General Eye Interest

/General Eye Interest

Makeup Tips for Eye Health

The products you use around your eyes play an important part in your eye health. Similar to brushing your teeth daily, eye hygiene and removal of make-up is essential. We all react to products on our skin differently and for those of us who are more sensitive, hypo-allergenic products are preferable. For those with dry eyes or contact lens wearers, it is particularly important to develop healthy habits with eye hygiene.
Eye make-up products; whether they are applied to our eyelashes or around our eyes, affect different anatomical parts of the eye. Below are some tips for different eye make-up application.

-Eyeliner. When using eyeliner, be mindful that application on the waterline (inner eyelid) can block the meibomian glands (see image 1) and contaminate the eye 1.  A study done in the Faculty of Science at Waterloo found that within 5 minutes, 15-30% more make-up particles were found in the tear film when eyeliner was applied to the waterline, compared to application outside of this 1. Our meibomian glands secrete the lipid layer of our tears which stop our tears from evaporating and thus it is important that these glands are open and functioning. Shortly after application of eyeliner, there are demonstrated changes to the tear film and its stability 2.
Eyeliner application if used, should avoid the waterline to reduce its effect on our tears.

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Image 1. Layers of tears.

-Eyeshadow. This is applied further from the glands and inner structures of the eyes, however certain types of eye shadows that smear easily, may also end up in your tear film. Studies show that this product in addition to mascara, can cause the greatest discomfort amongst many cosmetic products 3. Contact lens wearers should also be mindful that eyeshadow may deposit on their contact lenses and this should be avoided 3.

-Mascara. This is a common make-up item that needs to be changed regularly. Our skin has normal bacteria such as Staphylococcus Aureus and some people may have a build-up of bacteria on their eyelashes termed ‘anterior blepharitis’. A maximum of 3-month use of a mascara wand before replacement is important to reduce harbouring bacteria 4. When your optometrist performs a slit lamp microscopy exam, they look at your lashes for signs of blepharitis. If this is present, you may need an additional eyelid cleaner such as an antibacterial foam, which is used to scrub your lids and lashes at least once per day. Research has demonstrated that mascara can also cause pigmentation inside the eye at the lacrimal sac (part of the duct to the lacrimal system which contains anatomical structures used for tear production and drainage) 5.

-Anti-ageing eye creams. These creams are often applied around the eyes. Research shows that the retinoids present in these eye creams can negatively affect meibomian gland function (the glands which secrete the oil in our tears), and potentially contribute to dry eye disease 2. Studies investigating the effect of systemic isotretinoin on animal models demonstrated signs of blepharitis and meibomian gland ductal epithelium thickening, as well as decreased mature gland acini, which contribute to the lipid (oily) layer of our tears 2. There was also reduction in the number and size of meibomian gland acini (see image 2) 2. Human studies of those taking systemic isotretinoin for acne also demonstrated dry eye symptoms, blepharitis and Meibomian gland dysfunction. The lacrimal gland, which secretes the aqueous tears, also releases isotretinoin. “The potential impact of the usage of anti-aging facial and eye creams and gels on developing meibomian gland dysfunction and dry eye syndrome is great” 2.

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Image 2. A single meibomian gland has clustered acini that secrete meibum. (Knop et al, 2011.)

• Pigmented products used over many years, may accumulate in the conjunctivae and the lacrimal system 2,6. The conjunctiva is a mucous membrane forming most of the surface of the eye – the white part of the eye you see in the mirror.

• Cosmetic products may also cause contact lens spoliation 2.

Removal of make-up before going to sleep is essential. Water alone cannot effectively remove cosmetic products, whereas surfactants in cosmetic removal products dissolve and alter the solubility of oils and waxes found in make-up 2. Note that water-proof mascara is removed best by oils, so investing in an oil-based make-up remover is beneficial 2. Oil-free make-up removal products have different surfactant concentrations which are good at removing cosmetics, however may solubilize the sebum in the eyelids and irritate the skin around your eyes 2. Your optometrist has eye-lid wipes and antibacterial foams that may also be used for make-up removal, particularly for those with dry/sensitive eyes.
The Tear Film & Ocular Surface Society Dry Eye Workshop (DEWS 2) latest report notes that exposure to cosmetic products, many of which contain toxic products, can elicit dry eye symptoms 7. For those with very sensitive eyes and/ or moderate to severe dry eyes, your optometrist may recommend avoiding eye make-up.

**Take home messages **
• The best way to ensure no additional irritation of the eyes, dry eyes and deposits on your contact lenses is to avoid eye make-up.
• When make-up is applied, avoid the inner part of the eye, particularly the waterline, as this can affect your tears and cause irritation.
• Retinoids present in anti-ageing creams and gels can contribute to dry eye and meibomian gland dysfunction.
• Ensure you have a good make-up remover that you use before going to sleep.
• Ensure all make-up products are changed regularly and that make-up brushes are washed regularly too.
• Your optometrist examines the health of your eye with a slit lamp microscope and can detect signs of cosmetic products depositing on the eye, tear film and/or your contact lenses.

 

References
1. Alison Ng, Katharine Evans, Rachel V. North, Christine Purslow. Migration of Cosmetic Products into the Tear Film. Eye & Contact Lens: Science & Clinical Practice, 2015; DOI: 10.1097/ICL.0000000000000124
2. Alison Ng, Katharine Evans, Rachel V. North, Christine Purslow. Impact of Eye Cosmetics on the Eye, Adnexa, and Ocular Surface. Eye & Contact Lens: Science & Clinical Practice, 2016. 42(4): 211-220. DOI: 10.1097/ICL.0000000000000181
3. Gao Y & Kanengiser BE. Categorical evaluation of the ocular irritancy of cosmetic and consumer products by human ocular instillation procedures. J Cosmet Sci 2004; 55: 317– 325.
4. Pack LD et al. (2008). Microbial contamination associated with mascara use. Optometry. Oct;79(10):587-93. doi: 10.1016/j.optm.2008.02.011.
5. Clifford, Luke & Jeffrey, M & Maclean, H. (2011). Lacrimal sac pigmentation due to mascara. Eye (London, England). 25. 397-8. 10.1038/eye.2010.209.
6. Ciolino, Joseph & M Mills, David & R Meyer, Dale. (2009). Ocular Manifestations of Long-Term Mascara Use. Ophthalmic plastic and reconstructive surgery. 25. 339-41. 10.1097/IOP.0b013e3181ab443e.
7. Gomes, J et al. (2017_. TFOS DEWS II iatrogenic report. Ocul Surf. Jul;15(3):511-538. doi: 10.1016/j.jtos.2017.05.004.

Research at Gerry & Johnson

Did you know Gerry & Johnson Optometrists are involved in clinical in-practice and international research projects?

Kate is busy working on her PhD, researching the optics of OrthoK and eye muscle coordination, which is due to be completed in July. All of the data for this research was collected from the practice, with our special PhD participants being involved in the key data collection phase from 2014 to 2016.

Kate and Paul are also working on an international research collaboration which will measure signs of UV damage and their effect on reading focus across a number of countries.

Kate & Paul returned back from a trip to Las Vegas in January to give presentations & learn about the latest treatments with contact lenses at the Global Specialty Lens Symposium Conference.

Paul (pictured above) is directing a new set of contact lens studies investigating new designs, for which we have been recruiting QUT School of Optometry students, who get to learn about contact lenses while participating in research. One day in February, we had 10 participants in the practice until 8pm that night trialing three different types of soft lenses for fit and comfort differences. We fed them pizza to show our appreciation!

Eye myths… fact or fiction?

Eating carrots helps you see in the dark.

True! Carrots are full of vitamin A which is a precursor to an important chemical substance used by the light sensitive cells in the retina (the rods) for vision in low light / night time. If you are deficient in vitamin A, you can have problems with night vision.

[1] However, having an excess of the vitamin does not enhance your vision above what is normal. So eating carrots all day like Bugs Bunny will not give you superhuman eyesight but just ensure your visual system is working normally!

If you watch TV for too long, you will go cross-eyed.

Myth! Watching TV for a long period of time won’t cause you to become ‘cross-eyed’ but it can make your eyes quite tired, sore and red. This is because when you are concentrating on screen (TV, phone, computer etc), you blink less than normal which contributes to an increase in evaporation of your tears.[2] Your tears normally create a uniform film over the front surface of the eye to protect it. Watching a screen has been shown to reduce our blink rate meaning that the interval between blinks increases. This allows the atmosphere to evaporate our tears leading to dry eyes. The symptoms of dry eye include red, sore, gritty, tired, stingy and watery eyes. It is recommended that you spend a maximum of 30 minutes on a screen before taking a break to allow your eyes a chance to rest.

Wearing glasses will make your eyes dependent on them and your vision worse.

Myth! At least 2 or 3 of my patients will ask me whether this is true each and every day so it is a very popular myth. It is not at all true. However, most people will think their vision seems worse when they take their specs off compared to before they put their specs on. This has nothing to do with the eyes themselves but with your brain. Your eyes are the hardware of vision – receiving the light signals from the world around us; and the brain is the software of vision – interrupting the neural signs from the eyes to perceive and interpret the information. The brain very much prefers clear vision so once you put specs on, your brain quickly adapts to accepting the improved vision. Once you remove your specs, your brain does not like the same blur that was there before. Your brain becomes less tolerant of the blur but your eyes remain the same.[3] Vision, however, does change particularly with age, but this change will happen regardless of whether you wear specs a little, a lot or not at all.

Onions make you cry.

True! Onions contain acids and enzymes within their cells. This acid is kept separate from the enzymes, but chopping onions allows the acid and enzyme to mix. This causes the onion to release its juice and sulphur based gas. This gas wafts towards your eyes and reacts with your tear film, combining to form sulphuric acid.[4] The sulphuric acid causes your eyes to burn / sting which in turns stimulates your tear glands to produce more tears in an effort to dilute the noxious substance. This is how you inevitably end up crying while chopping onions! Try refrigerating the onion before chopping – this will help reduce the gas emitted from the onion and avoid the tears.

It is impossible to sneeze with your eyes open.

Myth. It is really only possible to keep your eyes while sneezing if you make a big concerted effort to do so or if you force your eyes open (ie hold your eyelids apart) as the natural response to sneezing is always closing your eyes. This happens due to an involuntary reflex. The nose and eyes are linked by the trigeminal nerve (one of the cranial nerves).[5] The stimulation for the sneeze sends a nerve signal up one nerve to the brain and down another nerve to the eyelids triggering a blink. So, much like a reflex to kick your foot out when the doctor taps on a tendon / nerve just under your knee, closing your eyes while sneezing just happens automatically.

If you have know any other eye myths you would like debunked (i.e. old wives tales or something your colleague at work told you), let us know and we will debunk away!

 

References

[1] Nutrition and eye health book

[2] Wimalasundera S. Computer vision syndrome. Galle Medical Journal. 2006;11(1):25-29.

[3] Cufflin MP, Mankowska A, Mallen EA. Effect of blur adaptation on blur sensitivity and discrimination in emmetropes and myopes. Invest Ophthalmol Visual Sci. 2007;48:2932–2939

[4] Nagata T. An onion enzyme that makes the eyes water. Nature. 2002;419:685.

[5] Birch, CA. Sneezing. Practitioner 1959;182:122-124.

By | 2018-06-28T07:03:00+00:00 24th February 2016|General Eye Interest, Just for fun|0 Comments

Protecting eyes against UV

We’ve all heard about the importance of wearing hats and using sunscreen to protect our skin from the harmful effects of UV radiation. But how can we protect our eyes? Sunglasses offer some of the best ocular protection from UV light but blocking the harmful rays from reaching the delicate tissue of our eyes. Most sunglasses block (category 2 and 3) block more than 95% of UV radiation. Keep in mind that the colour or the darkness of the lens tint does not indicate how much UV is blocked so always check the tag/label to determine the level of protection.

Some prescription spectacle lenses also block UV light. At Gerry & Johnson Optometrists, all of our prescription lenses block 100% of both UVA and UVB light to protect our eyes from the early development of eye disease. The UV protective treatments are applied on the front and back surface of the lens, as around half of UV light entering the eye is reflected from the back surface of the lens.

Some contact lenses also offer UV protection. Although sunglasses can efficiently block the UV radiation coming directly from the sun, they may fall short elsewhere. Unless the frame is designed to wrap the face like a pair of goggles, sunglasses block very little of the obliquely incident UV radiation (as seen in the figure below).  Peripheral UV radiation has been shown to be a particular threat to eye health due to the phenomenon of peripheral light focussing (PLF), where oblique light is refracted by the peripheral cornea and focused at the nasal limbus (white part of the eye towards the nose).

PLF has been shown to play a significant role in the development of pterygium and some forms of cataract. Since soft contact lenses cover the cornea and land just past the limbus on the white of the eye, they are able to protect the eye more completely. Also, as contact lenses are worn generally for significantly longer periods of time than sunglasses, they are able to provide continuous protection against UV.

The benefits of UV light

At the risk of confusing the issue, did you know that UV light is not all bad!? In small amounts, UV radiation is actually a benefit to the human body. UV radiation is required for the synthesis of vitamin D which is needed for the growth and maintenance of strong healthy bones. UV light has also been shown to be beneficial for the eyes as research shows that it has a myopia control effect. Myopia, or short-sightedness, is fast becoming one of the major vision problems around the world. Even small degrees of myopia significantly increase a person’s risk of eye health complications such as glaucoma, cataract and retinal detachment. Research suggests that the protective effect of UV radiation involves the light-dependent release of dopamine in the retina. Dopamine has been shown to inhibit axial elongation (increases in eye length) which leads to myopia development and also progression. The amount of UVR required for good health is easily gained by spending approximately ten minutes outside each day in ambient light. So for any outdoor activities, especially over the summer (think the beach, pool and shopping days!) remember to wear protective eyewear and clothing!

If you haven’t already, check out last week’s blog on the known health effects of UV!

References

Bergmanson, P.G., Sӧderber, P.G. The significance of ultraviolet radiation for eye diseases. A review with comments on the efficacy of UV-blocking contact lenses. Ophthalmic Phys Optics. 2002; 15(2): 83-91.

Sliney, D.H. Photoprotection of the eye – UV radiation and sunglasses. J Photochem Photobiol B: Biol. 2001; 64(2-3); 166-175.

 

By | 2018-06-28T07:03:01+00:00 4th November 2015|General Eye Interest, Sunglasses|0 Comments

Tasmanian Lifestyle Congress wrap up!

This past weekend, Kate, Paul and myself braved the incredibly chilly Hobart weather to attend the 11th Tasmanian Lifestyle Congress (TLC). It was a weekend sure to be filled with fun, an exciting private viewing of the artworks in the Museum of Old and New Art (MONA) and of course, lots of nerdy learning!

Both Saturday and Sunday were jam packed full of interesting lecture topics ranging from kids’ vision (we had particular interest in this!), retinal disease, novel lenses for people with significant vision loss and good nutrition for the eye. Sunday morning over a delicious breakfast, Paul presented a lecture on the history of orthokeratology which highlighted the improvements in orthoK technology (lens designs, assessment techniques etc) over the past few decades. Sunday afternoon, Kate presented a lecture on myopia control in kids – one of her biggest optometric passions and a lecture she has presented at conferences around the world. It was very inspiring watching and listening to two people who are so passionate about optometry and what we as optometrists can do for our patients!

Amongst all the learning, we managed to explore the sites of Hobart – including an incredibly quick visit to the Salamanca markets in the wind, rain and freezing temperatures! My Aunt and Uncle, local Hobart residents all their lives, took me to a lovely French inspired cafe in Battery Point (oldest part of Hobart) for breakfast on Saturday morning. I was excited to wander around the Salamanca markets but as it was a particularly unfavourable day weather-wise, I only lasted about five minutes before hightailing it back to the warmth of the hotel! I may be a well seasoned shopper, but even I couldn’t do much damage in that time!

Saturday was the Congress Dinner at MONA. We had an hour where the museum was only open to us so we could explore and check out the artwork. One of my personal favourite installations was the ‘Waterfall wonder’ – random words cascade down the sandstone backdrop to represent the flood of words/information we are constantly exposed to. There are some pretty ‘out there’ artworks at MONA too but I’ll leave it to you to Google search what I am talking about!

All in all, TLC was a great conference with a relaxed and welcoming vibe where I learnt lots of new things, met some wonderful colleagues around the country and got to spend some time in beautiful Hobart.

By | 2018-06-28T07:03:01+00:00 3rd September 2015|General Eye Interest, What we've been up to|0 Comments

Make up – the eye’s friend or foe?

It is true that some well applied makeup can absolutely make your eyes pop! Makeup can be subtle for a natural everyday look or more dramatic for a glamourous night time occasion. But have you ever thought of what our eyes actually think of the makeup we apply? Well, interestingly I saw a patient recently whose case begged me to ask that exact question.

Melanie came in to see me about her sore and irritated eyes last month. She explained that her eyes had been playing up for about a week and they weren’t getting any better. Her eyes were watery, stingy and generally feeling irritable. She also thought her vision was not great now either despite never having had any vision problems in the past.

On examination, I found that no combination of corrective lenses made much difference to how Melanie was seeing. I assessed her ocular surface and found that her corneas (clear dome over the coloured part of the eye, responsible for allowing light to enter and then focus in the eye) were completely covered with superficial damage. This was causing her symptoms of discomfort and irritation and also impacting her vision.

This type of damage to the ocular surface is often seen in toxicity reactions – the cornea has an inflammatory type reaction to something it finds toxic. So after figuring out what was going on with Melanie’s eyes and her vision, we needed to do some detective work and figure out what was causing the reaction.

I asked Melanie whether she had started using any new face products like eye cream, face wash and moisturiser, or makeup like mascara, foundation and concealer. Melanie said that she had recently (within the last week and a half – just before symptoms began!) started using a cheaper brand concealer as her expensive makeup was not waterproof for when she was sweating it out at the gym!

I asked Melanie to avoid using the new concealer and to treat her corneal toxicity reaction with copious non-preserved lubricating eye drops for one week then return to see me.

On review one week later, Melanie reported that her eyes and vision felt totally back to normal – no watery or stingy eyes and her vision was fine. On assessing her cornea, the superficial damage had almost completely healed.

This case demonstrates how something like a new makeup or face product may not always agree with our eyes. I am not suggesting never to wear makeup (I certainly would not heed my own advice if that was the case!) but to perhaps consider products that are more natural or hypoallergenic, and to certainly take care around the delicate eye area to avoid ocular contamination.

By | 2018-06-28T07:03:01+00:00 26th August 2015|General Eye Interest|0 Comments