The heat is on: Ensure patients’ protective eyewear is, too

In her Arkansas practice, the conversations between Angela Howell, O.D., and some of her patients have turned to summer and eye protection options.

Whether parents are looking to play it safe as their children enroll in summer sports camps and leagues or they’re trying to get a jump on a back-to-school comprehensive eye exam before the fall, or golfers are looking to line up their putts, Dr. Howell sees an uptick in patients this time of year.

“I do a lot of contact fittings for children in the summer months,” says Dr. Howell, who practices at Elite Eye Care and Optical with family-friendly offices in Jonesboro and Paragould. “We do fittings in summer because families are not rushed getting ready in the morning as much and have more time for practicing insertion and removal. I also think they want contacts for vacations, sports camps and sports performance. We also try to promote back-to-school readiness early in July.

“It is a common occurrence for mom, dad and the kids to get examined on the same day—sometimes grandparents, too,” she adds.

’Tis the season

While basking in the sun presents potentially harmful ultraviolet (UV) light, seeking refuge indoors can mean dry conditions.

The wind and air conditioning can inhibit our ability to make tears, which lubricate and nourish the eye.

“Colorado is especially dry during the summer and with high UV exposure due to the elevation, sunglasses are essential,” says Joshua Watt, O.D., past chair of the AOA Sports and Performance Vision Committee. “A good pair of sunglasses can really help with dry eyes, especially when doing any physical activity outside. The wrapping and coverage of a good pair of sunglasses can really make a significant difference.

“Sunglasses are especially an important aspect to lifelong ocular care, regardless of the patient’s refractive status,” Dr. Watt adds. “Protective eyewear is essential when needed based on patients’ hobbies, activities and work environment. Most patients do not see it that way and do not understand the importance that the proper eyewear can have on their life, and so it is the doctor’s and associated office team members’ job to help educate the patient on the best recommendations for them given their circumstances and activity levels.”

Protecting against UV light

During the summer months, UV exposure is more intense so wearing protective sunglasses is very important, says Fraser Horn, O.D., dean of Pacific University College of Optometry in Oregon. For years, Dr. Horn has worked with student athletes and other amateur athletes.

“The impact of UV on our skin is evident with the possibility of a sunburn, and the same can happen to our eyes,” Dr. Horn says. “A short-term effect can be a type of ‘sunburn’ called a keratitis (inflammation of the cornea), which is essentially where the front of the eye is exposed to too much UV, and it is temporarily damaged. This is painful and something that can be avoided. Long-term UV exposure can have an impact with cataract formation and possibly age-related macular degeneration. Combined with wind, this can also cause the formation of pinguecula (analogous to a callous on the mucus membrane that lays on top of the white part of the eye).”

Karl Citek, O.D., Ph.D., is chair of the AOA Commission on Ophthalmic Standards. Dr. Citek represents the AOA on the Z80 Accredited Standards Committee for Ophthalmic Optics. The committee develops and maintains voluntary American national standards for ophthalmic optics. He also teaches at Pacific University College of Optometry in Oregon.

Dr. Citek offers some important tips to the public in selecting sunglasses:

• Lens should have 100% UV protection.
• Frames should be contoured, comfortable to wear and fit close to the face and head—not too large and not too small.
• Alternately, if the front of sunglass frames is flat and not contoured, the temple arms should be wide enough to help prevent harmful UV rays from getting to the eyes through the sides of sunglasses.
• Density of tint should be dark enough to allow the wearer to see comfortably in given lighting conditions.
• Further, tint color should not interfere with color vision, especially if wearers will use the sunglasses when driving or participating in other activities for which proper color perception is important.
• Tint should be polarized to help reduce glare from horizontal surfaces when driving, cycling and during water activities (fishing, boating, etc.).
• Most importantly, be a discerning buyer. Purchase sunglasses from reputable vendors—premium-brand sunglasses at "bargain prices" may be counterfeit and may not provide the required UV protection. But legitimate low-priced sunglasses can provide the same UV protection as higher-priced models.

“Nonprescription, over-the-counter sunglasses are perfect if a patient wears contact lenses,” Dr. Citek says. “For patients who cannot, or choose not to, wear contact lenses, virtually any prescription, including progressive addition lenses, can be made with a sunglass-level tint. But they should choose a frame large enough to fully cover the orbit of the eye, extending to the brow and cheek. For some prescriptions, it may even be possible to provide the correction in a highly curved lens that can fit into a contoured frame.”

Protecting against injury in summer leagues, camps

Proper eyewear for youth playing sports is essential to their safety and performance, Dr. Watt says. Doctors of optometry can educate parents on the subject of “proper sports glasses” versus the risk of wearing casual or dress frames.

“Parents will often think that ‘sportier’-looking glasses provide the protection needed when that is not necessarily the case,” Dr. Watt says. “Certain sports have a higher injury risk, and some have requirements for ocular protection. Parents will want to ask questions about those sports to ensure they are getting the protection needed, and doctors of optometry and opticians should be aware of those needs as well.”

Says Dr. Horn: “If you are participating in any sports or activities where there may be a risk for impact or eye injuries, then consider utilizing impact-resistant frames that meet ASTM standards. Also, polycarbonate frames and lenses are important for impact.”

Pool safety matters to the eyes, too. Water and contact lenses don’t mix. Give patients these instructions:

• Remove contact lenses before swimming, showering or using a hot tub.
• Use watertight goggles if contact lenses must be worn in water.
• Dispose of contact lenses immediately if they are exposed to water.

“Contact lenses and swimming can be a challenging topic to address because some patients with really high astigmatism, myopia or hyperopia can’t imagine not wearing correction while swimming or playing in the pool,” Dr. Watt says. “Daily use contact lenses are a great option for the occasional swimmer or pool goer. A pair of prescription googles is a wonderful option for the patient with high refractive errors.”

Summer vision resources

Go to AOA Marketplace to find the newly updated patient education pamphlet, "Protect Your Eyes from the Sun."

Share with patients a short AOA video on the benefits of proper sunglasses.

Patients: Find a doctor of optometry.