Travel can be tough on our eyes – and any problems relating to eyes cause huge concern. Dr Jane Wilson-Howarth helps you tell mere irritations from vision-threatening dangers
Eyes are precious. Subsequently, if you experience symptoms focused around them you’re likely to worry – especially if there is no trusted clinician around. You will doubtlessly be concerned that your vision could be permanently affected.
Fortunately, few eye symptoms are significant. But, to put your mind at rest, here are the most common complaints, and pointers on how to deal with them.
Probably the commonest eye problem is conjunctivitis: inflammation of the transparent covering of the coloured part of the eye. If the cause is a bacterial infection, eyes become red and gunky. Often victims’ eyes will be so sticky that it is hard to open them in the morning. They also feel gritty and sore.
What to do? To help clear the crud, bathe the eyes with plenty of warm water using cotton wool if you have it, or clean hands if you haven’t. Then visit a pharmacy to buy some antibiotic eyedrops, which need to be instilled every two hours for the first few hours; they will rapidly clear the infection. In Britain you’ll need a prescription for these but in many destinations they are available over the counter. Delaying treatment will do no harm but, as this is an unpleasant condition, you will want to deal with it asap.
Bacterial conjunctivitis is especially common in the tropics and in sandy environments; wash your face when you get in from a hard day’s sightseeing. Be aware that conjunctivitis is highly contagious – it will spread easily to your travelling companions through touch.
We all know that scratchy sensation – when it feels like something is lodged in our eye. This is common in smoggy, gritty cities.
What to do? Grasp the eyelashes of the upper eyelid and, while looking up, pull the upper eyelid over the lower and blink a lot; repeat this a few times. This will usually sweep the foreign body out.
An eggcup can be useful as an improvised eye-bath. Fill the eggcup with boiled, cooled water then hold it over the eye socket, tip your head back and blink like mad. If this doesn’t work you might need to find a clinic.
Irritated eyes are increasingly common in polluted cities, especially those where there are a large number of vehicles. If both eyes are a bit inflamed and you have the sniffles, then you need do nothing – a viral form of conjunctivitis is very common with the common cold. It will just pass as the cold passes; there is no advantage to using eye drops.
Pinkish eyes are also a common symptom of hay fever – if this is a problem for you, ask a pharmacist for some suitable eye drops.
If one eye becomes red, and especially if light causes pain and/or you can’t see normally, you need proper and prompt assessment in a clinic or hospital to see if you need treatment for iritis.
What to do? If you’re concerned, seek expert advice as quickly as possible. Pack some ‘artificial tears’ lubricant eyedrops – available over the counter.
The quality of the pain will point to the cause, and thus the treatment. A common cause of severe eyeball pain is sinusitis, which can strike during a flight, especially if the sufferer has a cold or is congested with hay fever. Some victims say it is so painful it can feel like their eyeball is shattering.
What to do? Steam inhalations (if you are in a place where that is possible) usually relieve the pain very quickly. Boil a kettle of water, pour the water into a bowl, lean over the bowl with a towel over your head and inhale. You can add essential oils if you have them.
Decongestant tablets or nasal sprays can help, but see a GP before travel if you are prone to sinusitis.
There are many causes of swelling around the eye but even the slightest inflammation can rapidly evolve into something that looks horrendous, especially if you don’t resist the urge to rub. A mosquito bite close to the eye might look bad but won’t harm the eye. If the swelling is a tender bump the size of a zit, this is a stye.
What to do? For general swelling, apply a soothing cold compress: wet a face cloth and hold it against your shut eyes. For a stye, apply a warm compress – run a face cloth under the hot tap and apply to the eye frequently; the cloth shouldn’t be uncomfortably hot.
Some travellers may experience the whites of their eyes turning yellow – a symptom more likely on extended backpacking trips in resource-poor destinations or after long-haul travel. The pigment-change suggests that the liver is struggling. The commonest cause of this is hepatitis E, acquired from eating contaminated food; hepatitis A also does this but most travellers are immunised against this widespread tropical infection.
What to do? See a doctor for a diagnosis – there are some serious causes of this colour change, including life-threatening forms of malaria. Be guided by how you feel though. If you feel ill, evacuate to a hospital. If you are just a touch off colour, arrange a check-up within a week or so.
Eyes often become smeary when you are tired, or if you’ve been in an environment where there is a lot of airborne grit. Visual disturbance that comes as zigzags or bright
flashes is often the start of a migraine, but something that looks like a net curtain in
one eye is a serious symptom.
What to do? If simply tired, bathe the eyes and rest. If experiencing the ‘net curtain’ symptoms, go smartly to an emergency eye clinic: you may have a retinal detachment, which is serious and vision-threatening.
1. If you have had eye trouble in the past, find out the likelihood of it recurring – and know how to treat it.
2. Excessive exposure to the sun makes cataracts more likely – protect your eyes with good-quality sunglasses , preferably a pair bearing the BS kitemark, especially if travelling to places where the sun will be heavily reflected off water or snow. A peaked cap also helps protect the eyes, and reduces sun exposure to the face.
3. If you have eye problems and buy drops over the counter, ensure the medication contains no steroids (eg dexamethasone) – these can harm the eyes.
4. If you wear glasses, travel with a spare pair and also your prescription – replacement spectacles are often cheaper aboard.
5. If you wear contact lenses, travel with glasses as a backup.
6. Contacts should not be worn when the eyes are infected or inflamed.
7. Discuss your optical requirements with your optician before any long trip; ‘daily wear’ contacts are often best for travellers.
8. Don’t wear contacts for any flight longer than four hours.
Bungy jumping stresses the body: sight-threatening retinal haemorrhages are possible. Don't bungy if you've experienced retinal detachment or are very short-sighted – these factors are a risk.
Dr Jane Wilson-Howarth’s Nepal memoir, A Glimpse of Eternal Snows, was published by Bradt in October. Among other things, it describes her experiences of practising medicine in a dusty conjunctivitis-promoting environment.