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Eye Care During the Coronavirus Pandemic
(by Dr Leo Seo Wei)

Recent studies have shown that COVID-19 may be transmitted through the eyes. The virus can cause red eyes (conjunctivitis) and possibly be transmitted by aerosol droplet contact with the eye. The virus can invade the conjunctiva, which might, in turn, serve as a source of its spread.

So how do you take care of your eyes during this period?

Eye screening and elective eye surgeries are not allowed during the circuit breaker period. The eye specialist clinics are still open for urgent and medically essentially services. If there is any symptom like acute blurring of vision, eye pain and redness, you should still seek treatment without delay.

Rest assured that the clinics will follow strict hygiene and disinfection guidelines. For patients with stable conditions, the appointments will be postponed and medication refills will be arranged.

If you do visit the clinic in person during the coronavirus pandemic, expect changes to the clinic procedures. The clinic/hospital is restricting the number of visitors and each patient is only allowed to have one visitor. If you do not need someone to be there with you, please do not bring anyone to your appointment.

Both patient and accompanying person will need to do health declaration and use SafeEntry to check in/check out. SafeEntry is the mandatory national digital system for contact tracing. In addition, the ophthalmologist will use a special plastic breath shield on the slit lamp machine when examining your eyes. The shields will be also found on other equipment.

How do you protect your eyes?
  • Avoid touching/rubbing your eyes, nose and mouth. Avoid touching any eye discharge.
  • Wash hands frequently. Scrub the hands thoroughly with soap and water for at least 20 seconds. If that is not available, use hand sanitiser which contains at least 60% alcohol. Alcohol free hand sanitisers which contain quarternary ammonium compounds (usually benzalkonium chloride) are not effective against SARS-CoV-2 virus.
  • If you wear contact lenses, it may be beneficial to switch to spectacles. Generally, contact lens wearers touch their eyes more than the average person. In addition, wearing glasses may add a layer of protection and shield the eyes from infected respiratory droplets.

    The sides, tops and bottoms of the glasses are still exposed and safety goggles are recommended for people coming into contact with COVID-19 patients. If you are still wearing contact lenses, do not forget to clean your hands carefully and thoroughly (please see above for method) followed by hand drying. This should occur before every contact lens insertion and removal.
  • Is it safe to wear eyelash extensions (assuming the beauty salon reopen after the circuit breaker period)? Although there is no definitive study, you should not risk it as the virus can potentially live on those surfaces for days. Do avoid eyelash extensions and be sure to clean your make up brushes and applicators regularly.
  • Stay at home if possible. Practise social distancing when you are out. Regularly disinfect commonly touched surfaces and items in the house, such as doorknobs and counter tops.
How do adults working from home and children on home-based-learning avoid eye strain since they have to stare at computer or mobile screens every day?

Eye strain can result in eye discomfort.

  • Schedule planned breaks to prevent prolonged uninterrupted screen time using the “20-20-20” rule. For every 20 minutes that you are on the screen, look at something 20 feet away for at least 20 seconds.
  • Minimise time spent on recreational screen-based activities like binge watching Korean drama or online gaming. Replace these with physical activities in the house or outdoor exercise in compliance with Circuit Breaker measures. Getting away from the computer to stretch the body is essential to avoid the body aches caused by prolonged computer use.

    For children (especially those with myopia), it is recommended to spend 1 to 2 hours outdoors daily. If circumstances do not allow it, let the children spend time in sunlit areas like the balcony or open the curtains to let sunlight into the house.
  • Proper monitor position: The monitor should be positioned at or slightly below eye level and at least 25 inches, or arm’s length, away to reduce the intensity of the light and the stress on the eyes.
  • Adjust the brightness, contrast and text size. As screens which glow brighter than the surroundings force the eyes to work harder, match the screen brightness to that of the room and increase the contrast to reduce eye strain. Black print on a white background is the best combination to facilitate reading. Different times of day and the weather may affect these settings.
  • Reduce glare: Avoid glare from windows and lights as much as possible and use anti-glare anti-glare or matte screen protectors for monitors. Position the computer such that the windows are at your side, instead of being in front of, or behind, your screen. If you wear spectacles, use lenses with an anti-reflective coating. Direct the desk lamp away from the screen to avoid excessive reflection
  • Get an updated spectacle prescription and use the right eyeglasses, especially for people who are presbyopic.
  • Don’t forget to blink: Usually, we naturally blink between 8 to 21 times per minute. Blinking provides moisture to the eye by irrigation using tears and a lubricant the eyes secrete. The eyelid provides suction across the eye from the tear duct to the entire eyeball to keep it from drying out. Blinking also protects the eye from irritants.

    Studies indicate that blinking decreases by more than 50% when staring at computer screens or other digital devices. Reduced blinking results in dry eyes causing eye discomfort, redness and foreign body sensation. Make a conscious effort to blink as often as possible to keep the eyes moisturized.
  • Other measures to avoid dry eyes include using artificial tears/lubricating eye drops and adding omega-3 fatty acids to your diet. These are available as supplements and in foods such as flaxseed, salmon and sardines. Contact lens wear can be reduced to avoid dry eyes. Increase the humidity of your environment, avoid a fan blowing directly at your face and do not sit directly under the air vent so as to decrease tear evaporation.
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