I am a sort of fanatic when it comes to the National Health Observances promoted in cooperation with the Department of Health and Human Services. Organizations often provide useful resources online or by mail to help you educate the public about a particular condition or cause. Every month I check to see what is being highlighted. Some designations are highly specific; most are very practical and target general patient populations.
Eye health has become a summertime focus. Following the change to daylight savings time with the increased hours of sunlight, Prevent Blindness America promoted UV Awareness during the month of May. UV Safety Month (American Academy of Ophthalmology) falls in July, along with the end of Eye Safety Awareness Week (June 27 to July 5). June was designated Vision Research Month and coming up in August are Cataract Awareness Month and Child's Eye Health and Safety Month.
Prevention in Practice
As nurse practitioners (NPs), we are accustomed to warning our patients about skin damage from UV exposure and the risk of skin cancer; we regularly caution them to always apply sunscreen when they are going to be outside. Even public messages about preventing skin cancer are commonplace. Yet how often do we remind patients about protecting their eyes from UV rays?
Sunglass manufacturers are not as consistent as they should be in putting out messages about protection and prevention. I do not remember my ophthalmologist ever giving me any specific recommendations about protecting my eyes from the sun's rays. Similarly, I admit that I do not routinely advise my patients about preventive eye health other than in relationship to an acute eye infection, and patients over 40 years old, or at high-risk for glaucoma or other familial eye diseases.
Promoting Eye Health
This month's CE about glaucoma "opened my eyes" to the numerous diagnostic and treatment options available today. The article explains in greater detail the new tests my ophthalmologist performed at my last routine visit. A diagnosis of glaucoma is often made as part of a routine screening examination and not as a result of a presenting complaint of diminished or blurred vision. Although sun exposure is not a contributing factor in developing glaucoma, there are several eye conditions that can be directly attributable to excessive sun exposure: cataracts, age-related macular degeneration, pterygium, and photokeratitis (corneal sunburn). The effects of sun exposure are cumulative so again, patients may not notice any change in vision until years after the damaging exposures. These conditions should be included in the differential, after asking the appropriate questions during the history, when a patient presents with a visual complaint. Some can lead to permanent blindness.
Prevention of blindness is the reason to promote eye health. When viewing weather reports for temperature predictions, also take note of the UV Outlook Index that indicates the level of sun exposure expected that day. Any number 6 or above is rated high and extra precautions should be taken to protect the eyes, as well as the skin. Wearing a wide-brimmed hat and/or sunglasses that filter 99% to 100% of UVA and UVB rays are the basic recommendations. Do not forget that children also need to wear hats and shades.
As an NP, I tend to refer many eye complaints and problems, especially when the response to treatment is not as expected, because I do not want to miss a potentially serious condition. Eyes are our "windows to the world." Promote protection and prevention.
Jamesetta Newland, PhD, APRN, BC, FNP, FAANP, FNAP
Editor-in-Chief