13 Tips for Using Eye Makeup

Makeup may be an essential part of your every day routine. Or it could be something you do for special occasions or to make a fashion statement. Regardless of the occasion, eye makeup needs to be used with care to prevent infection or vision loss.

Here are 13 tips for using eye makeup.

1. Wash Your Hands
You are constantly using your hands and touching everything, so bacteria are always on them. This means you can transfer these bacteria onto your makeup and in your eyes. Wash your hands before applying any makeup.

2. Never Share, Never Borrow
We were all taught to share when we were children. This is not a good idea when it comes to cosmetics. When you share your makeup you are also sharing bacteria. The main danger is passing on viral conjunctivitis, or pink eye. The bacteria exist before the symptoms are apparent.

3. Eyeliner Has Its Place
Eyeliner is to be used to line the eye outside the top of the lash line and not in the eyelid margin that runs along the surface of the eyeball. There are tiny pores in the margin that produce the essential oils required for stable tear film. If the pores become clogged, it can lead to a sty, dry eyes, irritated or infected eyes.

4. Mascara
Throw away any mascara after six months because it dries out and can flake off, getting into the eye. Depending on the ingredients in the mascara, those flakes may contain something that could scratch the cornea or become an eye irritant. Also be careful when applying mascara that the wand does not touch the eye to avoid contamination.

5. False Eyelashes
Be wary of putting too much glue on the lashes and not letting it dry a bit before placing them on the lid above your own lashes. If glue enters the eye it can cause abrasions, bacterial infections, or you could be allergic to the ingredients.

6. Storage Is Important
Don’t store makeup in warm or hot places such as your car or suitcase on a warm day. Heat destroys the preservatives that keep bacteria away. Hot temperatures are a breeding ground for bacteria. Even at home keep your cosmetics in a cool, dark place.

7. Shelf-Life
Just like most perishables that use preservatives, cosmetics need to be discarded after 3-4 months to prevent possible infection.

8. Keeping Clean
Wash your brushes and applicators thoroughly and regularly to keep them clean and avoid the buildup of bacteria and oils. This also includes eyelash curlers. Think about using disposable applicators that get used once and are then thrown out.

9. Know Your Ingredients
It is important to know what is in your eye makeup. Some mascara contains parabens which can cause an allergic reaction and a stinging sensation if it gets in your eye. Kohl eyeliners may contain lead. Pencils and shadows that are iridescent, glittery or shiny may contain ingredients that could scratch the cornea or irritate the eye. Never use glitter on your eyes as it can severely scratch your cornea.

10. Don’t Mix Uses Don’t use a lip pencil on your eyes or vice versa. The danger is bacteria, as the bacteria in your saliva in different from the bacteria in and around your eyes. The FDA warns to never use your saliva to moisten cosmetics such as eyeliner, mascara or eye shadow.

11. Irritated Eyes
If your eyes appear irritated or infected contact your eye doctor and suspend ALL use until directed by your doctor. Before you go back to wearing eye makeup, replace all of it to void spreading the bacteria, and wash all applicators thoroughly.

12. Don’t Be Moving
Never apply makeup in a moving vehicle. Even if you aren’t driving, another vehicle can rear-end you and any applicator will go in your eye, possibly cause the loss of an eye. Do not apply makeup when driving, as your eyes should be focused on the road and not a mirror.

13. Removing Eye Makeup
It is important to carefully and gently remove your eye makeup each night before bed to make sure that your cosmetics don’t work their way into your eye, build up and cause damage. Try not to use waterproof mascara as it is harder to remove and increases your chances of getting something in your eye. Avoid foaming options as they likely contain sodium lauryl sulfate which can dry out the skin around the eye. Also watch out for any ingredients that are known to clog pores or contain fragrances. Try not to use waterproof mascara as it is harder to remove.

5/19/16

Susan DeRemer, CFRE
Discovery Eye Foundation

AMD and a Healthy Diet: How they Relate

While there is still no concrete answer as to why some do not develop age-related macular degeneration (AMD) and other’s do, significant studies have proven the importance of a healthy diet and the mitochondria.

AMD is the leading cause of vision loss for those over 60 years of age in the developing countries. For decades we have studies that show the genetics and environmental factors associated with AMD. There have been over 20 genetics modification associated with AMD but there is no single gene that “causes AMD in all cases.” The genes most highly associated with AMD are found in the complement system, an important system related to controlling the inflammation in our body. A change in the complement factor H (CFH) gene from a low risk gene to a high risk gene has been associated with 43% of those developing AMD.

However, some people who have this high risk CFH gene but never develop AMD. This leads us to believe that the genetics are not the entire answer. The other factor has to do with the environment. Smoking is the leading risk factor, along with aging, exposure to sunlight and higher body mass index (obesity). But again there are obese people that smoke and never develop AMD. So, while the environmental risk factors are important, they do not answer the entire question of “why do some people get AMD but others do not?”

Recently, researchers have recognized that a major factor in the dry form of AMD is that the retinal cells begin to die off. Therefore, they have looked at important factors that keep cells alive. The mitochondria are one of the most important elements that protect the cells in the body. These subunits or organelles, produce energy for the cells, acting like batteries for the cells. And just like the batteries in a flashlight – if the batteries are not working then the flashlight dies. The same thing happens with cells – when the mitochondria are not healthy, then the cells eventually will die. Therefore to protect ourselves, it is important to keep the mitochondria healthy. One way to do this is to eat healthy foods. Over the past 20 years, the National Eye Institute (NEI) has conducted a series of studies that have identified foods and supplements that are good for the retinal cells and also the mitochondria.

super greens, spinach The National Eye Institute has recommended that people who are high-risk for developing AMD eat diets rich in green leafy vegetables, whole fruits, any type of nuts and omega 3 fatty acids. Many of these foods have anti-oxidant properties that help to “turn off” genes involved with inflammation, an important factor of retinal diseases. Salmon, mackerel and sardines have the highest levels of omega-3 fatty acids. An analysis that combined the data from 9 different studies showed that fish intake at least twice a week was associated with reduced risk of early and late AMD. Other studies show that Omega-3 fatty acids improve mitochondrial function, decreases production of reactive oxygen species (free radicals that damage cells) and leads to less fat accumulation in the body. The green leafy vegetables contain important protective macular pigments (carotenoids) called lutein and zeaxanthin that reduce the risk of AMD by 43%. High levels of lipid or fat deposits in the body (obesity) can “soak-up” the lutein and zeaxanthin so that they are not available to protect the retina.

The goal is to increase the omega-3 fatty acid and carotenoid levels to protect the eye. Below is a list of foods that are eye healthy:

Foods that have lutein or zeaxanthin:

– 6mg/d of lutein and zeaxanthin – decreased

– Lutein/zeaxanthin content – ug/100g wet weight

– Kale, cooked – 15,798

– Spinach, raw – 11,935

– Spinach, cooked – 7,053

– Lettuce, raw – 2,635

– Broccoli, cooked – 2,226

– Green peas, cooked – 1350

Source: Johnson, et al 2005 Nutr Rev 63:9

To help kickstart an eye healthy diet, here is a list of “eye-healthy recipes” that provide nutritional support for the mitochondria and retinal cells.

Asparagus Soup
Kale Chips
Quinoa Collard Green Wraps with Summer Vegetables
Smoked Salmon Rillettes

Sources:
Geoffrey K. Broadhead, John R. Grigg, Andrew A. Chang, and Peter McCluskey Nutrition Reviews. Dietary modification and supplementation for the treatment of age-related macular degeneration VR Vol. 73(7):448–462

Chong et al., Dietary omega-3 fatty acid and fish intake in the primary prevention of age-related macular degeneration: a systematic review and meta-analysis. Arch Ophthalmol 2008;126:826–33.

5/19/16

courtesy of the

Pink Eye Tips and Prevention

Pink eye is an inflammation or infection of the thin, clear covering of the white of your eyeball (the conjunctiva) and the inside of your eyelids. When the small blood vessels in the conjunctiva become inflamed they are more visible making the whites of your eye to appear pink. Also called conjunctivitis, it can affect one or both eyes.

Common symptoms of pink eye include:

Redness in the white of the eyeball(s) and or inner eye lid(s)
Increased tearing or discharge
Slightly blurred vision from discharge
Crusting of the eyelashes from the discharge that may prevent eyes from opening after sleep
Mild eyelid swelling
Itching or burning sensation
Increased sensitivity to light
Irritation or gritty feeling in your eye(s)

Make an appointment with your eye doctor if you notice and of the symptoms of pink eye. Some forms are highly contagious for as long as two weeks, so an early diagnosis could protect those around you from contacting the disease. If you were contact lenses, stop using them until directed by your doctor.

There are four general types of pink eye.

Allergic Conjunctivitis
This form is caused by eye irritants such as pollen, dust, animal dander and other environmental factors. It is not contagious. Treatment often includes applying a cool compress to your eyes and using allergy eye drops and artificial tears. In severe cases non-steroidal and anti-inflammatory medications may be prescribed.

Bacterial Conjunctivitis
This type is most often caused by staphylococcal or streptococcal bacteria, is highly contagious and can cause serious damage to the eye if left untreated. This is treated with antibiotic eye drops or ointments to speed up the healing process that can take one to two weeks. While you may see improvement after three to four days, the entire course of treatment needs to be used to prevent a recurrence.

Because this is so highly contagious here are a few things to remember so you don’t spread it to others or re-infect yourself:

Don’t touch your eye with your hands
Wash your hands frequently and thoroughly
Change towels and washcloths daily – and don’t share them
Change pillowcases often
Get rid of all eye cosmetics and personal care items such as eye creams – and don’t share them
Avoid swimming
Don’t reuse tissues when wiping your eyes, and throw them out immediately
Follow your eye doctor’s instructions related to your contact lens usage and care

Viral Conjunctivitis
This is the same type of virus associated with the common cold. Antibiotics will not work on a viral infection. Like a cold, the infection just needs to run its course which could take anywhere from a few days up to 2-3 weeks. It is also contagious like a cold, so follow the same instructions as listed above to not spread the infection.

Chemical Conjunctivitis
This can be caused by irritants like air pollutions, chorine in swimming pools or exposure to noxious chemicals. To treat this type of pink eye requires a doctor to carefully flush your eyes with saline and may require topical steroids. Acute chemical injuries are very serious and need prompt medical attention to avoid corneal scarring, intraocular damage, vision loss or the loss of an eye.

Of course the best way to deal with pink eye is not to get it. Here are some ways to protect yourself and others.

2/24/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

4 Super Greens for Better Sight

A healthy diet not only helps your heart, but also your eyes. Your diet should include lots of fruits and vegetables to provide you with a natural source of nutrients to help protect your sight. As wonderful as supplements are, eating the actual foods is always better. Some of the best vegetables for you are the dark, leafy greens that are rich in valuable vitamins and nutrients. These are the super greens for better sight.

With the US experiencing bitter, freezing temperatures on the East Coast, while the West Coast is having summer in February, with record-breaking hot temperatures, I thought it would be interesting to see how you could enjoy those super greens, no matter what the temperature is outside. Below is a quick look at four dark leafy greens that are a great addition to a healthy diet, watercress, arugula, spinach and kale. For each vegetable I have included a recipe that is served hot, along with one that is served cold.

Here is what you need to know about super greens for better sight.

WATERCRESS

Watercress is a cruciferous plant and part of the brassica family, like arugula and kale. It contains vitamins A, B6, B12, C, K, iron, magnesium, calcium, phosphorus, lutein and zeaxanthin. In fact, weight for weight, watercress contains more vitamin C than an orange, more calcium than milk, more iron than spinach and more folate than bananas. Watercress has the highest amount of nutrients for the smallest amount of calories.

The health benefits of watercress include boosting immunity, cancer & diabetes prevention, reducing cognitive decline, thyroid support, better cardiovascular health and stronger bones. As for your eyesight, it can help prevent or slow the onset of age-related macular degeneration and possibly cataracts.

Watercress is most commonly enjoyed fresh in salads, but can also be use in pastas, casseroles, soups and sauces. Choose watercress with deep green, crisp leaves, with no signs of wilting. Trim the stems, rinse the greens in cold water and dry. It is best if used immediately, but can be store for up to four days in the refrigerator.

Watercress Soup by William Anatooskin

Watercress and Grapefruit Salad by Martha Stewart

ARUGULA

Arugula is also known as a salad or garden rocket. It is a small low growing herb that is packed with vitamins, minerals and antioxidants. It is rich in folates, vitamin A, B-complex, C and K and has copper, iron, calcium, potassium, manganese and phosphorus.

The health benefits of arugula include a lowered risk of cancer, healthy bones, strengthened brain function, improved mineral absorption and it boosts the immune system. Because of being a source of carotenoids, it also helps to slow the progression of age-related macular degeneration.

Arugula is popular in salads, used with milder greens to add a peppery flavor. But it can also be used in pastas, casseroles, pizzas, soups and sauces. Choose arugula that is crisp with green young leaves. Avoid the flowered harvest as those leaves are tough and have a bitter taste. Wash leaves in a bowl of water, swishing thoroughly to get rid of all sand and soil. Drain and pat dry before storing in the vegetable bin of your refrigerator for no more than a few days.

Grilled Stuffed Swordfish by Stormy Scarlett

Pasta Salad with Goat Cheese and Arugula by Martha Stewart

SPINACH

Spinach is a very popular leafy green vegetable, with two common varieties cultivated for food; the savory-type with dark green crinkled leaves and the flat-leaf type with smooth surfaced leaves. Spinach contains vitamin A, B-complex, C and K, along with lutein, zeaxanthin beta-carotene, potassium manganese, magnesium, copper and zinc.

The nutrients in spinach help improve blood glucose control in diabetes, lower the risk of certain cancers, reduce blood pressure, increase bone health and help iron deficiency. The lutein, zeaxanthin and beta-carotene help to potentially prevent and slow the progression of age-related macular degeneration. Lutein also works to protect the eye from free radical damage by helping filter out damaging blue and ultraviolet light.

Spinach is a universally popular vegetable, used around the world in a variety of ways, including salads, soups, noodles, pies, casseroles, dips, sauces, etc. Look for leaves that are dark green in color, crisp and not dull or yellow and spotted. Wash thoroughly to remove sand and soil, dry, trim away tough stems and store in the refrigerator for up to a week.

Turkey-Spinach Meatballs from Bon Appètit

Spinach Salad with Dates from Bon Appètit

KALE

Kale is a member of the mustard and cabbage families and has more nutrients than spinach. Less than ½ cup has 333% of the recommended daily allowance (RDA) of vitamin A, 587% RDA of vitamin K and 200% RDA of vitamin C. This frilly-leafed vegetable also has vitamin B-complex, lutein, zeaxanthin, beta-carotene, copper, calcium, sodium, potassium, iron, manganese, and phosphorus.

The health benefits of kale include healthy muscles and skin, improved blood glucose control, lower colon and prostate cancer risk, better cardiovascular health, stronger bone health, reduced neuronal brain damage and support for red blood cell formation. The advantage for your eyes comes from the lutein, zeaxanthin, beta-carotene and vitamin A, all which work to support a healthy retina. They help protect against blue and ultraviolet light as well as the early onset and progression of age-related macular degeneration. Because of the positive impact on diabetes it also reduces the onset and progression of diabetic retinopathy.

Kale is very versatile and can be served in a variety of ways including salads, soups and casseroles. It can also be braised, broiled, sautéed and even made into kale chips by tossing them in extra-virgin olive oil and sprinkled with your choice of cumin, curry powder, chili powder, red pepper flakes or garlic powder and baking at 275 degrees for 15-30 minutes depending on how crisp you want them to be. When shopping for kale look for leaves that are crispy and crunchy with a brilliant dark blue-green color. Wash thoroughly to remove soil and sand, dry well, and remove all tough stems. It is extremely perishable, so use it as quickly as possible.

Kale and Chicken Casserole by Martha Stewart

Kale with Pomegranate Dressing and Ricotta Salata from Bon Appètit

All of these dark green leafy vegetables are not only healthy for you, but can be used in many ways to make it easy to incorporate them into your diet. Here are a few ideas:

Throw a small handful into your blender when making your favorite smoothie
Add them to your next omelet or egg scramble
Use them for making pesto or adding to pasta sauce
Sauté with a small amount of extra-virgin olive and season with freshly ground black pepper and freshly grated Parmesan cheese to serve at a topping for your baked potato
Add it to your wrap, sandwich or flatbread

2/17/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Wearing Contact Lenses in Winter

This has been a cold winter so far, and since it is only January, it is bound to get colder. The extreme cold, combined with winds, snow, rain and other environmental factors, can really take a toll on your eyes. And while it may be snowing or raining, winter air is actually drier than any other season. This can be especially difficult if you wear contact lenses. Here is what you should know about wearing contact lenses in winter.

Wear sunglasses for protection from UV rays and wind. Your eyes can become sunburned which cause blurry vision and can make your eyes feel like they are burning (think of your sunburned skin feels) for 24 to 72 hours. It will also protect your eyes from snow, rain or anything else the wind can send your way.
Avoid direct sources of heat such as heating vents and fireplaces. Indoor heating can draw the moisture out of the air, so consider a humidifier to help maintain the correct amount of moisture in the air to help keep eyes moist. Cool-air humidifiers have less of a tendency toward mold and bacteria.
Speaking of hydration, we also tend to drink less water in the winter months, so make a concentrated effort to keep up your water intake.
If it is so dry, why are my eyes watering? This is a common question and the answer may be a bit counter-intuitive. Anything that irritates your eyes, including dryness, causes a tearing reflex. Your tear glands go into overdrive trying to replace the moisture to your cornea. To try and reduce the tearing, you can use eye drops or artificial tears specifically designed for use with contact lenses.
Your eyes are not the only thing that dries out in the winter, so does your skin. Try to put in your contacts before moisturizing your skin, especially your hands. So wash your hands, put in your lenses and then use your creams and lotions.
Change out your contact lenses regularly in cold weather according to the recommended schedule, be it daily, every two weeks or monthly. This will allow them to better conduct oxygen, reduce irritation and increase comfort.
Take a break from your contacts and wear your eyeglasses. Putting them on when you get home from work can make a big difference. Contact lenses dry your eyes out on their own, when you add cold weather it gets that much worse.
Get plenty of sleep, which also helps with the dryness and fatigue. This will help you start the day with your eye refreshed and ready for the many things you will put them through throughout the day ahead.

Do you have any other suggestions that have helped you cope when wearing contact lenses in winter?

1/15/16

Susan DeRemer, CFRE Vice President of Development Discovery Eye Foundation

Silent Thief of Sight – Glaucoma

January is National Glaucoma Awareness Month. The National Eye Institute, through their education program NEHEP, have created this infographic to provide you with information you need to know about this blinding eye disease.

When adults reach their 40s, they often begin to notice small changes in their vision that can affect their daily lives and jobs. It could be difficulty in reading a book or working on a computer. This can be annoying, but it can often be addressed by seeing an eye care professional for comprehensive dilated eye exam. This allows the doctor to detect diseases and conditions that can cause vision loss and blindness and yet have no symptoms in their early stages.

Silent Thief of Sight – Glaucoma

Glaucoma is one of these age-related eye diseases that has no early symptoms, which is why it is called the silent thief of sight. It is actually a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness. Open-angle glaucoma is the most common form disease.

In addition to an eye exam, you can reduce your chances of losing your vision to glaucoma by also:

Live a healthy lifestyle that includes maintaining a proper weight, eating healthy foods, and not smoking.
Know your family history to determine if you are at a higher risk for some eye diseases.
Protect your eyes against harmful UV rays from the sun or your computer by wearing sunglasses when you are outdoors or computer glasses when using the computer for extended periods of time.

Silent thief of sight glacoma — Courtesy of NEI/NEHEP

1/5/16

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

9 Tips To Relieve Digital Eye Strain

Online shopping has continued to grow this year, which means more people are spending more time on computers, tablets and phones. While the convenience of online shopping can’t be beat, it could be costing us sleep, giving us headaches, making our vision blurry…and even affecting our posture.

Digital Eye Strain

Digital eye strain (DES), also known as computer vision syndrome (CVS), is a consequence of spending two or more hours at a time looking at a digital screen. Nearly 30% of adults spend more than 9 hours each day using digital devices, while 25% of children use digital devices more than 3 hours a day.

This can result in dry or itchy eyes, blurred vision, eye twitches, headaches and even back and neck pain. Using digital devices for an extended period of time increases your tendency to lean into the device, as you try to focus or compensate for glare from reflected light (room lighting or windows). Holding these positions for long periods of time are what create the back and neck pain.

As for the many eye symptoms, they can come from

poor lighting
improper viewing distance from device
not blinking often enough
poor screen contrast
glare on the screen
UV blue light

To help you deal with DES, here are 9 tips to relieve digital eye strain.

12/22/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

6 Tips to Help With Holiday Stress

We all know that the holidays can be stressful with the many demands of shopping, baking, parties and the expectation that you should be filled with cheer and goodwill. This is all daunting under the best circumstances, but if you are also losing your vision to eye diseases such as glaucoma, age-related macular degeneration or diabetic retinopathy, the depression can increase.

6 Tips to Help With Holiday Stress

Being realistic, planning ahead and asking for help will let you deal with the stress and depression that may come with the holidays. Here are six tips that will help you deal with the pressures of the holidays, with additional tips for those with vision loss.

Begin by realizing you don’t have to be happy just because the holidays are here. You may have experienced a loss of someone close to you that makes celebrating the holidays hard.

With vision loss: You may miss seeing or putting up decorations; baking for friends and family; or seeing the joy and smiles of loved ones. You can’t force yourself to be cheerful because of the time of year.

While the common reaction to depression is stay home and isolate yourself, don’t, it will only make you feel worse and dwell on things you cannot change. Join friends when they ask you out, find community events to attend or volunteer. Sharing time with others can provide a welcome distraction and lift your spirits.

With vision loss: It is common to be uncomfortable with asking friends and family for a ride, but if they are attending the same party of community event, ask them if you can get a ride. They won’t mind a will be glad you are there. Worst case, call a taxi or use Uber.

Don’t expect perfection. You need to define for yourself what would make a great holiday and not let the media and retail stores tell you what the holidays should be. Also remember that your traditions will change as your family changes and grows. Look at this as an opportunity to be creative and start new traditions.

With vision loss: Scale your holiday to what is comfortable to you. If fewer decorations make it safer and easier for you to navigate around your home, then reduce the number of things that go up to a few larger items you can enjoy more easily – you can even “decorate” with holiday music.

Even traditions may need to change. Allow someone else to host the family or neighborhood celebrations. It is nice to pass the honor on and you won’t be so stressed and tired you can’t enjoy the festivities.
Plan ahead so you don’t feel the pressure. This refers to budgeting both time and money.
• Plan extra time for decorating, shopping, baking, wrapping presents, or any other activity you want to include. Rarely do things run smoothly, especially at holiday time.
• Decide how much money you can spend, and stick to it. To make money go further, give homemade gifts, start a gift exchange instead of shopping for everyone in your family or office, or make a donation to a charity in someone’s name.

With vision loss: The same concepts apply – you need to budget your time and money.
Don’t over extend yourself and learn to say no. If you don’t you may become resentful and overwhelmed. Friends and family will understand if you can’t do everything. If your guilt gets the better of you, ask the person making the request to help with the tasks. They will gain a new appreciation of what you do.

With vision loss: Don’t be afraid to let people know that you may not be able to do things as easily as you could in the past. No one, except you, know the limitations you have with your vision. It can be very uncomfortable for others if they think they are asking too much of you, and you could become resentful for being asked to do something beyond your capabilities.

Stay healthy. The best way to do this is to watch what you eat and drink, get plenty of sleep, continue any exercise routine you have and take time to relax.
     • You will be tempted with lots of sweets and snacks. Try eating something healthy like cut veggies before you go to the party to curb your appetite. Remember to limit your alcohol because of the calories and the fact that it is a depressant.
     • Sleep will keep you alert and better able to focus what you want to get done and will help keep you more positive.
     • Exercise is a great way to help relieve the stress you feel, give you an extra burst of energy and help you clear your head.
     • Taking 15-20 minutes to just listen to music, take a bath, go for a walk or read book can help you think more clearly and relax. You will actually get more done when you can “re-charge” yourself.

With vision loss: Everything listed above is good for good eye health. A good diet of brightly colored fruits and vegetables and exercise are very important. Being tired can affect how well you see, and stress has been known to have an adverse effect on a person’s vision.

Because of the busy holiday season, this month we will only be publishing once a week, on Tuesdays.

12/8/15

Susan DeRemer, CFRE
Vice President of Development
Discovery Eye Foundation

Low Vision Aging Adults at Higher Risk for Falls

Low vision in aging adults varies as do the occupational therapy techniques that might help older adults in becoming more independent. Mr. P has glaucoma resulting in a narrowed field of view. He is light sensitive, and keeps his blinds closed, darkening the house. He is responsible for doing his laundry, yet his washer and dryer are in the basement, causing a safety concern. Mrs. K has macular degeneration with 20/400 visual acuity. She has severely reduced contrast sensitivity, and can no longer drive or recognize faces easily. She no longer gets to the senior center for regular exercise sessions, which is concerning to her and her OT. Ms. T was diagnosed with diabetic retinopathy. She has struggled for years to accurately see her glucometer and insulin. She has recently developed peripheral neuropathy, leading to wheelchair dependency. Each of these patients is likely to leave their home less often because of their low vision, eventually leading to a decline in lower extremity weakness, balance, endurance and confidence. The fear of falling leads to more isolation, which can cause even more lower extremity weakness, problems with balance, decreased endurance, and even depression. The irony is that this cycle, which began with caution and a fear of falling, lends itself to exactly that. . .a fall.

Why are low-vision aging adults at higher risk for falls?

According to the CDC, “Each year, millions of older people-those 65 and older-fall. In fact, one out of three older people fall each year, but less than half tell their doctor. Falling once doubles your chances of falling again.” The typical aging adult with low vision faces challenges that others do not. Difficulty seeing details combined with reduced contrast sensitivity leads to a decline in mobility and socialization.

So how do we help older adults with low vision lower their risk for falling? When considering safety within the home, persons with low vision must make it a priority to add lighting & contrast whenever possible. Consider all rooms of the house, including entrances, hallways and stairways.

Placement of night lights in hallways, stairway, etc.

Keep flashlights in accessible places throughout the home where night lights are not possible.

Instead of closing blinds, keep them open & wear appropriate colored filters to manage glare/light sensitivity.

Small battery operated stick-on lights or rope lighting is inexpensive, and easy to place on steps to light up a stairwell.

Line edge of steps, or stairway railing with brightly colored duct tape to increase visibility.

Make sure grab bars, tub benches, shower chair are high contrast, to be most visible.

Remove throw rugs, with the exception of those providing function, such as the one at the entrance and bathtub. Their purpose is for providing dry shoes and feet, but they should have a non-skid back and a high contrast color to “stand out.”

Reduce clutter in rooms to increase safety by removing items from floors, walkways and stairwells.

Consider investing in a Medical Alert System to provide added piece of mind, confidence, especially when living alone.

Persons with low vision can decrease their frequency of falls by staying social and walking in the community. Unfortunately, many low vision adults become more house bound when they can no longer drive. Locating sources of alternative transportation may be helpful. Seeing faces is difficult, making socializing a challenge, which can lead to depression. The following recommendations take into consideration the challenges of not seeing details or across the visual field normally, while improving lower body strength, endurance, coordination, confidence, and hopefully reducing the risk of a fall.

Encourage regular trips to the grocery stores and the mall to keep physically fit. Malls are safe environments to walk around because of wide, straight hallways. Use magnifiers to see price tag/label details, or take advantage of personal shoppers who assist with locating items.

Participate in regularly scheduled exercise sessions (videos, groups, etc). Sit/stand in the front row, ask instructor to provide clear verbal instruction, instead of only demonstration. Consider hiring a personal trainer in order to get 1:1 instructions for how to use exercise equipment. If watching a video, move closer to your largest TV screen. Home exercise equipment can be labeled with high contrast markings to increase visibility of its details.

Consider joining a senior center in the community. Some have low vision support groups.

Access driving alternatives, such as the Smart Bus, Senior Centers, Local Volunteer or Church groups. Consider using money previously spent for a car and its expenses to hire a private driver.

Use appropriate colored filters in bright outside conditions or darker inside environments (i.e. Amber outside in the sun; Yellow inside a dark restaurant or outside with overcast weather).

Consider using a walker or support cane when walking longer distances in the community or neighborhood. Many individuals decline using an assistive device, not realizing how active and fit it can make them. Rolling walkers are even available with seats, allowing for rest breaks wherever necessary.

While the fear of falling is great amongst all seniors, those with low vision need to consider adding strategies that specifically benefit them. Making changes within the home may be as simple as improving lighting and contrast. Remaining physically fit outside of the home may be done with shopping or exercise equipment, but either way staying active will improve confidence, the fear of falling, and hopefully decrease the chance of a fall. If you are unsure of what approach is best for you, consult with your ophthalmologist about scheduling a low vision eye exam and occupational therapy.

Reference:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control-CDC 24/7: Saving Lives, Protecting People

12/3/15

Annette M. Babinski, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center

Michelle Buck, MS, OTR/L CLVT
Henry Ford Health System
Vision Rehabilitation Center

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