have it—if not, use clean water. If you get the debris out and your eye is no longer red, watery, or irritated after 20 minutes, you’re probably in the clear, but see an eye doctor if the redness returns, your eye hurts, or you have trouble seeing. If something is embedded in your eye or you get a chemical in it, seek medical care immediately.
2. Your eyesight will likely change as you age
Presbyopia, a natural process of aging that makes it difficult to see objects up close, happens to everyone at some point after age 40: Hello, reading glasses. “Sadly, none of us escape it, and there’s a good chance it’ll get progressively worse as you get older,” says Ryan Parker, O.D., an optometrist in Denton, TX. (If you are nearsighted and wear glasses or contacts for distance, presbyopia may happen a little later for you, Parker adds.) In each of your eyes is a lens that helps you focus on objects. When you’re looking at something at a distance, the lens is a certain size, explains Parker, and when you want to focus on something close, it needs to get bigger. Your eyes’ lenses are able to do this easily when you’re younger, but over time they lose elasticity as the eye muscles start to wear out, making it tough for your lenses to change so you can see things clearly when they are close.
3. What you eat matters.
Yes, carrots are known to feed your eyes—but you should munch on these surprisingly eye-friendly foods too.
Kale
This leafy green is a great source of lutein and zeaxanthin, phytonutrients that protect eyes from the harmful effects of the sun and artificial light. Research shows that they can also reduce the risk of chronic eye diseases such as cataracts and age-related macular degeneration.
Lemons and Limes
Their vitamin C lowers the risk of cataracts and other vision problems by protecting lenses from UV light-induced oxidative damage. It may also help protect the skin around your peepers from free radicals, which are known for their link to skin issues.
Peanuts
These crunchy legumes are packed with vitamin E, which helps prevent the breakdown of eye tissue, and that may reduce the risk of vision problems and eye disease. Peanuts also contain some healthy fats, which your body needs to absorb the eye-aiding nutrients lutein and zeaxanthin, says licensed dietitian Torey Armul, M.S., R.D.N., of Columbus, OH.
Oysters
Zinc is crucial for eye health, and there’s no better source of this mineral than oysters. “Just one oyster provides nearly 100% of a woman’s recommended daily allowance of zinc,” Armul says. Zinc also helps move vitamin A, another nutrient that supports vision, from the liver to the eyes.
4. Certain eye symptoms shouldn’t be ignored.
No one wants to have yet another doctor’s appointment, but early treatment for eye issues could save your sight. Even if your vision is perfect now, it’s smart to get checked out if you’re experiencing any of these symptoms:
- eye pain
- blurry, double, or obscured vision
- frequent headaches
- difficulty seeing at night
- bright flashes of light or large floaters dry or watery eyes
- eyestrain after staring at screens
- sensitivity to light
5. Exercise is good for your eyes.
You know it can boost your heart and brain health, but blood vessels and connections to your brain are vital for eyesight, so it makes sense that exercise might be a boon for eye health too. In fact, research on mice and humans suggests that regular exercise may lower the odds of developing age-related macular degeneration and glaucoma and improve tear production. It can also help control diabetes, possibly reducing the risk of diabetic retinopathy.
6. You may be able to renew your glasses Rx online.
A number of apps and websites now offer tools that measure your vision and connect you with an eye care pro who can prescribe new glasses or contacts without your ever having to set foot in a doctor’s office. Unfortunately these tools can’t diagnose eye diseases or ensure that contact lenses fit correctly. Experts recommend online vision tests only for adults between 18 and 39 who have previously had a comprehensive in-office exam, show no signs of eye disease, and don’t wear contacts.
7. Optometrists and ophthalmologists aren’t the same thing.
Optometrist:
This health care professional has a doctor of optometry (O.D.) degree after having spent four years in optometry school (beyond getting an undergraduate degree). This person isn’t a medical doctor, but they can perform eye exams, prescribe glasses and contact lenses, detect some abnormalities, and prescribe certain eye-related medicines.
Ophthalmologist:
This person has a medical degree that requires at least eight years of study after undergraduate school. They can diagnose and treat all eye conditions, perform surgery, and prescribe corrective lenses.
Which specialist should you see?
Most people can start with an optometrist, who will refer them to an ophthalmologist if they need more tests or treatment.
Everyday eye fixes
An important part of taking care of your peepers is knowing what to do when they’re giving you trouble. Here’s how to handle common eye problems so you’ll be able to see clearly for years to come.
Allergies
When it’s allergy season or too many dust bunnies are hanging around the house, your eyes may become an annoying, irritated mess. Eye-related allergy symptoms:
- May cause white, stringy discharge
- Typically affect both eyes at the same time
- Include redness, swelling, or watering or intense itchiness or burning
- Develop while spending time outdoors or after having the windows open
What to do:
Step one is to “start taking your preventative or controller meds early. For spring that’s around March, while August is a good time for fall allergy season,” says Purvi Parikh, M.D., an allergist at Allergy & Asthma Network. Wear glasses or sunglasses to help shield your eyes from pollen and other allergens when spending time outdoors, and change clothes (and ideally shower) as soon as you come inside. Keeping windows closed on high-pollen days and running an air purifier that’s certified asthma- and allergy-friendly by the Asthma and Allergy Foundation of America can also help. Using eye drops may soothe discomfort. If nothing seems to do the trick, an allergist may recommend allergy shots to help desensitize you to allergens over time, Dr. Parikh adds.
Eye infections
If bacteria get into your eyes or your eyes are exposed to a virus (often through respiratory droplets), that can cause an eye infection and trigger icky symptoms such as:
- Redness, itching, swelling Sensitivity to bright lights
- Pus or mucus-y discharge that can be yellow, green, or white
- Eyes crusted together (especially upon waking)
- Pain or difficulty seeing
What to do:
First, see a doctor to figure out if the problem is bacteria- or virus-induced; for bacterial infections, you may need prescription antibiotic drops. Smart moves to prevent eye infections from becoming a regular thing include tossing old eye makeup and replacing eyeliner and mascara every three months to keep it from harboring germs. Always insert contact lenses with clean hands, and don’t sleep in them. Also, wash your hands frequently and try to avoid touching your eyes in general.
Digital eyestrain
Do you spend all day staring at a computer screen or your phone? If so, you’re probably familiar with the effects of digital eyestrain, such as:
- Dry or red eyes Blurry vision
- Non-eye-related symptoms such as headache and neck or back pain
What to do:
Blinking too little strains your eyes, so put a “Remember to blink” sticky note on your laptop where you won’t be able to miss it. Follow the 20-20-20 rule throughout the day to relax and rewet your eyes—every 20 minutes, look 20 feet ahead of you (away from the screen) for 20 seconds. Try matching screen brightness to ambient light. Position your laptop or phone so you’re looking slightly down at it rather than up or directly at the screen; this promotes eye relaxation, better blinking, and less tear evaporation, explains Annie Nguyen, M.D., an assistant professor of clinical ophthalmology at the University of Southern California Roski Eye Institute.
Dry eye
Yes, it’s true that dry eye is a symptom of many eye-related issues, but when your eyes lack essential components such as water, mucus, and oil, it can also be a problem on its own, says Ahmed Omar, M.D., codirector of the Dry Eye Center at University Hospitals Eye Institute in Cleveland. You may experience sensations such as: Dryness
What to do:
First, avoid exposure to things that make it harder for eyes to produce tears, thereby triggering dry eye. These include excessive screen time without breaks, blowing air, and airborne irritants. Over-the-counter artificial tears may help lubricate and soothe dry eyes. To ease your discomfort, try laying a clean washcloth soaked in warm water on your eyes or wearing a heated eye mask twice a day for 10 minutes.
Strange symptoms explained
Redness, swelling, and discomfort in the white part of your eye:
This could be episcleritis, a condition whose cause is often unknown that can be relieved with artificial tears, cold compresses, and oral nonsteroidal anti-inflammatory drugs such as ibuprofen, says Emily Schehlein, M.D., a glaucoma and cataract surgeon at Brighton Vision Center in Brighton, MI. Persistent cases may require a short course of steroid drops. If episcleritis recurs frequently, it may be related to an auto immune condition or an infection.
Blurry or wavy vision:
Sometimes a thin film of fibrous tissue called an epiretinal membrane forms on the back of the retina, causing straight lines to look wavy. The only treatment is surgery to remove the tissue. “It’s a delicate surgery, basically like peeling a piece of plastic wrap off the retina,” says Robert Latkany, M.D., an ophthalmologist in private practice in New York City, “so we wait until it’s noticeably impacting vision.”
When eye problems get serious
BY STACEY COLINO
These are the issues for which you are going to need a doctor and might even require surgery—but don’t stress, just get your eye exams and learn what to look for.
Cataracts
“The lens in the eye is clear when we’re young, but over time it becomes cloudy and stiff,” notes Dr. Schehlein. Both of these changes can decrease the quality of your vision; you may also experience glare, trouble reading or seeing into the distance, or difficulty driving at night.
Could this happen to you?
Getting older is the biggest contributing factor, but other risk factors include having an eye injury, a family history of cataracts, lots of exposure to UV light, or a chronic medical condition like diabetes; frequently using medications such as corticosteroids; and smoking. A dilated eye exam will spot them, and your doctor will advise you as to how often you should have eye exams to monitor their progression.
What you can do:
“No one can completely prevent cataracts, but you can slow their progression by protecting your eyes from the sun,” Dr. Schehlein says. “That means wearing sunglasses that block 100% of UV rays as well as wearing a hat.” And cataracts may not need to be treated at all if they’re not compromising your vision— a change in your eyeglasses prescription may be all that’s needed. For more significant vision changes, surgery can be performed to remove the cloudy lens and put in an artificial one during a brief outpatient procedure. Afterward your doctor will prescribe eye drops to prevent inflammation and infection, says Alice Lorch, M.D., M.P.H., an assistant professor of ophthalmology at Mass Eye and Ear and Harvard Medical School.
Age-Related Macular Degeneration
This condition with a mouthful of a name is also referred to as AMD, and it occurs when the macula, a small area in the center of the retina, is damaged, often simply due to the aging process. There are actually two types of AMD, dry and wet. In the dry version, which is much more common, tiny deposits called drusen grow in the macula, affecting vision. With the wet version, abnormal new blood vessels form under the retina and can leak blood into the eye, explains Dr. Lorch. The dry form sometimes, though not always, progresses to the wet form; you can also have a different form in each eye.
Could this happen to you?
The primary risk factors are being over 50, smoking, obesity, having a family history of AMD, and having had significant UV light exposure. Other risk factors include atherosclerosis, hypertension, and cholesterol abnormalities. Both types of AMD can be discovered during a dilated eye exam and/or with an optical coherence tomography (OCT) scan, which produces a high-resolution cross-sectional image of the retina so an ophthalmologist can see each layer of the eye, explains Purnima S. Patel, M.D., a clinical spokesperson for the American Academy of Ophthalmology, a retina specialist, and founder of ORA Vision in Atlanta. “This can detect early forms of the disease as well as its progression.”
What you can do:
There’s currently no cure for either form of AMD, but there are ways to keep it in check. Dry and wet AMD are treated with nutritional supplements called AREDS that contain high doses of anti oxidants (specifically, vitamins C and E, beta-carotene, zinc, and copper). A recent review from the U.K. confirmed that people with AMD who take these supplements are less likely to have the disease progress. “These formulas are widely available, and no prescription is needed,” says Marguerite McDonald, M.D., a clinical professor of ophthalmology at NYU Langone Medical Center and Tulane University Medical School in New Orleans. For those with dry AMD who have what’s called geographic atrophy (an advanced form of dry AMD), there’s some good news: In 2023 two new injectable drugs to slow down the atrophy, which can help preserve vision, gained FDA approval.
Wet AMD is treated with anti-VEGF (vascular endothelial growth factor) drugs that are injected into the eye (after it is numbed) to prevent the growth of abnormal blood vessels and stop progression. “Treating it on the sooner side leads to better outcomes,” Dr. Lorch says.
Glaucoma
“While there are different types of glaucoma, the common denominator is damage to the optic nerve, usually due to elevated eye pressure,” explains Robert Latkany, M.D., an ophthalmologist in private practice in New York City. The pressure usually results from fluid building up in the eye, often because of a blockage or another problem with the eye’s drainage system. “But because there are no early signs, glaucoma is often called ‘the silent thief of sight,’” says Dr. Schehlein.
Could this happen to you?
Having a family history of glaucoma is a risk factor, as is being over 60, having increased eye pressure or thin corneas, being African American or Hispanic, using steroid medications long-term, and having a history of severe eye injury. Nearsightedness (myopia) and the presence of certain medical conditions like diabetes and high blood pressure may also be associated with glaucoma. A recent study from South Korea suggests that people 40 and older who have chronic and severe migraine have a greater risk of developing open-angle glaucoma. Fortunately, glaucoma can be detected with a comprehensive eye exam that includes measuring pressure in the eye, examining the optic nerve for damage, and inspecting the eye’s drainage angle as well as testing vision.
What you can do:
Once diagnosed, “glaucoma can often be controlled with eye drops to lower the pressure and protect the nerves,” Dr. McDonald says. Also, there are two types of in-office laser surgery that allow fluid to drain from the eye so pressure stays low, and there are surgical approaches that can be very helpful as well. Unfortunately, as of now damage from glaucoma can’t be reversed, but medicine and surgery can prevent further damage. Because glaucoma is symptom-free until it’s very advanced, having annual eye exams is essential.
Diabetic Retinopathy
With this condition, blood vessels in the retina leak fluid or bleed, distorting vision. “People with diabetes can have elevated blood sugar levels that cause blockages or damage in blood vessels in the retina,” Dr. Latkany explains. “These blood vessels can wreak havoc in the back of the eye, leading to scarring.” If the scars cause the retina to pull away from the back of the eye, this is called retinal detachment, and it is a medical emergency because if not treated promptly it could lead to permanent vision loss.
Could this happen to you?
A significant number of people are at risk for diabetic retinopathy given that more than 38 million people in the U.S. currently have diabetes. “It can happen with type 1 or type 2 diabetes,” Dr. Lorch says, “and the longer people have diabetes, the more at risk they are.” It can be diagnosed through a dilated eye exam, Dr. Patel notes, adding that those with diabetes “need an annual eye exam at minimum” to detect diabetic retinopathy early. Unfortunately, research shows that only 65% of adults with diabetes had a yearly eye exam in 2022, roughly the same percentage as in 2019. A hidden perk of these exams: The eyes provide a window into the body, allowing doctors to discern other diabetes- related damage that may be occurring. “The only place in the body where we can see blood vessels is the eye,” explains Dr. Patel. “So if we see blood vessel damage in the eye, we can tell that there’s damage elsewhere in the body.”
What you can do:
Good management of blood sugar and blood pressure are the mainstays of treatment for diabetic retinopathy; in some instances this may even improve vision. Depending on the severity of the disease, anti-VEGF injections can reduce inflammation, stop progression of the problem, and improve vision, Dr. Latkany says.
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