December 2018

BALANCING ONLINE AND OFFLINE WORLDS
MORE THAN MEETS THE EYE
OLD WIVES' TALES OR FACT?
GLASSES FOR AIDS
CONTACT LENSES ARE POLLUTING OUR WORLD
20/20 HINDSIGHT

BALANCING ONLINE AND OFFLINE WORLDS

Digital technology has become an integral and inescapable part of our daily lives, providing us with information at our fingertips and access to connect whenever and with whomever we wish. As adults we have become more and more reliant on electronic devices, and they feature prominently in the daily lives of children at home, at school and socially. While the value of these devices cannot be underestimated, there is a growing awareness of the harm excessive exposure to them can do to children's cognitive, emotional, social and overall development and well-being. Research reveals that children start using digital devices as young as six months of age. By their teens, some children use screen-based media for up to seven hours daily.
 
Between birth and age three the brain develops quickly and is particularly sensitive to the outside world. This is known as the critical period because the changes that happen in the brain during these first tender years become the permanent foundation upon which all later brain function is built. The development occurs mainly through direct interaction with the environment. Seeing, hearing, tasting, touching, and smelling are the primary ways we experience our world, so if we are not using these five senses, then we are not learning to the best of our brains' abilities.
 
According to one expert, too much screen time too soon "is the very thing impeding the development of the abilities that parents are so eager to foster through the tablets. The ability to focus, to concentrate, to lend attention, to sense other people's attitudes and communicate with them, to build a large vocabulary—all those abilities are harmed."
 
Research has shown that when children of any age spend excessive time in "virtual world interactions", they are found to be at risk of developing learning disabilities. They have a decreased attention span and increased hyperactivity. They often find it difficult to deal with their emotions and have trouble socialising with their peers. A relationship has been reported between screen time and general health because children spend long periods being sedentary instead of engaging in physical activity.
 
As expected, too much screen time has an impact on vision and visual development. Eye care specialists report a marked increase in children with computer vision syndrome, previously seen predominantly in adults. Children are experiencing fatigue, eye strain, dry eyes, blurry vision, headaches, and neck and shoulder pain. There is a world-wide increase in short-sightedness (myopia) which is believed to be at least partly linked to the increase in time spent looking at digital devices. There is evidence to suggest that children who spend more time outdoors are at lower risk of developing myopia.
 
Extended time in front of computers and hand-held devices is visually demanding, requiring the eyes to converge and focus for lengthy periods. Sudden onset misalignment of the eyes (crossed eyes) seems to be becoming more common. Some people find that their ability to change focus when looking at various distances is not as quick or effective as it once was.
 
In spite of the negative effects of over-exposure to digital screens, they are here to stay and do have many benefits that cannot be discounted or ignored. In fact, some experts are of the opinion that having no access to the digital world has a negative impact on children. Screen time itself is not harmful but certain reasonable guidelines need to be followed to ensure that their benefits are maximised, and the dangers minimised. It is up to parents to help their children become digitally literate, by being aware that what children are watching, playing and reading is high quality and age-appropriate. While parents have been advised to limit screen time, research suggests that it is the nature rather than the amount of screen time and the role technology plays in family life that matters. One study found that the way parents set rules about screen time and being actively involved in the digital world with their children is more important than time spent on digital devices.
 
When working on a computer, the closer the screen, the greater demand on the eyes. With a TV, the further away the better. Ideally, a desktop computer screen should be no closer than 70cm to 80cm. In addition, the child's seat should be raised, or the screen lowered so that they are looking slightly down on the computer screen, rather than up or straight ahead. This is a more comfortable position for the eye muscles. Provide optimal room and screen lighting to reduce eye strain. Encourage practicing the 20-20-20 rule - after every 20 minutes of screen time, take a 20-second break and look 20 feet away. Children need to be reminded to blink frequently to lubricate the eyes.
 
Balance screen time with outdoor play. It is important that children use their eyes to look at things far away as well as up close. They need to learn how to accurately track objects such as moving balls, to make good visual estimates of distances, and to develop the use of their peripheral vision. These visual skills can't be developed if children spend all their time in front of a two-dimensional screen.
 
Ultimately, children should be in control of their screens rather than have their screens control them. They should know that technology is only one part of their world, understand the clear boundaries between the virtual world and the real one, and separate themselves from the screen in order to explore new experiences and take part in physical activities. It is the duty of parents to guide their children towards achieving the balance between the online and offline worlds.


MORE THAN MEETS THE EYE

The sun supports life on our planet, but its life-giving rays also pose hazards. With the constant publicity around the dangers of ultraviolet rays for our skins most of us apply sunscreen with hardly a second thought. What we are generally less aware of is how ultraviolet light from the sun affects our eyes. While the body needs a certain amount of UV light for the production of vitamin D, an excessive amount can be harmful to the skin and eyes. There are three types of ultraviolet (UV) radiation. UV-C is potentially the most dangerous, but almost all of it is blocked by the ozone layer – a situation that may change with ozone depletion, especially in countries like Australia and South Africa. However, UV-A and UV-B radiation can have long- and short-term effects on the eyes and vision. In low doses UV-B rays stimulate the production of melanin resulting in a suntan, but in higher doses they can cause sunburn and premature aging of the skin. UV-A rays have the lowest energy but can pass through the cornea, damaging the lens and the retina.
 
If your eyes are exposed to excessive amounts of UV radiation over a short period of time, you may experience photokeratitis. Like a "sunburn of the eye," its symptoms include red eyes, a gritty feeling in the eyes, extreme sensitivity to light and excessive tearing. Fortunately, these symptoms are usually temporary and rarely cause permanent damage to the eyes. The longer the eyes are exposed to solar radiation, the greater the risk of developing cataracts or macular degeneration later in life. UV damage begins in early childhood, is cumulative and irreversible.
 
Levels of UV radiation vary, depending on a number of factors. Average UV levels in summer are three times greater than in winter and are most damaging in the middle of the day. UV levels are higher at higher altitudes, greater in tropical areas and lower as one moves further away from the Equator. The risk of UV exposure is lower in urban areas where tall buildings provide shade, and greater in wide open spaces particularly if there are reflective surfaces like expanses of water and sand. In addition certain medications can increase the body's sensitivity to UV radiation. Most important to remember is that UV radiation is present even on cloudy or overcast days.
 
Over the years, sunglasses have become a fashion accessory worn to make a statement but let's not forget that their primary function is to protect the eyes. When buying sunglasses how do we know that what we choose will be effective in protecting our eyes? More expensive does not mean more protection and the colour or darkness of the lens does not necessarily indicate the level of sun protection. Most sunglasses today have some UV protection embedded in the lens and most reputable brands list UV protection on their label. Rather than looking at the price tag, look for a label that says "100% protection against both UVA and UVB". The lenses should also be free of distortion and imperfections. Scratches on the lenses will not harm the eyes but looking through a defective lens could cause unnecessary eyestrain. If you spend a lot of time outdoors wrap-around sunglasses will protect the eyes from UV rays coming in from the side, as well as protecting the delicate skin around the eyes.
 
One would expect that the darker the lenses are the more protection they offer, but this is not always the case, as the treatment of the lenses determines their level of protection. The colour of the lenses has a role to play in blocking UV radiation. Brown tinted lenses filter blue light best and improve contrast on grass and against the blue sky. Grey and green-grey tinted lenses do not alter the colours of the surroundings, making it easier to estimate distances. Yellow and orange tinted lenses are generally used for specific types of sports glasses. Ultimately, the colour of the lenses is a matter of personal preference.
 
In order to minimise glare, sunglasses with anti-reflective and polarised lenses are recommended. Polarisation has nothing to do with UV light absorption, but many polarised lenses are now combined with a UV-blocking substance. As well as the reduction of glare, the benefits of polarised lenses include improved visual comfort, improved visual clarity, reduced eyestrain, reduced reflections and true perception of colours. Photochromic lenses automatically darken in response to UV light, fading back to clear away from UV light. They are convenient in that one doesn't need to keep changing glasses when moving from indoors to outdoors and back again and are a good choice for people who are sensitive to light.
 
Thanks to widespread awareness about the dangers of ultraviolet rays, most parents are vigilant about protecting children's skin with sunblock, hats and clothing. But they tend to forget about eye protection. Children spend a lot of time outdoors and their eyes haven't fully developed yet. A child's pupil is larger than an adult pupil, allowing more light to enter the eyes. Added to that, children's eyes do not filter UV radiation as effectively as adults' eyes do. They need sunglasses that protect against UVA and UVB rays, even on overcast days. A wide-brimmed hat is a good idea, but it doesn't replace sunglasses. Reflections from the sun are still getting into their eyes.
 
When choosing sunglasses for children, the lenses should be polycarbonate if possible as they are impact-resistant, UV protective and lighter than standard lenses. A large frame always provides the best protection, with temples that are a little wider to prevent peripheral sun from getting in. The frame should be close-fitting and flexible so that they are less likely to break easily. If a child already wears prescription glasses, photochromic lenses that change from light to dark may be a better option than an extra pair of sunglasses.
 
When getting children to wear sunglasses, lead by example. If parents are wearing sunglasses and putting a hat on when they go out into the sun, children are more likely to mimic that behaviour. Let the child have input into choosing the glasses, so that they feel committed to wearing them and being responsible about taking care of them.
 
There is the misconception that once summer is over the danger of UV damage to the eyes is over too. While it does pose less risk than in summer, the radiation from the winter sun can cause eye damage. Sunglasses are the key to eye protection regardless of the season or the weather.


OLD WIVES' TALES OR FACT?

Old wives' tales abound about numerous topics including the eyes and vision. Some of them are clearly myths, often used by parents or grandparents to frighten or discipline children into behaving themselves. An example of this is if you cross your eyes and the wind changes, your eyes will remain crossed forever! Many other myths have some foundation in fact but are sometimes embellished with information or theories that may or may not be true.
 

SITTING TOO CLOSE TO THE TV IS BAD FOR THE EYES

Watching too much TV or sitting too close to the screen may give you a headache or make your eyes feel tired or strained, but there is no evidence to suggest that it will harm your vision. In fact, children can generally focus up close with no eyestrain better than adults can, so they often develop the habit of sitting close to the TV without any ill-effects. Parents need to be aware, though, that needing to sit close to the TV may be an indication of shortsightedness which requires an eye examination by your optometrist. The same is true for children holding a book close to the face while reading. This may or may not be cause for concern but a visit to your optometrist will detect whether there is a problem or not.
 

COMPUTER USE IS HARMFUL TO THE EYES

Electronic screens won't harm the eyes but staring at them for an extended period can increase dryness and eyestrain, partly because we tend to blink less frequently while working on computers. Discuss with your optometrist using lubricating eye drops and glasses specifically for computer work. Take frequent breaks by following the 20-20-20 rule – every 20 minutes look away from the computer at a spot 20 feet away for 20 seconds. And remember to blink!
 

EATING CARROTS CAN IMPROVE VISION

Carrots themselves are not a magic food for eye health but they are rich in vitamin A, an antioxidant essential for maintaining healthy eyes and vision. Other foods which contain this essential nutrient include green leafy vegetables, asparagus, apricots, milk, egg yolk and liver. A well-balanced diet can provide the vitamin A and other nutrients needed for all-round health and good vision. Poor nutrition, on the other hand, has been implicated in certain diseases of the eyes.
 

POOR VISION IS GENETIC

While this is a more complex issue than simply genetics and environmental factors having a role to play, it has been determined that certain vision problems have a strong genetic link. There is a greater risk of developing cataracts, glaucoma and age-related macular degeneration if there is a family history of these conditions. Refractive errors (shortsightedness, farsightedness and astigmatism) are genetically determined and are more likely to occur if one or both parents have these vision problems. Discussing your family medical history with your optometrist and having regular eye examinations will lead to early detection and management of inherited vision conditions.
 

WEARING YOUR GLASSES TOO MUCH WILL WEAKEN YOUR EYES

The purpose of glasses or contact lenses is to help you see more clearly. Not using them for fear of making your eyes too dependent on them will lead to eyestrain and headaches. The eyes may weaken over time and your prescription may change. This is not caused by "over-wearing" glasses or contact lenses but rather by numerous factors including changes to the eyes as we get older or the presence of eye disease.
 

ONLY BOYS CAN BE COLOUR BLIND

This is not strictly accurate but the incidence of colour blindness is significantly higher in males than females. It is estimated that 8% of males and 0.5% of females are colour blind (or more correctly, colour deficient). The genes responsible for the most common form are on the X chromosome. Males only have one X chromosome, while females have two X chromosomes. In females, a functional gene on only one of the X chromosomes is enough to compensate for the loss on the other. Generally, the gene for colour blindness is carried by the mother and the deficiency emerges in her male offspring.
 

LOOKING STRAIGHT AT THE SUN WILL DAMAGE YOUR EYES

Looking at the sun may not only cause a headache and distort your vision temporarily, but it can also cause permanent damage to the retina at the back of your eye. Any exposure to sunlight adds to the cumulative effects of ultraviolet radiation which has been linked to eye conditions such as macular degeneration, solar retinitis, cataracts, pterygia, and corneal dystrophies. The most dangerous times for sun gazing are at midday and during a solar eclipse. The brightness of the sun may be hidden but the dangerous invisible rays that permanently damage your eyes are not reduced.
 

DO EYE EXERCISES AND THROW AWAY YOUR GLASSES

People normally need glasses to correct their vision because of the shape and size of their eyes, among other factors. While regular eye exercises may strengthen eye muscles, they will not alter the shape of the eyes or influence the need for glasses.
 

WEARING SOMEONE ELSE'S GLASSES WILL DAMAGE YOUR EYES

Although you may not be able to see very well with them and may get a headache or double vision your eyes won't come to any harm from wearing glasses that are not your prescription.
 

READING IN DIM LIGHT WILL MAKE YOU SHORTSIGHTED

Reading in dim light or in the dark is highly unlikely to cause any permanent damage to your eyes, but it could cause your eyes to feel strained or tired. Your eyes are designed to adjust to the light around them and your pupils enlarge in order to collect the maximum amount of light possible. Although you will not harm yourself by reading in the dark, it is more difficult to see and it may cause some discomfort.
 

CONTACT LENSES CAN GET LOST BEHIND YOUR EYES

The membrane that covers the white of your eye also lines your eyelids, making it impossible for a contact lens to get lost behind your eyes.
 

A NIGHT LIGHT IN A CHILD'S ROOM WILL CONTRIBUTE TO SHORTSIGHTEDNESS

There is insufficient evidence to support this claim. In fact, some experts are of the opinion that keeping a night light on in a baby's room may actually help him or her learn to focus and develop important eye coordination skills.
 

YOU CAN SLEEP WITH CONTACT LENSES IN YOUR EYES

Unless you have been told specifically by your optometrist that you can sleep in your contact lenses, you should avoid this. Your eyes need to breathe whilst wearing contact lenses, and this is more difficult when your eyes are closed. When you are asleep and not blinking your contact lenses will not move on your eyes as much as when you are awake, increasing the risk of infection. Follow your optometrist's instructions. If in doubt take them out!
 

IF YOU CROSS YOUR EYES THEY WILL STAY THAT WAY

Contrary to the old wives' tale, eyes will not stay that way if you cross them! However, if your child is constantly crossing one eye or both eyes, schedule an appointment with your optometrist. Children do not generally outgrow strabismus or crossed eyes on their own but this can be more easily corrected at a younger age.


GLASSES FOR AIDS

With World AIDS Day on 1st December, it is fitting to acknowledge a man who we don't usually associate with HIV and AIDS, but rather with music and his signature accessory, imaginative, often quirky and always flamboyant eyewear. Elton John, one of music's biggest stars for over five decades, was shortsighted for many years before he had his vision corrected, making a personal statement with the choice and sometimes invention of his glasses. As well as unusual shapes, sizes and colours, some of his more memorable creations include glitter, ostrich feathers, windscreen wipers on the lenses, and individual lights which lit up to spell his name. In 1975, when he received a star on the Hollywood Walk of Fame in Los Angeles, his obvious eyewear choice was star-shaped frames! With an estimated 250,000 pairs of glasses, Elton John has a walk-in closet in which to store them.
 
In 1985, Elton John had what he called a life-changing experience. He befriended a 13-year old boy named Ryan White, a haemophiliac who contracted HIV from a blood transfusion. As there was little research about it at that time, Ryan spoke out about the misconceptions around HIV and AIDS. Ryan tragically lost his battle with the disease at 18 years of age, but his strength in dealing with it is believed to be the reason for Elton John establishing the AIDS Foundation in honour of Ryan and his family.
 
The Elton John AIDS Foundation is a nonprofit organisation established in 1992 in the United States and 1993 in the United Kingdom to support innovative HIV prevention, education programmes, direct care and support services to people living with HIV. The Foundation's objective is to improve the individuals' quality of life so that they can live a life of dignity and self-determination. It has raised over $200 million to support HIV related programmes in fifty-five countries. Two of the fund-raising events are the annual "Enduring Vision" benefit concert and the periodic "Elton's Closet", when Elton's old outrageous stage costumes are sold with the proceeds going to the AIDS Foundation. When asked if the eyewear is part of Elton's Closet Sale, Elton John smiled and answered that he would never sell his glasses and was planning to hold an exhibition of them some day. However, about 50 pairs of glasses were included when Sotheby's held an auction of the singer's personal items in 1998, one pair selling for 16,830 pounds.
 
For his charitable work, John was knighted by Queen Elizabeth II on 24th February 1998. Sir Elton John recently received the Rockefeller Foundation Lifetime Achievement Award and the Harvard School of Public Health AIDS Initiative Leadership Award for his commitment and contribution to the fight against HIV/AIDS. Starting out as a music sensation, Elton John's enduring legacy will be the use of his legendary fame, wealth and signature eyewear to benefit the fight against HIV and AIDS.


CONTACT LENSES ARE POLLUTING OUR WORLD

With the pollution of our planet very much in people's consciousness, we are starting to understand the impact of disposable contact lenses. Their popularity has grown rapidly over the past decades and one can understand why. However, just as usage of disposable lenses has increased over time, so has public awareness of the damage disposable goods can cause to the environment. Like most disposable goods, disposable lenses are usually made of non-biodegradable plastic, leaving them bad for both trash and compost. The blister packs in which they are distributed consist of foil and plastic, both of which create their own recycling problems.
 
It may seem like a small thing, but with over 45 million contact lens wearers in the United States and between 5% and 20% of the population of Europe wearing them, all that plastic adds up. We are talking about 22 metric tons of contact lenses being improperly disposed of every year in USA, unnecessarily adding to the hundreds of thousands of tons of microplastics floating in our oceans and wreaking havoc on our environment.
 
According to new research out of the American Chemical Society, 20 percent of people who wear contact lenses dispose of them by flushing them down the toilet or sink. As medical devices, contact lenses are specifically designed to withstand harsh environments, and therefore they don't biodegrade easily. An added concern is that their size and flexibility allow them to slip through filters meant to keep nonbiological waste out of wastewater treatment plants. The chemical and mechanical processing at these treatment facilities is unable to fully break down contact lenses, leaving them as part of the final matrix of treated water. Post-treatment, wastewater is typically spread on fields, where contact lenses can make their way into surface water, runoff from heavy rains and eventually running into rivers and oceans. Alternatively, they could remain in soil, drying out in the sun and becoming very brittle before shattering into tiny particles which may be consumed by birds and insects.
 
Contact lenses are designed to absorb liquid, and that includes not just water but anything that's in the water. Because of their ability to absorb various toxins in the environment, like pesticides and herbicides, there would be more of an impact with these microplastics than with other materials. The accumulation of toxic pollutants can ultimately become part of the human food chain.
 
Contact lenses improve the quality of life of millions and are a justified use of plastic. If we decide as a society that we want to use plastic for these purposes, we should be aware of how to get rid of them in a responsible fashion. Environmental researchers would like manufacturers to provide information on the packaging of contact lenses describing how to properly dispose of them, preferably with solid non-recyclable household waste. Certain eye care companies have started their own recycling initiatives.
 
If you're one of the many people who wear glasses rather than contact lenses, you too can make an environmentally friendly choice when getting rid of your old glasses. Instead of throwing them away, find out from your optometrist about programmes for collecting and disposing of old glasses.
 
These small actions can add up to making a big difference!


20/20 Hindsight

You know what they say about looking back in hindsight, how it's always 20/20 vision (or something to that effect). So as we wind down another year, it's easy to look back on certain things and wonder why we didn't see them coming.
 
We shoulda known petrol would go up and up and up. And that would mean the price of everything else would go up and up and up. Or maybe we did know and there was nothing we could do about it. But let's not get hung up on that...
 
We shoulda known all those scientific expeditions into space would bring home some big news. And they did. In July of 2018 it was discovered that there's water on Mars. There was great excitement at the announcement that there's a 20km lake up there, even though it's so cold that most of it is frozen. And with so many people eager to be part of the Mission to Mars, it seems like swimming season might be opening soon.
 
We shoulda known that the headlines would be dominated by a royal wedding. That was obvious from the moment Prince Harry popped the question. But little did we know we'd have two royal weddings, all thanks to Princess Beatrice. Gotta wonder how all those relatives felt about putting on their wedding outfits all over again and sitting through a second one. But in their polite English way they didn't seem to mind.
 
I wish I'd known those other royals were going to name their baby Louis. William and Kate announced the name earlier this year, and pundits had already been taking bets. I'm not sure what the odds were, but I do know anyone who put their money on Louis was smiling when the news came in.
 
From those who were born to those who were lost, it was a sad year as we lost Lois Lane AKA Margot Kidder. We also lost Stephen Bochco who created Hill Street Blues and LA Law – which was basically how we lived our lives before Netflix. And before that? Most of us were reading comic books, which is why we miss the iconic Stan Lee.
 
So it's been a year of many things. Looking back in hindsight we had the good, the bad and the just plain weird. (I'm talking about the Orange-Skinned President now, but let's not get into that...)
 
And the most bizarre news story of 2018... the announcement that Toblerone chocolate would be reverting back to its original shape. The bar was redesigned in 2016 with gaps between the mountain peaks. And the world didn't like it. It took two years for things to change, but it's finally gone back to the way it used to be.
 
And on that note, happy holidays and a sweet 2019.