Eyeworld

EW NEWS & OPINION 20 December 2017 by Maxine Lipner EyeWorld Senior Contributing Writer the microperimetry that they didn't have any real changes." For patients who had changes on the OCT and on the microper- imetry, Dr. Deobhakta used adaptive optics. "One of the most notable things that we saw was a distinct difference in the eyes that were affected by the eclipse," he said. "We could see actual damage." There were changes noticed with the adaptive optics modality. This could be helpful in continuing to follow the most severe patient because the adaptive optics show at a precise lev- el that damage reached almost down to individual photoreceptors. "If there is some kind of resolution, we could follow that with this imaging technique," Dr. Deobhakta said. While there isn't any known treatment for eclipse-related sun damage, the American Society of Retina Specialists considered before- hand what physicians might try. "There was a statement made that we could try the AREDS2 vitamin that we use for macular degenera- tion patients to see if that helps the structures of the retina to heal," he said. "We don't know if anything will change but we're happy to try something." Regular viewing Even without an eclipse, it's im- portant to be aware of the sun. "It's important to be thinking about eye health in general," Dr. Deobhakta said. "People who have cataracts or who have a history of light sensi- tivity or allergies should always be cognizant of wearing sunglasses." Even when the sun doesn't seem particularly strong, it is important to be careful. Dr. Deobhakta pointed out that when the sun's rays reflect off something like snow, it polarizes differently. "It's a reflection, and the beam itself is different from looking at the sun," he said. "You have a different orientation of the way the light rays are when they're coming off the snow." That changes the way your eye deals with it. Because the unipolar light can bounce off snow and get in your eye quickly if you are not wearing tinted glasses or goggles, you can become temporar- ily blinded. Dr. Deobhakta said that especially if you're moving quickly in sports such as skiing or snow- were unprotected but who glanced up at the sun anyway. Dr. Deobhakta said that after the eclipse some patients came in saying that they felt as if their eyes weren't right. "I think there was a worry that maybe they had done something wrong and they wanted reassurance," he said. However, the patient who borrowed the glasses from a passerby was different. "She mentioned that she had a hole in her vision that would not go away," Dr. Deobhakta said. Practitioners ran a battery of tests on those who they thought might have damage. "We did an OCT to see if there were any layers that were affected by the eclipse, and we did other things like micro- perimetry, which showed patients if there was any damage to their visual field and where that corresponded on their retina," Dr. Deobhakta said. "This provided some peace of mind to patients in whom there was minimal change of the OCT that we could see; we could show them on Post-eclipse concerns In one case, a patient was nervous that he had damaged his eyes after misinterpreting some of the pre- vention information that he had gleaned online regarding using a pinhole for seeing the eclipse. Instead of viewing the shadow that emerged on another surface after the sun went through the pinhole, this patient put a pinhole through a gar- bage bag and then looked through this at the sun. "So he ended up having some transient symptoms," Dr. Deobhakta said. In the most serious of his eclipse cases, a woman went outside just as the eclipse was occurring and no- ticed that the person next to her was wearing glasses. "This person said, 'Why don't you take a look? I have these glasses,'" Dr. Deobhakta said. "She put those glasses on and looked at the sun for 15 to 20 seconds." The problem was that those were not the standard glasses, and since she didn't think she was doing anything wrong, she ended up having more exposure than those who knew they Eye health and the sun D uring the recent solar eclipse, all eyes were on the sun as it hid behind the moon. While most heeded warnings to wear protection when viewing this rare spectacle, some patients later emerged in ophthalmic offices. However, even on normal days without the proper protection, the sun can wreak havoc. EyeWorld took a closer look at this. Avnish Deobhakta, MD, assis- tant professor, New York Eye and Ear Infirmary at Mount Sinai, New York, found that after the eclipse quite a few patients came in fearful that they had damage from the sun. "We had a few patients who had mild symptomatic change, whether that be blurry vision or a generalized light sensitivity," he said. "Most did not have any permanent damage." However, Dr. Deobhakta did have a few cases, including an especially notable patient, with some substan- tial damage to the retina. Beyond eclipsing concerns

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