Robert Abel, Jr., MD
Robert Abel, Jr., MD, ophthalmologist, Christiana Care Health System, Wilmington, Delaware, and former professor of ophthalmology at Thomas Jefferson University, Philadelphia. He is author of The Eye Care Revolution.
You probably know that people with diabetes are at greater risk for eye disease. What you may not realize is that a number of other common physical ailments are hidden risk factors for eye problems, too—and some of them are quite serious.
If you have one of these common medical conditions, you’re at increased risk for the following serious vision problems…
People who have high blood pressure and/or cardiovascular disease are at increased risk for ischemic optic neuropathy (ION).
Sometimes called an “eye stroke,” ION is a sudden, painless loss of vision resulting from decreased blood flow to the optic nerve. Untreated high blood pressure can cause blood vessels in the eye to narrow, similar to what happens in the heart. Unlike an ischemic stroke, which affects the brain and typically both eyes when vision loss occurs, the type of ION associated with high blood pressure usually affects only one eye and tends to happen at night when blood pressure naturally drops.
If you awaken to a sudden loss of vision in one eye and are experiencing ION, it may help to breathe into a brown paper bag for about 10 minutes to build up the levels of carbon dioxide in your blood and increase the size of your blood vessels. This technique helps unblock blood flow to the eye. Also, taking an 81-mg aspirin tablet may help protect the other eye.
However, any vision loss could signal a different serious condition, including ischemic stroke. For that reason, the safest approach for anyone experiencing vision loss is to get to an emergency room to be evaluated. Immediate treatment for ischemic stroke is crucial. An eye stroke must also be promptly treated to prevent permanent vision loss from occurring.
Caution: Taking blood pressure medication at night can sometimes increase risk for ION by lowering blood pressure even more than naturally occurs during sleep, further depriving the optic nerve of blood. If you’re on blood pressure medication, ask your doctor whether you would benefit from taking it in the morning to avoid this vision-threatening dip. Some blood pressure drugs need to be taken at night, so do not make any changes without talking to your doctor.
If you have arthritis, you’re at increased risk for dry eyes. What’s the link? Dry eyes and arthritis (osteoarthritis and rheumatoid arthritis) are inflammatory conditions in which antibodies attack tissue linings throughout the body, including in the eyes.
If you have chronic dry eyes: Try an omega-3 fatty acid supplement—1,000 mg of docosahexaenoic acid (DHA) and 200 mg of eicosapentaenoic acid (EPA) daily. Good product: Carlson’s Super DHA Norwegian Fish Oil Concentrate.
Both DHA and EPA will enhance the quality and quantity of your tears while also improving arthritis symptoms. Warning: If you take a blood thinner, aspirin or other nonsteroidal anti-inflammatory drug (NSAID), consult your doctor before trying an omega-3 supplement—like these drugs, it can have blood-thinning effects.
If your dry-eye symptoms don’t improve within two weeks of taking this supplement, see your eye doctor. An artificial tears product may be prescribed. Caution: Many brands have ammonia-based preservatives that can worsen dryness. Look for a preservative-free product, such as Systane or GenTeal.
People with sleep apnea, which interrupts breathing during sleep, are at increased risk for glaucoma.
Here’s why: The liver, which metabolizes nutrients and transfers them to the eyes, is most active at night. Because sleep apnea compromises sleep quality and lowers oxygen levels to the retina, it is a little-known but major cause of glaucoma. Sleep apnea sufferers are 1.7 times more likely to develop glaucoma within five years of diagnosis of their sleep disorder than those without sleep apnea.
If you have been diagnosed with sleep apnea: Get treatment. The gold standard is a continuous positive airway pressure (CPAP) machine that helps people with sleep apnea breathe more easily at night. However, if you are waking up with red, irritated eyes, check the fit of your CPAP mask—it may be leaking air and drying out your eyes.
Important: People with sleep apnea should also be sure to get eye exams once a year.
If you develop cold sores from time to time, you’re at increased risk for corneal infection. By age 50, about 90% of American adults are carriers of Herpes Simplex Virus-1 (HSV-1), which can cause cold sores on the lips and inside the mouth. (A different herpes virus, HSV-2, causes most genital herpes.)
More than half of those who are carriers of HSV-1 may develop occasional cold sores that typically last for a week or so. For a small percentage of people who carry HSV-1, an infection may show up in the eye (ocular herpes), beginning with severe irritation and redness, tearing and light sensitivity. The infection can progress to a painful corneal ulcer. When the ulcer heals, scar tissue can form, clouding vision. In severe cases, the scarring can lead to blindness.
If you get cold sores: An HSV-1 outbreak is often triggered by the amino acid arginine, so limit high-arginine foods such as nuts (no more than a handful daily) and chocolate (up to two pieces a day). Also, use UV-protective sunglasses (sunlight is a trigger, too). Taking 500 mg daily of L-lysine, an essential amino acid, can help limit herpes outbreaks as well. It can be used indefinitely for this purpose, but check first with your doctor if you take medication or have a chronic health condition.
Important: Because ocular herpes is a serious complication of HSV-1, anyone diagnosed with this viral infection should keep a prescription for antiviral eyedrops, such as ganciclovir (Zirgan) or trifluridine (Viroptic), on hand. Begin using the drops as soon as eye symptoms occur, and see an ophthalmologist promptly.