Best Ski Protection for Your Eyes
A dear patient of mine is a professional skier and instructor. She is right now skiing the Alps till end of January. She also has some of the worse dry eyes I have ever seen. She is only 39 years old. She does have early ocular rosacea and I wondered if her ski profession was making her dry eyes worse.
She initially looked like this.
With treatment including Lipiflow and Meibomian Gland Probing, she looked much better below but still not 100% perfect. She feels better but still notices her eyes and we can see her corneal epithelium (the surface layer that stains bright green/yellow above with the streaks you can see above) are still there.
Looking at her closely over many months, it became clear that she had learned to stare when she concentrates and only half blink when she does blink. I had to re-teach her how to fully blink so we could heal the remaining epithelium.
Then I was consulted on a patient of my colleague who also was a professional skier and ski instructor. She too had similar findings. She was in her late 40’s and also fair skin with likely early ocular rosacea.
These two patients prompted me to find out what is going on with this sport for my dry eye patients. So I decided to take up skiing again. Ski is not my favorite sport given all the sports injuries I have seen in my patients (torn ACLs, fractures, sprains, etc). Even the crown prince of the Netherlands died in a ski accident, my husband warned. Still, I wanted to count how often I blink going down the slopes.
This is not a prospective, double blinded, randomized study in this case series of ONE obviously but here is what I found.
I tend to blink on average about 25-30 times per minute. The average person blinks about 15-20 times per minute. Likely I blink a bit more just out of a trained habit of treating thousands of patients with dry eyes over the years and seeing for myself how crucial full blinking is each minute AND hard blinking a couple of times every hour at least.
When I went down hill on skis (after remembering how to ski again after many, many years): I counted I blink about 8 times per minute before noon. I was not trying to blink less on purpose. But I was so concentrated on not falling and not hitting anyone, that I noticed I blinked less. As a result at the end of the day, I noticed much more reflex tearing. I had my snow goggles on the whole time so it was unrelated to any changes in wind. In the afternoon, I blinked about 10 times per minute. Likely the practice made me less stressed about falling and I was able to be more relaxed and blink more.
Why is Blinking so Important?
So blinking does the following crucial things for us:
1. Lubricate the cornea like a windshield wiper
2. Remove dust and debris from our eye surface
3. Protect the cornea from dead cells, debris, bacteria, and even viruses in our tear film
4. Constrict the muscle of Riolan at the orifice of the Meibomian Gland to push out some molecules of precious meibomian gland oil
5. Allows for a “mental break” that allows for increased attention capacity when eye are open again: see article below at Smithsonian Magazine.
Whether #5 is true will be proven in time. But there was an interesting paper published in 2015 that came out that may help explain why skiers blink less. The reference is #2 below.
The author’s graph below shows that “spontaneous eye blink rate predicted learning from negative outcomes of decisions, but not learning from positive choices. These observations support the notion that sEBR reflects tonic dopamine levels and relates to dopamine D2 receptor function. They also add to a growing body of work that relates individual differences in sEBR to individual differences in functions known to depend on striatal dopaminergic neurotransmission, such as inhibitory control (Colzato et al., 2009b) and reward-related processing (Pas et al., 2014).”
What this means in layman’s terms those who blinked relatively little
generally learned better from negative feedback than individuals
who blinked relatively often.
generally learned better from negative feedback than individuals
who blinked relatively often.
This paper in addition to many other studies that show we blink less when we concentrate or avoid negative things from happening to us, like hitting a tree or falling, helps explain why we blink less when we are skiing.
So:
What is the Best Ski Protection for Your Eyes?
1. No matter what googles you choose, be sure to blink actively as much as you can.
2. Take breaks when you go to the bathroom to wash your face with warm/hot water when you wash your hands.
1. Choose Ski Goggles that:
- block out 99 to 100 percent of both UV-A and UV-B radiation;
- screen out 75 to 90 percent of visible light;
- have lenses that are perfectly matched in color and free of distortion and imperfection; and
- have lenses that are gray for proper color recognition.
- are polycarbonate or Trivex® material: which are the most impact resistance.
- Make sure they fit over any glasses you have on completely so no rays go around your goggles or glasses.
2. Be sure to blink actively as much as you can.
3. Take breaks when you go to the bathroom to wash your face with warm/hot water when you wash your hands.
4. If you are a professional skier, avoid LASIK if you have any history of ocular rosacea in your family or you have any dry eye symptoms.
5. If your eyes periodically feel dry, see your eyeMD and get non-preserved artificial tears to use 4x per day to start to protect long term damage to your cornea.
6. Increase your Omega 3 intake to 2000-4000mg/day. All my diet advice still applies: https://drcremers.com/2016/12/anti-inflammatory-diet-best-initial.html?q=diet
Sandra Lora Cremers, MD, FACS
References:
The researchers came to the hypothesis after noting an interesting fact revealed by previous research on blinking: that the exact moments when we blink aren’t actually random. Although seemingly spontaneous, studies have revealed that people tend to blink at predictable moments. For someone reading, blinking often occurs after each sentence is finished, while for a person listening to a speech, it frequently comes when the speaker pauses between statements. A group of people all watching the same video tend to blink around the same time, too, when action briefly lags.
As a result, the researchers guessed that we might subconsciously use blinks as a sort of mental resting point, to briefly shut off visual stimuli and allow us to focus our attention. To test the idea, they put 10 different volunteers in an fMRI machine and had them watch the TV show “Mr. Bean” (they had used the same show in their previous work on blinking, showing that it came at implicit break points in the video). They then monitored which areas of the brain showed increased or decreased activity when the study participants blinked.
Their analysis showed that when the Bean-watchers blinked, mental activity briefly spiked in areas related to the default network, areas of the brain that operate when the mind is in a state of wakeful rest, rather than focusing on the outside world. Momentary activation of this alternate network, they theorize, could serve as a mental break, allowing for increased attention capacity when the eyes are opened again.
To test whether this mental break was simply a result of the participants’ visual inputs being blocked, rather than a subconscious effort to clear their minds, the researchers also manually inserted “blackouts” into the video at random intervals that lasted roughly as long as a blink. In the fMRI data, though, the brain areas related to the default network weren’t similarly activated. Blinking is something more than temporarily not seeing anything.
It’s far from conclusive, but the research demonstrates that we do enter some sort of altered mental state when we blink—we’re not just doing it to lubricate our eyes. A blink could provide a momentary island of introspective calm in the ocean of visual stimuli that defines our lives.
As a result, the researchers guessed that we might subconsciously use blinks as a sort of mental resting point, to briefly shut off visual stimuli and allow us to focus our attention. To test the idea, they put 10 different volunteers in an fMRI machine and had them watch the TV show “Mr. Bean” (they had used the same show in their previous work on blinking, showing that it came at implicit break points in the video). They then monitored which areas of the brain showed increased or decreased activity when the study participants blinked.
Their analysis showed that when the Bean-watchers blinked, mental activity briefly spiked in areas related to the default network, areas of the brain that operate when the mind is in a state of wakeful rest, rather than focusing on the outside world. Momentary activation of this alternate network, they theorize, could serve as a mental break, allowing for increased attention capacity when the eyes are opened again.
To test whether this mental break was simply a result of the participants’ visual inputs being blocked, rather than a subconscious effort to clear their minds, the researchers also manually inserted “blackouts” into the video at random intervals that lasted roughly as long as a blink. In the fMRI data, though, the brain areas related to the default network weren’t similarly activated. Blinking is something more than temporarily not seeing anything
2.
Spontaneous eye blink rates were not affected by age or gender.
While there is some work relating striatal D2-receptor binding to
aging, this work focused on a much wider age range (e.g., in Rinne
et al. (1993) 20–81 years old) than our study. We only included
young adults included, likely explaining why we did not observe a
significant relationship between age and sEBR. As to gender, there
were no significant differences in spontaneous eye blink rate between
men and women, although women blinked numerically
more often (15.2 times vs. 13.3 times per min) than men. Notably, a
previous study found no significant difference in striatal dopamine
D2-like receptors in male and female subjects although females
have numerically lower binding potentials (Brown et al., 2012).
Future studies using PET imaging combined with sEBR measurements
are necessary to shed more light on how gender and age
may affect these different measures of striatal dopaminergic
activity.
While there is some work relating striatal D2-receptor binding to
aging, this work focused on a much wider age range (e.g., in Rinne
et al. (1993) 20–81 years old) than our study. We only included
young adults included, likely explaining why we did not observe a
significant relationship between age and sEBR. As to gender, there
were no significant differences in spontaneous eye blink rate between
men and women, although women blinked numerically
more often (15.2 times vs. 13.3 times per min) than men. Notably, a
previous study found no significant difference in striatal dopamine
D2-like receptors in male and female subjects although females
have numerically lower binding potentials (Brown et al., 2012).
Future studies using PET imaging combined with sEBR measurements
are necessary to shed more light on how gender and age
may affect these different measures of striatal dopaminergic
activity.
In summary, spontaneous eye blink rate predicted learning
from negative outcomes of decisions, but not learning from positive
choices. These observations support the notion that sEBR re-
flects tonic dopamine levels and relates to dopamine D2 receptor
function. They also add to a growing body of work that relates
individual differences in sEBR to individual differences in functions
known to depend on striatal dopaminergic neurotransmission,
such as inhibitory control (Colzato et al., 2009b) and reward-related
processing (Pas et al., 2014). Together, these findings highlight
the usefulness of sEBR as a non-invasive and cheap method
for assessing the relationship between striatal dopaminergic
function and behavior.
from negative outcomes of decisions, but not learning from positive
choices. These observations support the notion that sEBR re-
flects tonic dopamine levels and relates to dopamine D2 receptor
function. They also add to a growing body of work that relates
individual differences in sEBR to individual differences in functions
known to depend on striatal dopaminergic neurotransmission,
such as inhibitory control (Colzato et al., 2009b) and reward-related
processing (Pas et al., 2014). Together, these findings highlight
the usefulness of sEBR as a non-invasive and cheap method
for assessing the relationship between striatal dopaminergic
function and behavior.
3.
UV Protection
Protecting Your Eyes from Solar Radiation
The sun supports life on our planet, but its life-giving rays also pose dangers. The sun’s primary danger is in the form of ultraviolet (UV) radiation. Artificial sources, like welding machines, tanning beds and lasers, can also produce UV radiation.Most people are aware of how harmful UV radiation is to the skin. However, many may not realize that UV radiation can harm the eyes, and other components of solar radiation can also affect vision.
There are three types of UV radiation. UV-C is absorbed by the ozone layer and does not present any threat. However, UV-A and UV-B radiation can have long- and short-term negative effects on the eyes and vision.
If your eyes are exposed to excessive amounts of UV radiation over a short period of time, you will likely experience photokeratitis. Like a “sunburn of the eye,” photokeratitis can be painful. Its symptoms include red eyes, a foreign body sensation or gritty feeling in the eyes, extreme sensitivity to light and excessive tearing. Fortunately, these symptoms are usually temporary and rarely cause permanent damage to the eyes.
If your eyes are exposed to excessive amounts of UV radiation over a short period of time, you will likely experience photokeratitis. Like a “sunburn of the eye,” photokeratitis can be painful. Its symptoms include red eyes, a foreign body sensation or gritty feeling in the eyes, extreme sensitivity to light and excessive tearing. Fortunately, these symptoms are usually temporary and rarely cause permanent damage to the eyes.
The longer the eyes are exposed to solar radiation, the greater the risk of developing cataracts or macular degeneration later in life. It is not clear how much exposure to solar radiation will cause damage. Therefore, whenever you spend time outdoors, wear quality sunglasses that offer UV protection and a hat or cap with a wide brim. Also, certain contact lenses can provide additional UV protection.
To provide adequate protection for your eyes, sunglasses should:
- block out 99 to 100 percent of both UV-A and UV-B radiation;
- screen out 75 to 90 percent of visible light;
- have lenses that are perfectly matched in color and free of distortion and imperfection; and
- have lenses that are gray for proper color recognition.
If you participate in potentially eye-hazardous outdoor work or sports, your sunglass lenses should be made from polycarbonate or Trivex® material. These lenses provide the most impact resistance.
If you spend a lot of time outdoors in bright sunlight, consider wearing wraparound frames for additional protection from the harmful solar radiation.
Don’t forget protection for children and teenagers. They typically spend more time in the sun than adults.
If you spend a lot of time outdoors in bright sunlight, consider wearing wraparound frames for additional protection from the harmful solar radiation.
Don’t forget protection for children and teenagers. They typically spend more time in the sun than adults.
Protecting Your Eyes from Shorter-Wavelength Visible Light
Chronic exposure to shorter-wavelength visible light (blue and violet light) may also be harmful to the retina. Many digital devices emit this shorter-wavelength visible light.
Blue light is part of the visible light spectrum. The sun emits blue light, as do artificial light sources, such as LEDs, computers and smartphones. Some types of blue light can be beneficial, helping us regulate our bodies’ internal biological clocks.
However, blue-violet light can be harmful to the eyes, specifically the retina. It is a risk factor for the onset of age-related macular degeneration, a deterioration of the part of the retina responsible for sharp, central vision.
A recent study found that Americans spend almost 2 ½ hours on their tablets and smartphones every day. In addition, most offices and stores use fluorescent light bulbs, and LED lights are becoming increasingly popular.
Lenses that absorb harmful blue light but allow beneficial blue light through your lenses are entering the marketplace. You could also apply a special clear coating to traditional lenses to enhance their ability to block these harmful rays while you use computers and smartphones.
Blue light is part of the visible light spectrum. The sun emits blue light, as do artificial light sources, such as LEDs, computers and smartphones. Some types of blue light can be beneficial, helping us regulate our bodies’ internal biological clocks.
However, blue-violet light can be harmful to the eyes, specifically the retina. It is a risk factor for the onset of age-related macular degeneration, a deterioration of the part of the retina responsible for sharp, central vision.
A recent study found that Americans spend almost 2 ½ hours on their tablets and smartphones every day. In addition, most offices and stores use fluorescent light bulbs, and LED lights are becoming increasingly popular.
Lenses that absorb harmful blue light but allow beneficial blue light through your lenses are entering the marketplace. You could also apply a special clear coating to traditional lenses to enhance their ability to block these harmful rays while you use computers and smartphones.
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If you can answer “yes” to one or more of the following questions, you could be at higher risk for harm to the eyes from UV radiation:
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| See your doctor of optometry every year for a comprehensive eye examination. It is a good way to monitor your eye health, maintain good vision and keep track of your solar radiation protection needs, as well as advances in eye protection. | ||