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News | Aug. 25, 2022

Don’t Blindside Your Ocular Health

By Douglas Stutz, Naval Hospital Bremerton

By Douglas H Stutz, NHB/NMRTC Bremerton public affairs officer -- Here’s an eye-opener.
For those reading this article on any electronic device, raise your arms and flex. Then continue to do so until the ending, as well as for the entirety of the time spent staring at some screen.
That tension, insists Navy optometrist Lt. Cmdr. Michael Buyske, demonstrates the same stress put on someone’s eyes when their attention is glued to a computer screen, video game or television monitor for a lengthy period of time.
“That example I use to my patients is that muscles which control the focus of the eye get fatigued.  If someone sat in a chair for three hours and flexed their arms, at some point they’re going to start to hurt. It’s going to be really hard to relax them. If they took a break every 20 to 30 minutes during that time, they could probably hold that flex a lot longer without having pain in the muscles. It’s an analogy which hits home,” said Buyske, assigned to Navy Medicine Readiness Training Unit Bremerton.
In conjunction with August being National Eye Exam Month, Buyske strongly advocates for everyone not to turn a blind eye on personal ocular health.
“How often should someone have an eye exam? There’s not one answer. It all depends on the patient’s age,” Buyske said.

For those in the healthy 20 to 30 year old range, Buyske suggests every two to three years is fine for an eye exam. Those age 40s or 50s should be seen every year or two. For those over 50, even if things seem fine with their vision, they probably need to be seen closer to every year because things tend to change a little more then, and not just with vision but with health of the eye.

“You have two eyes. If anything happens to one or both, not only does that affect your vision, but also your quality of life. Do what you can, while you can, to maintain the quality of vision that you desire for as long as you can. A big part of that is making sure you’re having an eye-care professional do an exam periodically, whether or not you feel it’s needed,” stressed Buyske.
The vast majority – some 75 percent - of Buyske’s patients, all active duty personnel stationed in the third largest fleet concentration in the U.S., complain of eye fatigue.
“Their eyes get tired after staring at a computer screen all day at work, or from taking on-line college courses at home looking at a laptop, or they’re a big gamer. Whatever has them looking at a screen for long periods of time. That wear and tear they put on their eyes can lead to fatigue, strain and in some cases, headaches. I really encourage them, even if they have computer or gaming glasses, to give themselves a break to let their eyes relax by looking out a window, across the room or at something far away for 20 to 30 seconds,” said Buyske.

All that computer time can even impact a person’s vision long afterwards.
“A person’s distance vision can feel blurry when they’re driving home after work because their eye muscles are so fatigued after staring at the screen all day with no breaks,” remarked Buyske.
There’s really two separate yet overlapping parts of ocular health which Buyske covers in every eye exam. There’s the vision aspect and the actual health of someone’s eyes. 
The vision part is generally subjective, says Buyske.
“Even with glasses or contacts, it’s pretty easy for a patient to tell if things aren’t as crisp or sharp as they used to be. When they tend not to be, they usually think it’s time to make an appointment to get checked. Get a new prescription and they’re happy. Then it fades again and they go again to see the doctor,” noted Buyske.
“The health piece, depending on what’s going on, is largely objective,” continued Buyske. “Glaucoma is a great example of this. Patients who have glaucoma, if it’s not treated could go blind. During the initial stages they really don’t feel or see any difference. Glaucoma is not common in our young active duty population but we still talk about. Because if it’s not managed, it could take someone’s sight. Once gone, it doesn’t come back.”
Cataracts – a natural aging process - are another common ocular health issue. Unless the symptoms are affecting a person’s vision and/or quality of life, surgery is not needed to remove them. Medication is usually prescribed.

“Once on treatment, which are usually eye-drops, a patient is on that treatment for life,” stated Buyske. “Macular degeneration is another buzz-wordy condition, but unlike glaucoma it affects the center of your vision. When someone starts to get it, they’re going to know it because their vision is going to be distorted. With glaucoma someone might not know until it’s too late, yet macular degeneration in known early on.”
Buyske stressed that managing glaucoma is a lifestyle change. It’s not something someone can just do for two weeks and stop.

“It’s for the rest of their life. It can be a tough sell for some patients. But we hit home on why we’re doing it, “You’re getting blind spots in your vision. You might not notice them yet, but by the time you do, that’s now your normal vision. If you don’t want that to happen, then this is what you’re going to need to do. We don’t see that much in active duty population but conversations like that do happen,” related Buyske.

Buyske is a prior Navy surface warfare officer who was commissioned as an optometrist in 2011, and has worked at duty stations on both side of the Pacific.
From the tropics at U.S. Navy Medicine Readiness Training Command Okinawa, Japan, to the Mediterranean climate at Naval Medical Center San Diego, and back in the Pacific Northwest seasonal weather for his second assignment at NHB, he has experienced distinctive environments which can impact a person’s sight.
Even in the Pacific Northwest, not exactly known for endless sunny days, ultraviolet (UV) radiation can be harmful to eyes through a thin cloud layer.
“Bright sun aside, the UV is also damaging. Even being outside when it’s somewhat cloudy, it’s still a good idea to have at least off-the-rack sunglasses. All sunglasses seem to have some level of UV protection. UV can damage the eyes over time. Cataracts can be advanced more rapidly with long-term exposure to UV rays. There’s also wind, dust particles, reflection off the water. General protection is always a good idea,” advocated Buyske.
From the ocular health standpoint, regardless if a patient is 19 or 99, a thorough evaluation of the retina is always done by Buyske to look for any of the aforementioned conditions.
For those who have not scheduled an eye exam recently, now is the time, encourages Buyske, to make that appointment.
“At the end of the day, whether it’s to help someone with a prescription to see clearer than they could, or giving them the opportunity to have their vision corrected with Lasik or PRK [refractive eye] surgery, it’s still gratifying to know we’re serving those heading out on deployment ensuring they have what they need,” Buyske said.
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