Making a Vacation Easier on the Eyes

Long-distance and airline travel aren’t hard just on your feet, back and neck. The eyes can suffer too, especially if you’re bound for high altitudes or sunny climates, wear contact lenses, have conditions such as dry eye or have had recent vision surgery.

Eye discomfort can begin soon after takeoff. Dry airplane cabins speed the evaporation of natural tears, says Jeffrey Weaver, an optometrist at the American Optometric Assn., and can make your eyes feel dry, gritty and scratchy. This can be especially nettlesome for contact lens wearers, he says.

To counteract the dryness, increase the production of natural tears by blinking more, Weaver suggests. If that’s not enough, use artificial tears, available over the counter. Contact lens wearers should take along rewetting drops, designed to be used while the lenses are in place.

If you wear contacts and your eyes become irritated during a flight, remove the lenses if possible, Weaver says, washing your hands first. Remove the lenses for the entire flight if possible, says Jay Schlanger, a Los Angeles optometrist who is a clinical instructor for UC Berkeley, the Montreal School of Optometry and the Pennsylvania College of Optometry, Philadelphia.

Determining whether reddened eyes are infected or just irritated can be tricky. “If there is redness, the thing you worry about the most is mucus or discharge,” Schlanger says. “That almost always means infection.”

If you suspect an eye infection, seek medical help. This is especially critical for contact lens wearers, says Dr. David A. Boes, an ophthalmologist in Great Falls, Mont., who has studied vision problems in travelers. “Contact lens wearers are at risk for corneal infections, which can lead to ulcers and permanent vision loss,” he says. Prompt treatment of eye infections can also ease the pain that often accompanies them.

If eye irritation and redness are the result of late nights, go easy on those “get-the-red-out” drops that work by constricting the blood vessels. “Using an eye whitener really masks any potential problems,” Weaver says. The vessels dilate to begin with, he adds, in response to some irritation such as dirt particles or wind. Better to pinpoint and get rid of the irritation. If you must use eye whiteners, Weaver recommends only short-term use. If irritation persists more than a day, you need to find the cause.

Travelers who have undergone Lasik surgery within six months of their trip should be especially cautious about eye care, Boes says.

Dry eyes, for instance, can be a problem, at least temporarily, for some Lasik patients. He tells travelers who have had Lasik to take along artificial tears--”the kind that are unpreserved,” he adds, because those with preservatives can irritate the eye.

Climbing to very high altitudes soon after Lasik surgery may cause some temporary deterioration of vision, he adds. Visiting altitudes of 8,000 feet or so for snow sports probably won’t cause a problem. But there can be a change for the worse at 18,000 feet or more. Boes cites the case of two physician climbers, both recent Lasik patients, who had this problem during their ascent of 22,834-foot Mt. Aconcagua in the Andes. One doctor estimated that his vision declined to 20/100 in one eye (20/20 is ideal) and 20/125 in the other, Boes reported recently in the Journal of Cataract and Refractive Surgery. The other’s vision declined to 20/160 and 20/30. Both reported the loss as temporary; their vision returned to 20/20 after descent.

Other cases of vision deterioration in patients who have undergone refractive surgery have been reported, but it is not known how widespread the problem is. “There are many climbers who have had Lasik who have gone to very high altitudes and not had vision problems,” Boes says. “But the more you baby those eyes in the first six months [after surgery], the better.”

To be safe, he suggests waiting at least that long after the surgery to ascend to 18,000 feet or higher.

All travelers should minimize ultraviolet exposure by wearing polarized sunglasses, especially in certain locales: “Lower latitudes and higher altitudes have higher ultraviolet levels,” Weaver says.

Choose sunglasses that block 99% to 100% of UV light, eye care experts suggest. Ultraviolet rays are associated with increased cataract risk and perhaps with the development of retinal disease. Too much UV light can also cause corneal inflammation and burns.

Frequent travelers who wear contact lenses might ask to be fitted with low-water-content lenses, Schlanger says. Low-water lenses are made of a stiffer material that doesn’t require as much water as other lenses to stay wet and comfortable. Some lenses with a higher water content, he says, need the eye to produce a lot of tears. But in a dry environment, the tears evaporate quickly.

Assembling a travel eye-care kit can preserve eye health and comfort. Experts suggest taking backup eyeglasses and a copy of your prescription as well as contact lens supplies, artificial tears and any medications normally taken.

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Healthy Traveler appears twice a month. Kathleen Doheny can be reached at kathleendoheny@earthlink.net.