COVID

8 Ways to Prevent Common Eye Drop Mistakes

Whether used to treat dry eye, allergies, conjunctivitis, ocular inflammation, or glaucoma, eye drops are among the most common products found in household medicine cabinets. Eye drops may also be prescribed following eye surgery in order to prevent infection or reduce inflammation.

To get the greatest benefit from eye drops, you need to use them properly. If used incorrectly or overused, eye drops can actually damage eye health.

If you’re struggling to use your eye drops as directed, don’t give up! Just follow these simple tips to obtain the greatest benefit from your eye drops and to minimize any side effects.

Tips For Properly Using Eye Drops

 

1. Always read the label.
   You wouldn’t believe how many people mistakenly put the wrong product into their eyes. Eye drop bottles may easily get mixed up with ear drops or other medications. Such mix-ups can potentially damage your eyes, and even result in chemical burns.
2. Remove contact lenses before applying eye drops
   It’s rather common for people to forget to remove their contacts prior to applying eye drops. This is problematic, because contact lenses interfere with the distribution of the drops, drastically reducing their effectiveness. Keep in mind that you should wait at least 20 minutes after administering the drops before reinserting your contact lenses. That way, you prevent any eye drop residue from adhering to the lenses.
3. Apply one drop at a time
   When you apply drops in quick succession, you’re wasting your drops, since applying them too quickly pushes out the first drops before they have a chance to be absorbed. If the instructions on the label say that you need to apply two drops, apply a single drop, wait a few minutes, and then apply the next one.
4. Apply drops on the center of the eye
   When applying eye drops, aim for the middle part of the eye. Targeting the inner part will lead the drops to collect near your nose and drip down your face.
5. Avoid blinking your eyes vigorously after applying eye dropsInstead, gently close your eyes for a few moments or blink as you normally would. By blinking vigorously, you will end up pushing the eye drops out of your eye.
6. Keep eye drops in your eye to prevent side-effects
   Your tears drain through a small canal into the back of the nose, which has many blood vessels.
   When you apply eye drops to your eye, the drops can enter the tear system and rapidly absorb into the bloodstream. To prevent this from happening, place pressure on the lower tear ducts (situated by the bridge of the nose) after applying the drops.
   Doing so will help reduce any potential side-effects, such as an increase in blood sugar or blood pressure (in the case of topical steroid drops).
7. Avoid having the tip of the bottle touch your eye
   Always make sure you hold the bottle at least 1 inch away from your eye. If the tip does touch the eye, it may lead to infection, as the bacteria from your eye can contaminate the solution.
8. Don’t mix eye drops
   If you have multiple prescriptions or use over-the-counter drops, apply them at different times during the day. Combining too many drops at once may reduce their effectiveness.

Though applying eye drops may seem like a straightforward task, not everyone does it right. If you have questions or are having difficulty applying eye drops, speak with Dr. Monte Harrel at Harrel Eyecare in today.

Did You Know That 20% of People Sleep With Their Eyes Open?

Ever heard the saying “to sleep with one eye open”? It’s generally used as a metaphor when advising one to stay vigilant. But sleeping with eyes open is a common eye and sleep disorder known as nocturnal lagophthalmos. In fact, the National Sleep Foundation estimates that about 1 in 5 people sleep with their eyes open.

This condition is problematic because it can interfere with sleep and impact eye health. People may not get as much sleep, or sleep as soundly as they’d like, due to the pain and discomfort caused by the eyes drying out during the night.

Nocturnal lagophthalmos generally indicates an underlying medical condition, such as a thyroid problem or an autoimmune disorder. If upon waking you experience irritated, dry, tired, red, or painful eyes, or if you suspect you might be sleeping with your eyes open, speak with Dr. Monte Harrel at Harrel Eyecare today.

What Happens When You Sleep With Your Eyes Open?

People who have nocturnal lagophthalmos may not even know they have it. It is difficult to evaluate whether your eyes are closed when you’re actually asleep. However, some important indicators may point to the condition, including:

• Eyes that feel scratchy, irritated and dry
• Blurred vision
• Red eyes
• Eye pain
• Tired eyes

For those with nocturnal lagophthalmos, the eye loses the protection of a closed lid and becomes dehydrated, causing the tear layer to evaporate and the eyes to become dry. Nocturnal lagophthalmos also reduces the eye’s ability to discharge contaminants such as dust and debris that fall into the eye during the night. These contaminants can potentially lead to:

• Eye infections
• Corneal damage, such as corneal abrasion, sores and ulcers
• Eye dryness and irritation
• Poor quality sleep
• Loss of vision

Why Do We Close Our Eyes to Sleep?

There are several reasons why it’s important to close our eyes while we sleep. Closed eyelids block light, which stimulates the brain to wakefulness.

Closing our eyes also protects and lubricates the eyes while we sleep. If your eyelids don’t close, your eyes become more susceptible to dryness, infections, and debris that can scratch and damage the cornea.

Why do Certain People Sleep With Their Eyes Open?

There are a number of reasons people might sleep with their eyes open. The most common reasons for nocturnal lagophthalmos include:

Problems With Facial Nerves and Muscles

Issues with facial nerves and muscles surrounding the eyelid can cause the lid to remain open during sleep. Weakness in facial nerves can be attributed to several factors.

 

• Injury or trauma
• Stroke
• Tumor
• Bell’s palsy, a condition that causes temporary paralysis or weakness of facial

muscles.

• Autoimmune disorders and infections, such as Lyme disease, chickenpox, Guillain-Barre syndrome, mumps, and several others.
• Moebius syndrome, a rare condition that causes problems with cranial nerves.

Damaged Eyelids

Eyelids can become damaged as a result of surgery, injury or illness, making it difficult to fully close the eyes during sleep. Furthermore, a condition known as floppy eyelid syndrome can also interfere with eye closure, and is often associated with obstructive sleep apnea (OSA). OSA is commonly linked to eye diseases like glaucoma and optic neuropathy.

Thyroid-Related Eye Problems

A common symptom of Grave’s disease, a form of hypothyroidism, is protruding eyes. The bulging eyes, known as Graves’ ophthalmopathy, can prevent the eyes from closing.

Genetics

There also tends to be a genetic component to nocturnal lagophthalmos, as it often runs in families. Whatever the cause, the symptoms of nocturnal lagophthalmos are uncomfortable and the consequences can lead to ocular complications.

Can Nocturnal Lagophthalmos Be Treated?

This condition can be treated in several ways, depending on the underlying cause and severity of symptoms. Treatments include:

• Administering artificial tears throughout the day, providing a film of moisture around the eyes that protects them at night.

• Wearing an eye mask or goggles to protect the eyes from external debris and visual stimulation. These items are uniquely designed to generate moisture for the eyes while you sleep.

• Using a humidifier, which provides a moisture-rich environment to prevent your eyes from drying out.

• Wearing eyelid weights to help keep the eyelids closed.

• In acute cases, surgery may be recommended.

Make sure to consult your eye doctor before undertaking any of these treatments.

Because nocturnal lagophthalmos sometimes signals an underlying condition, it is especially important to contact Dr. Monte Harrel at Harrel Eyecare in Tulsa for a proper diagnosis and to receive prompt treatment. If nocturnal lagophthalmos is left untreated for an extended period, patients risk seriously damaging their eyes and vision.

When Routine Eye Exams Return 

When stay-at-home restrictions begin to lift in many areas, optometry practices will open their doors for routine care, and eye exams for glasses, contact lenses, and eye surgery will be offered once again.

Practices are implementing strict precautions to prevent the spread of COVID-19, and to ensure everyone’s safety. Below are a few of the changes you should expect when you come in for your eye exam.

Expect the Following Changes at Harrel Eyecare

Harrel Eyecare in Tulsa has strict protocols in place to prevent the spread of coronavirus and other infections. You should expect the following during your next appointment:

• Your optometrist will wear a face mask, gloves, and eye shield or face-covering safety shield, while patients will be required to wear a face mask.

• You will need to wash or disinfect your hands upon entering the practice, as well as when you enter different rooms.

• Packed waiting rooms will be a thing of the past. We will be spacing out seating to reduce capacity, and scheduling appointments to limit patient interaction.

• If you aren’t feeling well or have been in contact with someone who is ill, we ask you to let us know prior to your visit, and we will postpone your appointment by two to three weeks.

• We will space out appointments in a way that will allow our staff to sterilize office fixtures and equipment before and after each patient’s visit. Exam rooms will be completely disinfected between appointments.

• We will frequently wipe down counters, chairs, equipment, and doorknobs. In the dispensary, eyeglass frames will be promptly disinfected after use.

• We will utilize a large shield during the slit lamp part of the exam, which requires the nearest doctor-to-patient contact. The protective shield will prevent respiratory droplets from being spread. (The slit lamp shines light into the patient’s eye, enabling Dr. Monte Harrel to examine the internal health of your eye.)

The only constant in life is change. COVID-19 has led to rapid changes across most industries, and optometry is no exception. We continue to adapt to this new reality, to ensure that our patients receive the care they need, in comfort and safety. .

Is your vision blurred? Are you seeing spots or floaters? Are your glasses broken? Do you need contact lenses? Contact Harrel Eyecare in Tulsa today for help.

4 Eye Hygiene Practices That Reduce the Risk of Infection 

Viruses are responsible for many infections, such as the flu, the common cold, conjunctivitis (pink eye) and coronavirus. With the coronavirus (COVID-19) pandemic in full-swing, it’s important to be aware of good hygiene practices, especially for the eyes, as they are a portal for infectious diseases. By implementing the practices below, you can significantly reduce the risk of contracting or transmitting a viral infection.

What Is a Virus?

A virus is a submicroscopic infectious agent that reproduces itself by invading a host cell, replicating its DNA inside it. This infected cell then replicates rapidly, spreading millions of new viral cells throughout the body. Once infected, we feel sick and experience the unpleasant side effects of rising temperature, sore limbs and other symptoms as our immune system recognizes the virus as being foreign and vigorously fights against it.

How Does a Virus Travel Between Organisms?

For a virus to cause disease, it must first enter a body, called a target host. A target host can get infected directly, via infected droplets (such as when kissing), or indirectly, when coming into contact with droplets from a cough, sneeze, or tears left on a surface. Infected droplets enter the body through one of the mucous membranes, such as the eyes, nose or mouth.

Even if the infected person shows no symptoms, they can still be contagious. Depending on the virus, it can survive on a surface for some time and can be picked up from a doorknob or an elevator button. This is why practicing good hygiene is an effective way to prevent indirect viral transmission.

4 Crucial Eye Hygiene Practices

By implementing the following hygiene practices, you will better protect yourself and others from viral infection.

1. Routinely wash your hands

We, humans, touch many surfaces throughout the day. If we’re not careful, we can catch an infection, particularly from hard surfaces like plastic and stainless steel.

Viruses can also be picked up while preparing and eating food; using the toilet; or handling an animal. Make sure that you regularly and thoroughly wash your hands, ideally for a minimum of 20 seconds with soap and water, to kill viruses (and bacteria) on the surface of your skin. If soap and water aren’t available, use an alcohol-based hand sanitizer.

2. Keep your hands off your face

Studies show that the average person touches their face up to 23 times per hour, and that the majority of contacts involve the eyes, nose and mouth. Doing so puts you at risk for getting a virus or transmitting the virus to another. Try to be conscious and avoid touching your face whenever possible.

3. Avoid rubbing your eyes

Rubbing your eyes is an instinctual response to tiredness or itchy eyes. It feels great to rub your eyes because doing so stimulates tear production, temporarily relieves itchiness, lubricates the eyes, and removes irritants. However, if your hands are unwashed, rubbing your eyes can put you at risk of contracting an infection, such as conjunctivitis or coronavirus. In fact, conjunctivitis has been linked to respiratory infections like the common cold, the flu, and COVID-19.

4. Use makeup with caution

Given the information provided above regarding infections, the following advice should come as no surprise:

• Don’t share your makeup with anyone else, whether for eyes, lips or face.
• Don’t use a cosmetic brush previously used by another when testing makeup products. Instead, request single-use applicators and wands.
• Don’t use a product past its expiration date.
• Don’t use the same makeup products after you’ve been sick or have had an eye infection.
• Don’t share face cloths or face towels with anyone else.

Harrel Eyecare at Tulsa is committed to helping you manage your long-term eye health. From all of us at Harrel Eyecare, please stay safe and take care of yourself and your loved ones.

The Power of Tears

Tears literally enable us to see. They lubricate our eyeballs and eyelids, thus preventing our eyes from dehydrating. They also provide a smooth surface for refracting light, supply oxygen, and are a vital component of the ocular defense system that protects against a range of pathogens. Below we’ll delve into the composition and types of tears, and further explain why they are so beneficial to our physical and emotional well-being.

Structure of Tears

Tears are made up of three layers: lipids, aqueous and mucous.

The lipid layer is the outermost layer and prevents the evaporation of tears. The lipids are produced by tiny glands in the eyelids called the meibomian glands.

The aqueous layer, which is the middle layer, makes up 95％ of our tears. This layer supplies nutrients to the cornea, prevents infection, and heals ocular damage. This layer is effectively made up of water and is produced by the lacrimal gland.

The mucous layer is the one closest to the eye. It coats the cornea and provides a level platform that allows for an even distribution of the tear film over the eye. This layer is produced by even smaller glands called goblet cells.

The Three Types of Tears

Tears are composed of water, salts, amino acids, antibodies and lysozymes (antibacterial enzymes). However, there are several types of tears, and their composition varies. For example, the tears we shed while crying are different from the tears that flood our eyes in the presence of irritants like onions, dust or allergies.

Humans produce the following three kinds of tears:

1. Basal – these tears are constantly at the front of the eyeball and form the liquid layer over the eyeball to keep it lubricated.

1. Reflex – these tears appear when the eye is irritated, such as when the eyes feel gritty or when we get dust, sand or other small foreign objects in our eyes.

1. Psychogenic – these tears are sparked by emotion. They possess a higher protein level than basal and reflex tears, which makes them thicker, causing them to stream more slowly. Psychogenic tears are made up of higher concentrations of stress hormones such as adrenocorticotropic hormone and leucine enkephalin (a natural painkiller). This suggests that emotional tears play an important role in balancing stress hormone levels.

Tears Serve the Following Functions

Prevent dryness
Tears prevent dryness by lubricating the surface of the eye. Each time we blink we spread this cushioning layer of tears across the front of the eyes.

Supply oxygen and nutrients
Oxygen and nutrients are delivered to the cornea through our tears.

Prevent infection
Not only do tears wash away foreign bodies that enter the eye, but they can also prevent infection thanks to an antibacterial property contained within tears called lysozyme. This antibacterial agent fights off the germs we pick up in our surroundings.

Heal ocular damage
Tears are made up of substances that heal damage to the surface of the eye. Damage can be caused by foreign objects and even high exposure to UV rays.

Create a smooth surface on the eye
Tears lubricate and smooth our eye’s surface, leading light to be correctly focused and enabling us to see clearly.

Remove Toxins
Emotional tears contain more toxic byproducts than reflex tears (caused by irritation), and can thus flush out many toxins and stress hormones.

Dull pain and improve mood
Crying for extended periods of time releases oxytocin and endorphins. These feel-good hormones can help diminish both physical and emotional pain. Once the endorphins are released, your body may enter a more relaxed stage, with oxytocin providing you with a sense of calm and well-being.

As you can see, tears are invaluable for clear vision, protecting your eyes, flushing out irritants, and soothing emotions.

If you feel that your eyes are not as comfortable or your vision is not as clear as usual, contact Dr. Monte Harrel at Harrel Eyecare in Tulsa today.

Why You Shouldn’t Rub Your Eyes

Though it may seem harmless, rubbing your eyes is something many of us do from time to time. Doing so feels good because it stimulates tear flow and eye lubrication, which offers relief for dry eyes and helps remove dust and other irritants. Furthermore, rubbing your eyes can be therapeutic, as pressing down on your eyeball stimulates the vagus nerve, which decreases your heart rate, thus relieving stress.

So why do eye doctors advise against rubbing your eyes? That’s because rubbing your eyes poses a threat, especially now, as COVID-19 can be spread through the eyes’ mucous membranes. Moreover, rubbing can potentially damage your eyes’ structure and vision.

Why is Rubbing Your Eyes Harmful?

• Continuous eye rubbing in susceptible individuals can cause the cornea to thin and weaken, leading it to bulge forward and become more cone-like. This is known as keratoconus — a serious condition that can lead to distorted vision and ultimately the need for a corneal transplant or specialized contact lenses, such as scleral lenses.

• If you have a foreign object in your eye, your natural instinct is likely to rub it in an attempt to remove the object. However, this can potentially cause more damage as the object can scratch the cornea. Instead, try flushing it out with saline solution or artificial tears.

• From a hygienic perspective, it’s important to remember that your hands are covered in germs and bacteria. Therefore, sticking a finger that hasn’t been thoroughly washed with soap and water into your eyes can cause an infection, such as conjunctivitis, to flare up. Recent evidence shows that the coronavirus can also be transferred from the hands to the eyes.

• Rubbing is harmful to people with certain pre-existing eye conditions. If you have progressive myopia (short-sightedness caused by a lengthened eyeball) or glaucoma (a condition that damages the optic nerve), rubbing your eyes can exacerbate the condition and worsen eyesight. Eye rubbing is particularly bad for a glaucoma patient with already heightened eye pressure. It can engender nerve damage and permanent vision loss.

• Retinal tear or detachment can occur due to the heightened eye pressure caused by the rubbing.

• Excessive eye rubbing can negatively affect your appearance. It can cause tiny blood vessels to break, resulting in bloodshot eyes, dark circles and wrinkles around the eyes.

Why Do We Rub Our Eyes?

When your eyes are itchy, it is tempting to rub them. But rubbing releases histamines, which make the itching worse, which in turn leads to more aggressive eye rubbing.

Rubbing your eyes isn’t all bad. It releases more tears, which in turn causes the meibomian glands, situated within your eyelids, to secrete much-needed oil into our eyes. That adds moisture and protects our tears from evaporating.

However, if you frequently rub your eyes because they are dry or irritated, contact Dr. Monte Harrel immediately.

How to Stop Rubbing Your Eyes

Keep your eyes hydrated by using artificial tears or eye drops. They can be found over the counter at the pharmacy, and are especially effective against dry eyes. Certain eye drops, such as antihistamines and mast cell stabilizers, can be prescribed by Dr. Monte Harrel to help prevent the itchy feeling that leads you to instinctually rub your eyes. In more severe cases, such as in allergy sufferers, steroid eye drops can be used to avoid chronic eye rubbing.

Excessive eye rubbing, whether due to chronic dry eye, itchy eyes, or habit, should be addressed to prevent any ocular and vision damage. Contact Harrel Eyecare at Tulsa to schedule a visit, determine the cause of your itchiness, and find out which drops to use in your specific case.

 

COVID-19 –  What Constitutes an Eye Care Emergency? 

An eye care emergency is defined as medical care for conditions requiring prompt medical attention due to a sudden change in ocular or visual health.

Eye trauma, chemical exposure to the eyes, foreign objects in the eye, and ocular infections are all considered eye emergencies and should be given immediate medical attention. If you have an eye emergency, it’s critical to get immediate care in order to avoid permanent damage to your vision.

While some may opt to visit an emergency room for an eye injury, research shows that most emergency room visits for eye emergencies could have been treated by an experienced optometrist. Furthermore, going to the hospital for an eye emergency during the coronavirus pandemic isn’t the fastest or safest way to treat the problem; the hospitals are already overloaded and you risk catching the virus during your visit.

Dr. Monte Harrel can offer personalized treatment for a wide range of eye emergencies and other ocular conditions. Call Harrel Eyecare for further instructions or call the number provided in the voicemail.

What Is an Eye Emergency?

Eye emergencies refer to any sudden onset of symptoms or obvious eye trauma that affect vision. These emergencies range from severe eye pain or vision loss to a sudden blow to the eye or chemical exposure. Call us if you experience any of the following:

• Eye pain
• Bleeding of the eye
• Blood in the white of the eye
• Swollen or bulging eye
• Vision loss or double vision
• New eye flashes or floaters
• Pupils that are unequal in size
• Severe photophobia (light sensitivity)
• Being hit in the eye
• Bruising around the eye
• Eye discharge
• Suspected eye infection
• Severe burning, stinging, itching eyes
• Scratched or cut eye or eyelid
• Split contact lenses in the eye
• A piece of broken eyeglass lens in your eye
• Foreign object stuck in the eye

If you’re uncertain whether or not your condition is an emergency, contact Harrel Eyecare immediately.

What Should I Do If I Have An Eye Emergency?

If you have a cut or foreign object in your eye, or if you suffered from other forms of eye trauma, DO NOT:

• Rub your eye
• Attempt to remove any foreign objects embedded in the eye
• Use tweezers or swabs in your eye
• Put any ointments or medication into your eye

First Aid for Eye Injuries

Refer to the following guidelines to prevent any long-term vision loss or eye damage.

Chemical Exposure

If a contact lens is in the eye, do not attempt to remove the contact lens using your fingers. Instead, flush saline solution or water over the lens immediately as it may dislodge the lens. Contact lenses can trap harmful chemicals against the cornea, causing unnecessary damage.

Seek emergency medical care promptly after flushing.

To avoid eye exposure to toxic or abrasive chemicals, always wear protective eyewear and use caution when handling these types of products.

Foreign Objects

Although your first instinct may be to rub your eye to get the foreign object out, try to resist the urge–as rubbing can further damage the eye.

If the object isn’t embedded in the eye, you may try to remove it by flushing it out. First, wash your hands with warm water and soap to prevent contamination or infection. Then, flush the eye thoroughly with clean water or preferably saline, if available. You can also try to induce tearing by using your fingers to gently lift the upper eyelid over the lower eyelid. Causing the eye to tear may flush out the foreign object.

If the object is visible, and not embedded on the eye, you can try to gently wipe it away with a damp, clean washcloth.

Seek immediate medical attention if the above methods do not work.

Blows to the Eye

To treat a black eye, apply a cold compress to decrease swelling and support healing. Use the compress for 5 to 10 minutes at a time, allowing the eye to rest between applications. A cold compress can be made by wrapping a bag of peas, or other soft frozen items, in a clean cloth.

Never place ice directly on the skin; use a clean cloth between the skin and ice.

Call Dr. Monte Harrel immediately if you notice any of the following symptoms after the eye is impacted:

• Changes in vision