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Every winter, as we battle the cold and smog, a familiar complaint follows. Eyes that burn, water and feel full of sand. Many people shrug it off as part of the season. Mostly it is harmless, but it is worth knowing when it isn't.
Why pollution bothers the eyes
Your eyes are among the few organs in direct contact with the outside air. The surface is protected by a thin film of tears, and that film is easily disturbed. Fine particles (PM2.5), smoke, nitrogen dioxide, ozone and dust settle on the eye and irritate the surface. They can also trigger an allergic response and make tears evaporate faster. The result is a dry, inflamed, uncomfortable eye.
Symptoms to expect
- Burning or stinging
- Redness
- Itching
- Watering, which seems odd but is often the eye's reaction to dryness
- A gritty feeling, as if something is stuck in the eye
- Mild swelling or heaviness of the eyelids
- Blurred vision that clears after blinking
These usually ease when you get away from the polluted air, and they tend to be worse in the morning and in the evening, when smog settles.
What you can do at home
1. Do not rub your eyes. It pushes particles across the surface and can scratch it.
2. Rinse your face and splash clean water over closed eyes after coming indoors. Do NOT splash water into the eyes, as it washes off the protective tear film.
3. Use preservative-free lubricating drops a few times a day. They wash out irritants and support the tear film.
4. Place a clean, cool compress over closed eyelids for a few minutes if they feel hot or itchy.
5. Wear glasses or wraparound sunglasses outdoors. They will not filter the air, but they cut down how much reaches your eyes.
6. Switch from contact lenses to spectacles on high-pollution days. Lenses trap particles against the eye.
7. Keep indoor air as clean as you can. Close windows during peak smog hours and use a purifier in the room where you spend the most time.
8. Take screen breaks. We blink far less when looking at screens, which makes dry eyes worse. So decrease screen time, or at least, take frequent breaks when working on screens.
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One caution: Please avoid pharmacy "redness-relief" drops and any steroid or antibiotic-steroid combination drop you have left over from an earlier illness. Steroid drops can raise eye pressure and damage the optic nerve, which is a particular risk for people with, or at risk of, glaucoma. They can also worsen certain infections. Some anti-allergy eyedrops can "whiten" your eyes temporarily, but the redness comes back as soon as you stop the eyedrops (called rebound redness). This is because these drops temporarily blanch the blood vessels. Some anti-allergy eyedrops can also increase the blood pressure in those who have a tendency for high BP.
When to see an eye doctor
Pollution irritation should settle within a day or two once you are away from the smoke. See an ophthalmologist promptly if you have:
- Eye pain that is more than a surface irritation
- Reduced or hazy vision that does not clear with blinking
- Marked sensitivity to light
- Thick, yellow or green discharge, or eyelids stuck together on waking
- Severe or one-sided redness
- Symptoms lasting more than two to three days despite the measures above
- Pain or redness while wearing contact lenses. Take the lenses out and get checked the same day, as lens-related infections can progress quickly.
- Seeing halos around lights, or a headache with eye pain and nausea, which can signal a sudden rise in eye pressure
- Children, older adults, contact lens users, and people with dry eye, allergies or glaucoma should have a lower threshold for getting checked.
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The bottom line
A little irritation on a smoggy day is common and usually manageable. But the eye is not a part of the body to experiment on. If something feels more than uncomfortable, or if vision is affected, get it examined rather than waiting for the air to clear.
(Dr Shibal Bhartiya, Ophthalmologist, Glaucoma Surgeon, and Director of Ophthalmology at Marengo Asia Hospitals and Research Collaborator, Mayo Clinic, Florida)
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