cataract and glaucoma may be prevented

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However, this is not the case. A study of the recent medical literature reveals that for cataract the causes have been largely identified, and for glaucoma there are clear indications of the likely causes.

Almost all the underlying causes of both conditions are related to lifestyle. This is fortunate because lifestyle can be modified, which means that each of us has some measure of control over whether or not these problems develop. Firstly, it is appropri ate to look at a little background information on cataract and glaucoma.

Cataract, which afflicts 50 million people worldwide, is the leading cause of blindness in the human race, followed by glaucoma.

The impact of these diseases provides an enormous public health problem in both developing and industrialised countries, not to mention the suffering involved.

Age-related (or senile) cataracts tend to affect people over 65, the incidence between 65 and 75 years of age being around 1 in 6 persons, while in the 75 to 85 year bracket, it's almost every second person.

Glaucoma also affects older people, and is more common in women than men.

The standard treatment for cataract is surgery, which is often successful, whereas there is no medical cure for glaucoma, which often gets worse even when the person is being treated.

THE CAUSES OF CATARACT AND GLAUCOMA

The causes of these two conditions appear to be substantially different, although among the factors listed by the researchers there is some overlap.

When we trace these causes back to their origins in lifestyle, we find still more overlap.

In the meantime, we will look at each disease separately.

CATARACT

A long list of risk factors is given by the Virginia State University, USA,( 2) and also the University of California( 3), and to this list has been incorporated a number of factors from other researchers.

The wide-ranging list is as follows:

Being older. [Age does not cause cataract, rather harmful effects have had time to do more damage];

Oxidation of lens tissue due to free radical attack;

Trauma (injury);

Inflammation within the eye;

Pharmaceutical drugs;

Steroid drugs (such as cortisone) are significant risk factors;

Radiation -- ultraviolet B and X-ray, etc. -- is an important risk;

Dehydration is a possible contributor;

Nutritional deficiencies, especially of antioxidant nutrients;

Heavy metal toxicity, especially of cadmium;

Obesity, defined as more than 20% overweight, is a major risk factor;

Excessive calorie intake, which contributes to obesity and other risks;

Diabetes increases the risk three to four times;

Galactose build-up due to high consumption of dairy products combined with inability to process galactose;

Smoking;

Alcohol;

High blood pressure.

UltraViolet Rays on the Eyes

Data from the US National Health and Nutrition Examination Survey suggested that total exposure to sunlight is significantly related to cataract.( 8) Polish researchers in 1997 suggested that it is, in fact, the main factor leading to age-related cataract .( 9) They say that UVB and visible light generate free radicals in the lens. However, in the year 2000, the Eye Research Laboratory, Boston, USA, concluded that UVA may be the more damaging radiation for cataracts, as it also, though indirectly, appears to generate free radicals.( 10)

The mechanism of UV damage remains unclear because there is very little oxygen in the lens, so oxidants may not be able to exert their harmful effects. Nevertheless, the radiation appears to cumulatively damage lens DNA and proteins and to generate damag ing oxidants through interaction with iron compounds.

Smoking Has Multiple Effects

There is a strong association between smoking and a number of common eye diseases, including cataract and glaucoma.( 11) Not surprisingly, the more smoking, the greater the risk.

The main contributing forms of damage are artery disease (atherosclerosis) and blood clots in the capillaries of the eye, the generation of free radicals and decreased levels of antioxidants. Thus, smokers have much greater risks of free radical damage a nd oxidation than non-smokers.

Strict Vegetarian Diet

An English study that compared Asians to Caucasians living in the City of Leicester found that age-related cataract was significantly more common in the Asians, and that a strict vegetarian diet was a significant risk factor for such cataracts in the Asi ans.( 12)

It is postulated by the writer that the problem with the strict plant diet may be vitamin B[ 12] deficiency which is more common when no animal products are consumed. This emphasises the importance for people on strict plant diets of having vitamin B[ 12] levels checked periodically.

'Sugar' Cataracts

Cataracts associated with diabetes and galactose build-up are categorised by their rapid onset. They are known as 'sugar' cataracts, because in diabetes the level of blood sugar (glucose) is high, while in galactosaemia the level of the sugar, galactose, derived from diary products, is at excessive levels.

The mechanism common to both types is the conversion of either glucose or galactose to sugar alcohols (or polyols) by an enzyme called aldose reductase.( 13) The process produces oxidative stress, while the build-up of sugar alcohols causes osmotic pressu re, leading to swelling of the lens and subsequent opacity.

For the technically-minded, aldose reductase is associated with the conversion of glucose to the sugar alcohol, sorbitol, and is found in the cornea, retina and lens of the eye, the kidneys, the myelin sheaths surrounding nerves and in some other tissues . Significantly, it is only when blood sugar level is high that this enzyme is activated, leading to the production of sorbitol. Conversely, if blood-sugar level is normal, there will be no cataracts associated with blood sugar.

The best-selling natural therapies text, Prescription for Nutritional Healing,( 1) states that while free radicals are probably the major factor in the increasing number of cataracts, the single greatest cause is the body's inability to cope with food sug ars. Galactose is the worst offender, followed by refined white sugar. The text adds, "Many eye specialists note that most people with cataracts eat diets that include substantial amounts of dairy products and refined white sugar."

Heavy Metals

The above text states that heavy metals increase in concentration in the lenses of both older people and those with cataracts. In particular, cadmium is found at levels two or three times higher than normal in cataract lenses.

Cadmium is one of the consequences of the use of superphosphate fertiliser in food production. The problem is exacerbated by the refining of flour because the cadmium remains in the white flour, while the protective zinc is milled away with the bran and wheat germ.

PREVENTING CATARACT AND GLAUCOMA CATARACT

To prevent the occurrence of oxidative injuries that lead to cataract (and also cancer, artery disease, Alzheimer's disease, Parkinson's disease and others), the body has a powerful self-defence system hinged on a wide range of antioxidants.( 5) These inc lude:

Enzymes, particularly glutathione peroxidase, superoxide dismutase and catalase.

Nutrients, particularly vitamins C, E and A and carotenoids, flavonoids, polyphenols and catechins.

The carotenoids particularly needed by the lens are lutein and zeaxanthin

Vitamin B[ 2], or riboflavin, (not an antioxidant) is essential for the production of glutathione.

Cataract patients tend to be deficient particularly in vitamin A, lutein and zeaxanthin.

Because of the prominence of glutathione in destroying free radicals, researchers have investigated which nutrients support the body's production of this enzyme. They are vitamins C and E, selenium (part of the structure of glutathione) and lipoic acid.( 6)

Other nutrients that benefit cataract suffers include vitamin B[ 5] (pantothenic acid), vitamin B[ 9] (folic acid), melatonin and the herb bilberry.

This defence system also exists within the lens itself, the lens containing the three enzymes mentioned above plus vitamins C and E and the carotenoids.( 19)

Vegetables and Fruit

A number of population studies have found that there is a reduced risk of developing cataract and other diseases in people who have high intakes of vegetables and fruit.( 4) Not only do these contain vitamins C and E and carotenoids in their perfectly nat ural forms, but they contain a myriad of other antioxidants, alkaline minerals and other beneficial nutrients.

As researchers are realising more and more the far-reaching health benefits of vegetables and fruit, they are conducting an increasing number of studies of these foods. In year 2000, the National Cancer Institute of the USA published an overview of the h ealth benefits of fruit and vegetable consumption.( 20) The report stated, "A new scientific base is emerging to support a protective role for fruits and vegetables in prevention of cataract formation ..."

The National Cancer Institute recommended increased consumption of a wide variety of vegetables and fruits, in particular, dark-green leafy vegetables, cruciferous vegetables and deep-yellow-orange vegetables, as well as a wide variety of fruits, in part icular, citrus and deep-yellow-orange fruits.

Plenty of Vitamin C is Needed

Vitamin C has many functions besides collagen formation to prevent scurvy. It increases the absorption of inorganic iron, has an essential role in the metabolism of folic acid, some amino acids and hormones, and is an important antioxidant.

There is evidence that we need much more vitamin C than the Australian recommended daily intake of 30 mg for women and 40 mg for men that prevents scurvy. The Linus Pauling Institute, Oregon, USA, concluded that an intake of 90 to 100 mg per day is requi red "for optimum reduction of chronic disease risk in non-smoking men and women." The Institute proposed that the RDI be increased to 120 mg/d.( 22)

Other researchers point out that for smokers the requirement is higher by at least 60 mg/d.

With regard to the safety of taking supplements of the main antioxidant vitamins, the International Antioxidant Research Centre, Guy's Hospital, London, found that they have wide margins of safety.( 23) Vitamin C is safe at least up to 600 mg/d and probab ly even up to 2000 mg/d. Vitamin E has very low human toxicity and an intake of 1000 mg/d is without risk, says the Research Centre. Even 3200 mg/d has been shown to be without any consistent risk. However, regarding beta carotene, large intakes must be viewed with caution because they have been found to be detrimental to smokers having a high risk of lung cancer.

Sun Protection

Against cataracts induced by sunlight, both blood levels and dietary intake of antioxidants have been found to be protective to some degree. Vitamins C and E were found to be significantly protective,( 19) the polyphenols in tea (especially the catechins in green tea) provide some protection,( 10) and sunglasses with ultraviolet filters are also useful.( 9)

Preventing the Development of Sugar Cataracts

Recalling that the enzyme, aldose reductase, is critical to the development of sugar cataracts, it has been found that if this enzyme is inhibited, cataracts will not develop.( 13) Potent inhibitors of this enzyme are the nutrients, flavonoids, especially quercetin, which are water-soluble phytonutrients occurring ubiquitously in plants, some being strongly antioxidant.( 24) They are abundant in foods like cranberries, green tea, beetroot, elderberries, raspberries, blueberries, red and black grapes and c itrus fruits.

According to Prescription for Nutritional Healing,( 1) flavonoids aid in removing toxic chemicals from the eye, a particularly rich source being bilberry extract. To prevent diabetes in the first place, the first requirement is a low-fat diet, which needs to be essentially vegetarian. To avoid the risk of galactosaemia, reduce dairy products to low levels. PREVENTING GLAUCOMA

Antioxidants

The body of research on glaucoma is much smaller than for cataract, reflecting the fact that the causes and preventative steps for glaucoma are much less understood than they are for cataract.

However, it has been found that glaucoma sufferers typically have compromised antioxidant defence systems just as do cataract sufferers.( 6) Therefore, most of what has been said about strengthening antioxidant defences to prevent cataracts can also be ap plied for the prevention of glaucoma.

Calorie Restriction

The effects of calorie restriction on the eye drainage channels was studied in mice at the University of Washington in 1997.( 25) 'Calorie restriction' in animals or humans means that all essential nutrients, including calories, are adequately supplied in the diet, but without any surplus of nutrients above needs for normal function -- as happens when animals (and humans) are allowed free access to food. When the mice reached 'old age', those allowed free access to food had drainage channels that had red uced in area by 34% or approximately one-third.

The researchers concluded that there is a possible role for life-long calorie restriction in reducing the damage that leads to glaucoma and perhaps delaying its development.

WHAT CATARACT AND GLAUCOMA ARE

Cataract means loss of transparency of the lens of the eye and/or its capsule, resulting in partial or total blindness. The lens becomes clouded or opaque and is unable to transmit light properly or to focus. The opacity is the result of precipitation of proteins or other constituents of the lens. Because the proteins in the lens are unusually long-lived, they are subject to extensive damage if harmful effects are ongoing.

Glaucoma is a serious disease characterised by abnormally high pressure in the fluid within the eyeball, which may eventually damage the retina (the light-sensitive membrane lining the inside of the eyeball) and ultimately destroys the optic nerve, resul ting in loss of vision and then total blindness. In some cases, the intraocular pressure is normal, but there is poor circulation, resulting in damage to the optic nerve.( 1)

There are two types of glaucoma -closed-angle glaucoma and open-angle glaucoma.

The closed-angle type presents itself as an acute and severe problem caused by narrowing or hardening of the exit channels from the eyeball through which the fluid that fills the inside of the eye cannot escape as it is meant to do. During the attack, th e person is likely to experience throbbing eye pain, reduced vision, especially peripheral vision (what you see at the edges of your field of view), mildly dilated pupils, and occasionally nausea and vomiting. This form of glaucoma can permanently impair vision in a matter of days. Fortunately, it is not so common.

Chronic open-angle glaucoma is the more common form. Although there is no physical blockage of drainage, some physical defect in the 'trabecular meshwork' restricts drainage and the intraocular pressure rises.

A problem with this condition is that there are usually no symptoms until very late in its development, by which time vision may be irreversibly damaged. The usual symptoms are loss of peripheral vision ('tunnel vision') and decreased night vision. There may also be chronic mild headaches and seeing halos around electric lights.

Free Radical Attack and Oxidative Stress

Free radical attack is the basis of the mechanism of cataract formation. For glaucoma, the researchers only give mild indications that free radicals may be partly involved. Let us first take a brief look at free radicals.

Although perceived as agents of mischief, free radicals --reactive oxygen species -- were involved in the evolution of life and are virtually ubiquitous in living things, being formed during normal cell metabolism.( 4) The body has an elaborate defence sy stem against free radicals, and it is only when there is an imbalance between their generation and the body's defences that there results a surplus of free radicals able to do damage.

These can manifest as degenerative diseases that include cancers, atherosclerosis, rheumatoid arthritis, Crohn's disease, ulcerative colitis and cataract.

The all-important question is, what causes free radicals?

The Japanese Niwa Institute for Immunology( 5) reports that free radicals are produced by environmental toxic agents. These include:

Herbicides such as paraquat;

Insecticides;

Nitrogen oxide, a prominent component of motor vehicle exhausts;

Ultraviolet radiation;

PCBs (polychlorinated biphenyls);

Heavy metals, including methyl mercury, manganese and cadmium.

Other prominent generators of free radicals include free iron, chlorine in drinking water and a number of other synthetic chemicals.

The body's defences against oxidative injury by free radicals are based on enzymes that include glutathione peroxidase, superoxide dismutase and catalase, and on antioxidant nutrients, particularly vitamins C, E and A, the carotenoids from which vitamin A is made, polyphenols, flavonoids and catechins. In fresh vegetables and fruits there is also a myriad of other antioxidants that fall under the general label of phytochemicals.

Glutathione attracts much attention because it destroys surplus free radicals in the body. Thorne Research Inc, Dover, USA, has concluded that deficient glutathione levels within the lens of the eye contribute to cataract formation. Nutrients that increa se the levels of glutathione include vitamins E and C, selenium, lipoic acid and vitamin B[ 2] (riboflavin).( 6)

Glaucoma is also linked to compromised antioxidant defences by Thorne Research Inc., which states that, like patients with cataracts, people with glaucoma typically have compromised antioxidant defence systems.

In cataracts, extensive evidence of oxidative damage has been detailed by the Department of Ophthalmology, Dokkyo University School of Medicine in Japan.( 7) In cataractous lenses they found decreased activity of antioxidant enzymes, increased oxidation o f lipids and lipoproteins and a marked decrease in the ability to scavenge oxygen radicals, as well as ongoing generation of free radicals within the lens. Ions of the potentially oxidising metals, iron and copper, were found in lens tissue, and the rese archers related this to the increased oxidation. An interesting consequence of oxidation was increased saturated fatty acids in the lenses.

The reactive oxygen species that initiate lipid peroxidation are superoxide (O[ 2-]), hydrogen peroxide (H2O2) and hydroxyl radical (OH).

GLAUCOMA

Not as much is known about the causes of glaucoma as of cataract. The literature mentions family history of glaucoma, age and obesity as risk factors.

Family history implies not only a genetic predisposition to a disease, but also 'inheriting' the diet and lifestyle of the parents, grandparents, etc. Even so, where there is a genetic predisposition, it is usually mutations of the inherited gene that ar e associated with the disease.

The Department of Ophthalmology of the University of Iowa, USA, found that mutations of the relevant gene cause most cases of juvenile-onset chronic glaucoma and around 5% of adult-onset cases.( 14)

Individuals have no control over inheriting particular genes, but we can reduce the likelihood of mutations occurring - by avoiding toxic chemicals and excessive calorie intake.

Restricted Blood Row

Swedish ophthalmologists suggest that the primary cause of glaucoma might be progressive increase in flow resistance in the veins in the eye.( 15) This ischaemia (lack of blood), combined with impaired nutrition, starts off the glaucoma.

The elevated intraocular pressure (lOP) is the result of narrowing or hardening of the exit channels through the trabecular meshwork that was referred to earlier. The cause of this narrowing or hardening appears to be not dealt with by the researchers.

The actual cause of diminished vision or blindness is thought to be the result of ischaemia damaging the optic nerve. The pressure in the eyeball reduces the flow in the veins, producing the ischaemia.

Other likely causes of ischaemia are atherosclerosis or blood clots in the capillaries of the eyes.

As this is the same process that occurs in the coronary arteries of the heart and causes heart attack, so the same lifestyle factors that prevent heart attack can be expected to prevent at least one possible cause of glaucoma.

The ischaemia theory was proposed by the Department of Ophthalmology of the University of Miami in 1999.( 16)

It appears that there is a vicious circle acting here. Diseased capillaries in the eye restrict the flow of blood which damages and blocks the drainage channels for the fluid in the eye (aqueous humor).

This creates pressure in this fluid which in turn presses on the veins and further restricts blood flow.

More damage is done to the drainage channels, the escape of fluid is even further restricted and its pressure climbs. The spiralling ischaemia eventually damages the optic nerve and hence impairs vision.

Vitamin B1 Deficiency

An early study of patients with glaucoma found that they had significantly lower blood levels of thiamine (vitamin B[ 1]) than people without glaucoma.( 17)

In view of the general association between B vitamins and nerve function, this finding is understandable.

Smoking

As was stated in the discussion on cataract, there is a strong association between smoking and eye diseases, including cataract and glaucoma.( 11)

Smoking generates free radicals in many parts of the body, including the aqueous humor and other tissues of the eye.

It may well be that free radical damage is part of the mechanism for the development of glaucoma. Smoking also promotes artherosclerosis and blood clots.

Diabetes

Whatever mechanism is involved, glaucoma is found to be more prevalent in diabetic people than non-diabetic people.( 18)

Antioxidant Supplements

It has been found that populations with higher blood levels of antioxidants have reduced incidences of cataracts.( 19) Also, vitamin E has been found to be effective in arresting the developing of cataracts in animals. Consequently, there has been a lot o f interest in whether supplements might prevent cataracts.

A 1994 Danish review of studies concluded that there is no evidence that antioxidant supplements would provide protection against cataract (or cancer, or atherosclerosis).( 4) A new study of supplements in relation to cataract was conducted by the School of Public Health at the University of Massachusetts in 1999. It looked at 74,000 woman, aged 45 or older, in whom there developed 1377 age-related cataracts.( 21) It was found that taking multivitamins or separate supplements of vitamins C, E or A did not reduce the risk of cataract, and only in specific groups was there any benefit, namely long-term vitamin C users who had never smoked, and in the women less than 60 years of age. The two groups had modest reductions in cataract incidence. The researcher s concluded that, "There is little overall benefit of long-term use of vitamin supplements for risk of cataract."

Clearly, something very significant is showing up here. With abundant evidence that antioxidant nutrients are protective, yet little if any benefit being found in taking antioxidant supplements, either a wider range of nutrients than just a few supplemen ts is needed, or else the supplements are not as effective as the food sources of nutrients.

Shedding some light on this question, the Japanese Niwa Institute for Immunology reported that synthetic antioxidant nutrients "generally showed low affinity to human cell receptors."( 5) In other words, the body's ability to use synthetic vitamins is poo r, and the natural sources are therefore far superior.

FOR BOTH CATARACT AND GLAUCOMA - Minimising Free Radical Damage

Minimise exposure to pesticides, herbicides and other toxic synthetic chemicals. Obtain organically-grown foods if possible, grow your own, or at least wash commercial fruits and vegetables with a safe 'organic' cleanser.

Avoid chlorine by purifying tap water or drinking bottled or rainwater.

Avoid exposure to industrial chemicals, especially solvents.

Avoid tobacco smoke, a powerful generator of free radicals.

Be cautious with medical drugs that might lead to cataract. Especially avoid steroids such as cortisone if at all possible.

Minimise exposure to radiation, especially X-rays. Wear sunglasses when outdoors in bright sunlight.

Avoid consuming rancid (oxidised) fats, likely to be found in deep-fried foods, biscuits, cakes, pastries, vintage cheese, cure meats, long-stored peanut butter, stale shelled nuts and seeds and so on.

Avoid surplus iron. Never take iron supplements unless there is iron deficiency, and beware of the more readily available iron in red meat.

FOR CATARACT AND GLAUCOMA - Problem Medications

Along with steroids increasing the risk for cataract, there are other medications that have side effects that affect the eyes. For this reason, avoid unless absolutely necessary antidepressant, anti-epileptic drugs, topical anti-glaucoma agents and chemotherapy/immunosuppressive agents. Some of the side effects of these drugs are reversible and some are not.[ 26]

FOR CATARACT AND GLAUCOMA -- Abundant Antioxidants

To obtain much higher levels of antioxidant nutrients and less calories than in the typical modern diet, follow Natural Health Dietary Guidelines. These are presented in detail in the Spring 1999 issue of New Vegetarian and Natural Health, pages 54 - 60. This issue is available from the Natural Health Society, $6 posted.

These guidelines are based on three-quarters of total intake being fresh, green, yellow and red vegetables and fruits, meaning approximately three-quarters to one kilogram daily for a person of average size, more for larger-framed people and less for sma ller-framed people. Along with minimising exposure to toxic chemicals, a high intake of these highly protective foods are the major things we can do to prevent cataract and glaucoma (as well as a host of other diseases, including heart disease, stroke an d cancer).

Fresh vegetables and fruits are the only abundant and ideal sources of vitamin C, carotenoids (from which we make vitamin A), flavonoids, other antioxidants and a host of other phytonutrients. They are also the outstanding sources of the alkaline mineral s, potassium, magnesium and calcium, as well as many trace minerals.

The dietary guidelines also include small but regular amounts of legumes, nuts and seeds, supplying high levels of vitamin E, zinc -- and selenium if we include a few Brazil nuts frequently.

HELP FOR EXISTING CATARACT AND GLAUCOMA

There is no medical cure for either cataract or glaucoma, and with glaucoma any damage to vision is irreversible.

CATARACT

With cataract, vision can be restored by surgery which replaces the opaque lens with a prosthetic lens implant. Although this is a fairly common and often successful operation, apparently some patients are dissatisfied with the result. Prescription for N utritional Healing( 1) concludes, "We believe that surgery should be resorted to only when absolutely necessary - when your natural lens becomes so opaque that you cannot read or drive."

It is probable that there is nothing in natural therapies either that can reverse existing cataract.

However, if there is still some level of vision, the steps given under 'Prevention' above may prevent the cataract progressing any further. This could obviously be a great benefit compared to progressing to blindness.

GLAUCOMA

For glaucoma, medical treatment aims at reducing the irreparable damage. However, as recently as 1999, medical treatment for glaucoma attracted extraordinarily disparaging remarks from the Wills Eye Hospital in Philadelphia, USA.( 27) It was stated, "In t he recent past, far more damage was caused by treatment for glaucoma than by glaucoma itself.

To repeat ... glaucoma and its treatment damage health more than any other eye disease except cataract, and the medical profession is responsible for a major part of that problem."

This strongly suggests that natural therapies is the better way to go.

The following guidelines are taken from Prescription for Nutritional Healing( 1) and a paper entitled 'Natural Therapies for Ocular Disorders'.( 6)

Vitamin C in high doses has been found to lower intraocular pressure via its osmotic effect. This is the most documented natural treatment for glaucoma. Almost normal pressure levels have been achieved in some people who did not respond to orthodox thera pies. A valuable natural source of vitamin C is rose hips, which also supply flavonoids.

Increase the intake of flavonoids (or bioflavonoids) which prevent the breakdown of vitamin C, improve the integrity of blood capillaries and strengthen the tissues of the eye. They are found in the peel and outer layers of fruits and vegetables, includi ng leafy vegetables, red onions, beetroot and red and blue berries. The readily available herb, bilberry extract, is particularly rich in these nutrients.

The herbs, eyebright and chickweed, are good for all eye disorders.

Ginkgo biloba increases the circulation to the optic nerve, which would be especially helpful.

Forskolin, an extract from a plant named Coleus forskohlii, has been successfully used to lower intraocular pressure without causing side effects.

Other nutrients that have potential benefit include magnesium, vitamin B[ 12], lipoic acid and the hormone melatonin.

Lipoic acid acts as an antioxidant by enhancing the properties of vitamins C and E and glutathione. Food sources include potato and yeasts, and it is available as a supplement.

Hydrotherapy promotes circulation. Have two bowls, one filled with hot water and the other with very cold (not icy) water. Soak a washer in hot water (take care not to scald), wring lightly and place over the eyes for 3 minutes. Have a second washer in t he cold water, wring lightly and place over the eyes for 1 minute. Repeat twice more, making three cycles of hot and cold altogether.

Avoid long periods of eye stress, such as watching television, reading or using a computer for long periods.

If you must do these things, take breaks every 20 minutes to flex and stimulate the eyes by focussing alternately on a distant object then a close object for a few minutes.

Avoid nicotine, caffeine and alcohol which can interfere with the circulation to the eyes.

REFERENCES
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By Roger French

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