What to Do When the Eyes Have Had It

While on vacation in Tahiti, a 57-year-old woman who wears soft contact lenses was careful to remove them each night before going to bed. But she developed an eye problem anyway. A local physician diagnosed a corneal ulcer and gave her intravenous antibiotics.

Three days later, her eye had not improved, so she flew back to the United States and sought treatment from an eye doctor. The ulcer healed, but scars remained, and she needed a corneal transplant.

Another traveler, a 64-year-old woman on safari in Tanzania, wore soft disposable lenses and was careful to replace them every day. But on Day 5 of her trip, she woke up with pain and loss of vision in her right eye. By chance, the tour group included an eye doctor, who prescribed antibiotic eye drops immediately. A few days later, the woman’s eye was nearly back to normal, although she had a faint corneal scar.

While these scenarios aren’t common, they do reflect the need for travelers to take along remedies for potential eye problems, especially if they’re prone to them, says Dr. Paul B. Donzis, a Marina del Rey ophthalmologist and clinical assistant professor of ophthalmology at the Jules Stein Eye Institute at UCLA School of Medicine. He treated both women travelers and reported on their cases in a letter published last year in the New England Journal of Medicine.

“Both patients had been given a host of emergency medications by their physicians before going on vacation, but the only ocular medications included were lubricants,” Donzis says. He suggests that travelers carry topical antibiotics, especially if they are going to remote locales.

Besides the infections experienced by Donzis’ patients, a host of eye problems hold the potential for aggravation, or worse, on a trip.

Dryness of the eyes on an airplane or in air-conditioned vehicles is a common problem, especially among contact lens wearers, according to Peter Leggat, an associate professor of public health in Australia, who wrote about travelers’ eye problems in the March 1999 Journal of Travel Medicine.

“Dryness may also predispose the eye to infection,” Leggat wrote. To minimize the problem of dryness, contact lens wearers should consider removing them during the flight, Leggat advised. But that is not always practical. So another option is to use lubricating drops frequently throughout the flight.

“Use them once an hour,” Donzis says. Contact lens wearers can use the re-wetting drops designed to be used with the lenses in place.

For reading on the plane, which often has dim light, Leggat suggested taking along a portable battery-operated reading light. If you work on a laptop, use an anti-glare screen. Walk around the cabin for a few minutes every hour to rest your eyes. And exercise them by switching your focus from near to distant objects and back again.

If your destination is snow-covered, wear sunglasses or goggles to protect against snow blindness. The light reflected from snow can burn the eye, Leggat warned. Symptoms include a gritty feel to the eye, pain and swelling. For immediate first aid, he recommended using sterile saline eye drops or artificial tears and then antibiotic eye drops before covering the eye with a pad and getting medical attention.

For allergies that affect the eyes, an over-the-counter topical antihistamine such as Naphcon-A can help, Donzis says.

Contact lens wearers should pack extra lenses and a spare pair of eyeglasses. “Always take your prescription for glasses or contact lenses,” Donzis advises.

Healthy Traveler appears on the second and fourth Sundays of the month. Kathleen Doheny can be reached at kdoheny@compuserve.com.