Smoking and Eye Health

Many would associate smoking with lung cancer; however, it can affect the whole body including our eyes. Studies have shown that smoking can increase risks of certain ocular conditions including dry eyes, cataracts, age-related macular degeneration (AMD), and diabetic retinopathy. What exactly are these conditions?


Cataracts are the world’s leading cause of blindness. It affects the lens in the eyes and as the lens starts to cloud, one may experience a decrease in vision. The risk of developing cataracts doubles with smoking. Symptoms to be aware of include: blurred vision, light sensitivity, glare, decrease in color brightness and poor night vision. Treatment includes surgery where the lens is removed and the lens is replaced with an artificial lens.

cataractsImage by:


Age-related macular degeneration is an ocular condition that affects the macula, the area of the retina that is responsible for the most detailed vision. The macula deteriorates over time and can cause central vision loss and irreversible blindness making it difficult to recognize faces even though peripheral vision is still present. AMD is not painful which can go unnoticed as time goes by thus it is very important for regular eye examinations. With smoking, it can increase the risk of AMD three times more compared to nonsmokers. If one is already diagnosed with AMD, quitting smoking can help slow the condition.

amdImage by: Gemma Corkery-McClean, Specsavers Whangarei, NZ

Diabetic Retinopathy

Diabetic retinopathy is associated with diabetes, a condition that causes high blood glucose or blood levels. Smoking can increase the risk of developing diabetes which can lead to retinopathy. This condition causes the blood vessels in the back of the eye to weaken and leak blood that can affect the field of vision and potentially loss of vision if it is severe.

d-retinopathyImage by:

The best way to protect your eyesight from damage that is linked to smoking is to quit or never start smoking. Be aware that second-hand smoking can also increase the risks of developing health conditions which can also affect the eyes. Though we cannot stop ourselves from aging, we can keep away from smoking. If you or your loved ones need resources to help quit smoking, here is a resource.

Author: Dr. Ia Ong Her
Published: 05/20/2021


What is glaucoma?

Glaucoma is the second leading cause of blindness. It is a group of diseases that damages the optic nerve, the connection of the eye to the brain, and may lead to progressive, irreversible vision loss. The main cells affected by glaucoma are the retinal ganglion cells and these cells process visual information from light entering into the eye and transmit it to the brain by axons, which make up the optic nerve. These cells allow you to send images to the brain and do not regenerate if damaged.

Glaucoma is usually related to high intraocular pressure. It can also be caused by certain conditions to the eye such as inflammation,severe cataracts and trauma which can affect the drainage of the fluid in the eye causing it to become closed or narrow. This pressure pushes on the optic nerve thus damaging the cells. However, glaucoma can be found in patients who have low intraocular pressure as well.


Early signs of glaucoma

The only way to detect early signs of glaucoma is through a comprehensive eye examination. Glaucoma does not show symptoms until laters stages. Thus, it is significant to get your eyes examined despite having good vision, especially if there is family history of glaucoma. Early detection can help slow the progression of the disease.
Symptoms that you may notice if glaucoma goes undiagnosed:

  • Loss of peripheral vision
  • Difficulty adjusting to dark rooms
  • Blurry vision especially in the morning
  • Halos around light
  • Pain
  • Headache

Keep in mind, different types of glaucoma do have different symptoms depending on the root cause.

Diagnosing glaucoma

In order to diagnose glaucoma, there are a variety of tests performed. Patients who are glaucoma suspects will be followed carefully and testing will be performed and used to compare to the baseline information.


Optical Coherence Tomography

An imaging machine used to scan the back of the eye (retina and optic nerve). This will provide us with measurements that will help with the diagnosis and management of many conditions such as glaucoma.

Visual Field

A special computerized test done to assess central and peripheral vision, as well as detect certain neurological defects. This test can provide early diagnosis for many eye diseases long before they become clinically detectable.

Fundus photography

Offers a high-quality digital photography of your optic nerve for those patients who want to record the appearance of this vital structure today before disease occurs.


An examination to look at the front part of your eye (anterior chamber) between the cornea and the iris. It is painless and examines whether the area where fluid drains out of your eyes (called the drainage angle) is open or closed.


A medical device used to measure the thickness of the eye’s cornea.


The treatment for glaucoma focuses on lowering the eye pressure in the eyes. Prescription eyes drops and oral medications are the most common course of treatment. If they are not effective, laser surgery may be considered. In severe cases, a shunt may be placed in the eye to assist in draining excess fluid for managing the pressure.

If you have any questions, please feel free to contact us and/or schedule an appointment!

Author: Dr. Ia Ong Her

Is it safe to wear contact lenses during the pandemic?

During the height of the pandemic, there were questions on whether wearing contact lenses may be a higher risk of getting the virus compared to wearing eyeglasses. Concerns included touching the eyes and the possibility of spreading the virus via that contact. However, according to the Centers of Disease Control and Prevention, there is no evidence suggesting that contact lenses wearers are at a higher risk of infection.

Before handling contact lenses, we stress safe and proper hygiene. Be careful, always wash your hands, practice good hygiene and proper handling of contact lenses. By doing this, it is still safe to wear contact lenses.

One should also consider switching from monthly and bi-weekly contact lenses to daily disposable contact lenses. With daily disposables, it decreases the risk of infection to the eye and there is no need to worry about contact lenses solution.


Here are some hygiene tips on how to wear your contact lenses:

  • ALWAYS wash your hands with soap and water for at least 20 seconds before handling your contact lenses, either inserting or removing your lenses.
  • Properly clean your contact lenses before and after wear. Gently rub and rinse your contact lenses with contact lens disinfecting solution when you remove your contact lenses. Do not use water, bottled water or saliva. Always use fresh solution and never top-off old solution.
  • Dispose your contact lenses as instructed. Do not extend wear.
  • Keep your contact lens case clean. Clean the case with contact lens solution, not water, then empty and dry it with clean tissue. Replace your contact lens case at least every 3 months.
  • Do not sleep in your contact lenses. Sleeping in your contact lenses causes a greater risk of an eye infection which could potentially harm the vision or eye.
  • Avoid swimming and showering in your contact lenses. Water can introduce germs or bacteria to the eyes through your lenses.
  • Avoid rubbing or touching your eyes.

washing hands to insert contact lenses

Author: Dr. Ia Ong Her

Publish: 12/28/2020

Ia Ong Her, O.D.

Digital Eye Strain and Blue Light

There has been an increase in digital device usage the past decade due to new features of technology and what it has to offer. However, just this year, the percentage of people using digital devices has increased due to an escalation of people working from home and children having school via virtual/distance learning. When constantly staring at a digital device for hours, symptoms may come along with it. The possible symptoms are the following:

  • Tired eyes
  • Eyestrain
  • Headaches
  • Blurry vision
  • Difficulty focusing

What is blue light?

Blue light can be found everywhere. The sun is the main source of blue light, but it can be found in digital screens, fluorescent and LED lighting. Blue light scatters more so than other visible light which makes it more difficult to be focused. Thus, this causes visual noises that reduce contrast and may contribute to eye strain and symptoms.

As one starts to experience these symptoms, it may cause discomfort but there are ways to alleviate them.

1. Taking breaks

There is one rule to remember: 20/20/20 rule. If you are spending a long period of time working on devices, take a break every 20 minutes, for 20 seconds and focus on something that is 20 feet to help relax the eyes.

2. Blue light filter/blocker

An option that can be added onto glasses is a blue-light blocker coating. Digital devices emit out blue light that can cause visual noises and these visual noises could cause the symptoms listed above. With this filter, it decreases blue light from getting to eyes and increases contrast which may decrease symptoms.

3. Adjust the brightness or contrast on the computer screen

The eyes work harder if the screen is brighter. Try matching the brightness of the screen with the level of the room or surroundings to reduce eye strain. Settings may differ based on time and weather.

4. Distance yourself.

Sit about 25 inches or at arm’s length from your screen.

5. Lubricate the eyes

As one stares at a screen, the eyes tend to forget to blink. Normally, the blink rate is at an average of 15 blinks per minute, but this decreases in half when staring at a screen or doing near activities such as reading. With a decrease in blinking, it may lead to dry eyes. Thus, it is important to blink and lubricate the eyes with drops.

digital eye strain

Author: Dr. Ia Ong Her – 11/20

Dry Eye Syndrome

Dry eye disease i s a common condition where the tears i n your eyes are not capable of providing moisture or sufficient lubrication to the eyes. Millions of people i n the United States suffer from i t but what causes i t? There are a number of factors that can cause dry eyes.

dry eyeCauses may include the following:

  • Aging process
  • Side effects of medications (antihistamines, antidepressants, diuretics)
  • Medical conditions (thyroid conditions, diabetes,
  • Sjogren’s syndrome, immune system disorder, etc.)
  • Environmental factors (exposure to smoke, dust)
  • Extended contact lenses wear
  • Eye surgery
  • Inflammation of the eyelids
  • Looking at electronic devices for a long period without blinking


The tear film may play an important role when i t comes to dry eyes. The tear film coats the surface of the eyes to provide moisture and comfort. A stable tear film also protects the eyes, reduces risk of infection, washes away foreign particles, and keeps your eye surface smooth and clear. There are 3 l ayers i n the tear film: oil, aqueous/water and mucous. The tear film helps replenish the surface of the eyes and i s coated after every blink. If our tear production slows down, i t can decrease the tear quantity i n the eyes. Other glands that produce oil can also cause less qualitative tears.


You may experience one or any combination of the following symptoms:

  • Dryness
  • Scratchy
  • Burning
  • Sore
  • Watery
  • Decrease in vision
  • Mucous secretion in the eyes
  • Sensitivity to bright lights


There are variety of treatments for dry eyes depending on the root cause. A different treatment may be needed if it is caused by an underlying condition. It also depends on the severity of the symptoms one may be experiencing. Treatments/products that may relieve dry eyes are the following:

  • Over-the-counter eye drops/artificial tears (Systane, Refresh, etc)
  • Prescription eye drops (Restasis, Xiidra)
  • Warm compresses/Bruder mask
  • Eyelid scrubs (OcuSoft, Cliradex)
  • Omega-3 fish oils
  • Eyelid cleaning with baby shampoo

In-clinic treatments that we provide for our patients

punctal plug

  • Punctal plugs
    • A silicone or collagen plug is placed where your tears drain to help conserve your own tears.
  • Blepharo Exfoliation
    • his procedure uses a tool with a micro-sponge that spins along the edge of your eyelids, exfoliating the eyelids. This helps reduce bacterial debris and biofilm formation. It is painless and takes 15-20 minutes.

Out-clinic treatments we can refer

  • Intense Pulse Light (IPL)
    • A light therapy that is designed to warm the skin and close any abnormal blood vessels around the eyelids. It also acts asa warm compress to help clear any glands that secrete oil. This is typically done per month for approximately 3-5 months and maintenance treatments are given every 3-12 months following. All patients will likely need maintenance therapy at least once a year.
  • LipiFLow
    • A procedure where a device is used to simultaneously heat and massage the eyelids in order to express meibomian glands (Glands that secrete oil layer in tear film) The treatment lasts about 12 minutes and you will feel a warm pressure sensation as the device assists in unclogging the glands.

If you have additional questions in regards to dry eyes or treatments, feel free to give us a call and/or make an appointment.

Author: Dr. Ia Ong Her.

Publish: 10/26/2020.

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