Dr Segun Ogundimu, a consultant family physician, is the managing director of Clearline international, a frontline health insurance company in Nigeria. In this interview with WINIFRED OGBEBO, he talks on the all-important topic of care for the eyes, types of problems that affect the eyes and more.
How does one care for the eyes?
The eyes are an important part of the human body because they tend to show the way and they are organs that every person must take good care of. The care of the eyes starts from nutrition. There are some diets that are helpful. Vitamin A for instance is very good. If one wants to have two eyes that will last through one’s lifetime, it must start from the cradle and that’s by breastfeeding. Breastfeeding is the first food that is important to the human eyes.
Any woman that breastfeeds is protecting her child for a good terrestrial life, for the eyes are an important aspect for a terrestrial life. With good eyesight, you can be sure to live very well. Breastfeeding is the foundation of very good sight. Babies that are breastfed have very clear and sharp eyes that will remain so through life. Strong bones, sharp brains, good skin, a good set of teeth are things that human breast milk affords us human beings.
So the first step is to ensure that when you have your child, you breastfeed that child for the first six months, exclusively and the rest is just a balanced diet from childhood to adulthood. Vitamin A can be found in milk, fish, meat, liver and particularly, carrots and bright coloured fruits like strawberries, cranberries and so on and so forth.
The other thing is to ensure that one takes care of the muscles that control the eyes. It is these muscles that move the eyes from right to left and up and down. We call them ocular muscles and if one is on a good diet and if he uses them well, by making sure that you sit properly when you’re reading, in light neither too bright nor too dull – enough light for you to be able to see clearly - then you’re protecting your eyes.
People who work with computers all the time, must ensure that the computer has an inbuilt filter to protect the eyes from the glare and those that work in factories must use Polaroid glasses; not just dark glasses but Polaroid that will protect the eyes. A lot of people do not know the difference between dark glasses and Polaroid glasses. Polaroid glasses are those that we recommend for people to wear, to protect their eyes, because just dark glasses will endanger the inner part of the eyes.
Also, people must know when their eyes are tired. You’re reading and your eyes are shutting by themselves, you feel weak - you have to sleep it off to rest the muscles that control the eyes. Most people don’t know this, but it’s very important that we mention that. And once you have problems seeing in the distance or far off objects, there’s no point straining those muscles beyond their limit.
You must go have an eye test in order to know what reading lens you need. You must see a qualified optometrist and if there’s any eye problem, you’ll be referred to an ophthalmologist.
There’s something we call proxy. Once you’re close to or above the age of 40, the lenses of the eyes tend to go stiff, along with the muscles that control the eyes. That’s why you need to see an optometrist and have some eye tests and be prescribed reading glasses that will make your eyes feel comfortable, if needed.
If you don’t use reading glasses when you’re supposed to, you’re just endangering the muscles that control the eyes and the lens itself. And once glasses are prescribed for you, every two years maximum, you must go for a check-up; most doctors will tell you not to wait for those two years, but to go earlier.
Also, for those who work in the sun, particularly, our traffic control officers, they should beg their bosses to purchase some Polaroid glasses for them, to make sure that their eyes last them longer than they would if continually used without protection. It’s a matter of necessity, not a luxury, to give them Polaroid glasses to use, to reduce the risk to their eyes.
Do people with large eyeballs have any advantage over those with small eyes?
You see, because the eye is like a camera, it retracts and detracts. There are some people that are endowed with large eyeballs; they may not need to wear reading glasses for a long time. When you have small eyeballs, images form behind the retina, so you need a lens to bring it forward for you to be able to see. But for those who have big eyeballs, instead of the image forming behind the retina, it is formed directly on the retina.
It’s just an anatomical advantage for those that have big eyeballs. You hardly find them having to use glasses to read, except they are hypermetropic. That means they have a problem seeing things at close range. But it does not mean that those that have big eyeballs have the advantage of using their eyes for a long time.
What diseases affect the eyes?
We have diseases like diabetes. You must make sure to find out whether you’re diabetic or not. When you are, you must make sure you look for proper control so that it doesn’t damage your eyes, because excess sugar in the bloodstream over a long period of time can lead to the deposition of sugar crystals at the back of the eyes, near the optic nerve. Once that happens, it can bring about blurred vision. It can also lead to lens degeneration, what is called cataract formation.
It’s quite common with uncontrolled diabetes. Most people who have diabetes don’t know that they have it. It is a very silent disease, it doesn’t make much noise, but once you’re passing urine more than necessary, particularly at night or you notice ants on your droplets of urine, it’s a sign of diabetes. Another sign is when you often have multiple boils in your armpit or the groin area; then you must see a doctor. It’s better to prevent it than to have to treat it.
Prevention starts from going for screening at least once every three months. Test your urine for sugar, that’s the first step, but the best bet is to have a blood test. Once you’re diabetic, it’s better to start controlling it early than to continue the habits that caused it and then the eyes start to lose their function gradually. The eyes are a very important part of the human body.
Secondly, when you have viral conjunctivitis, popularly known as Apollo, see a doctor. A lot of people do self-medication. They just go to a chemist’s and buy any of the available eye drops. It’s a good thing because one is trying to prevent secondary bacterial infection, but the Apollo virus, with or without treatment will go on its own. It’s a self-limiting condition.
Are contact lenses better than glasses for correcting sight defects?
Contact lenses are just a convenient way of correcting your vision, instead of you wearing something that can fall off, or make it obvious that you have an eye problem. Contact lenses do exactly what the glasses do.
Do they have any adverse effects?
No, if your body can tolerate them, they’re okay. Some people with sensitive compositions reject them, however; their eyes protest against the use of them.
What are the effects of stress, particularly on the eyes?
Stress is any condition that tampers negatively with the internal wellbeing of the human body and the first sign to look out for is an increased heart rate. There is positive and negative stress. Positive stress is very good for the human body. It makes it prepare for a flight, fright or for a fight. If for example, you have an exam to write, as the time to start approaches, on your marks, set, go! Your adrenalin rushes, the brain becomes sharper, you see clearly and your muscles tense. It’s the same thing at the start of a race.
And as soon as you finish the exam or finish the race, everything in your body should go back to normal. Positive stress makes you do whatever you want to do better and finish better. But when you have negative stress, that stressor in your body stays for a very long time, uncontrolled and unchecked.
That stressor is permanently up, the blood pressure is permanently up, you’re always agitated, the mouth is dry - no appetite, libido is low and your attention span very short. Those are the signs of stress. You become always edgy; you sweat a lot and get nervous or anxious. You’re under a state of stress and in this state, you may not want to eat at all, which is called anorexia, or you might want to eat and eat, which is called bulimia. So there are two sides to it when it comes to stress.
Negative stress can lead to hypertension and can also lead to what is called paranoid psychosis. A lot more people in Nigeria now are becoming hypertensive because of so many stressors - no electricity, no water, children’s education and tuition, lack of finances. There are so many stressors in Nigeria.
For the eyes, if one is under stress for too long, it blurs one’s vision. You stop being able to see clearly, because stress affects the mind and the mind controls what you see.
What causes blindness?
There are two types of blindness. There is what is called the gradual loss of vision in the quiet eye. Diabetes is one of the causes of the gradual loss of vision, because it precipitates sugar in the lenses of the eyes as it were, then the person starts to lose the transparency of the lenses of the eyes gradually and then the eyes start losing sight gradually. Or when there is real hard pressure on the eyes, what is called glaucoma; it tends to destroy the head of the optic nerve - the nerve that carries the sensation of sight to the brain. Just as we talked about hypertension in the bloodstream, the eyes also have some tension that must be normal. When it gets too high, it destroys the inner part of the eye.
Some sorts of migraines are partly due to the weakness of the eye muscles. Such people have frontal migraines. They could start foaming at the mouth, vomiting and have poor vision as a result. Analgesics usually don’t work.
The only solution is to do the convergence exercises that will strengthen the muscles. In some extreme cases, you have to do some surgery to relax the muscles, to ‘translocate’ the attachment of the muscles in the eye to another area, either forward or backward. It can be very serious in some people. That is why the muscles of the eye must be well taken care of.
Like you do 30 minutes of exercise everyday for the whole body, you can also exercise your eyes anytime of the day by rolling them round in a circular motion and up and down several times. We call that convergence exercises. It’s to give the eye muscles some tone and tension that will not translate into a headache for some people.
Does the National Health Insurance Scheme cover eye surgery?
Yes it does, especially for cataracts. Surgery in the eye is very limited, but there are some conditions that require a lens implant after the cataract extraction; the scheme does not cover that. The NHIS in Nigeria is still evolving but over time, the scope of cover will be enlarged.