Our eyes have been working overtime during the pandemic, with many of us staring at screens for hours on end. Dr. William Harbour, the new Chair of UT Southwestern’s Department of Ophthalmology, discusses strategies to combat eye fatigue as well as the research his team is doing to safeguard patients’ vision in the face of age-related degeneration and ocular cancer.
from the time we wake up in the morning until we fall asleep at night. Many of us spend so much time in front of our digital devices that our eyes don't seem to get a break. So in a society that's becoming increasingly screen dependent, how can we protect our vision health joining us with that answer and more is Dr Bill Harbor, a clinician, scientist, professor and chair of ophthalmology here at UT Southwestern Doctor Harbor. Thanks for joining us. How has this virtual environment in the work from home era affected our vision health. Initially it was a real struggle figuring out how to get patients in to get their exam. What we ended up coming up with are different strategies to allow the patients to come in uh and get their imaging done uh and then perhaps go home and then they would have a telemedicine visit. Unfortunately, what happened early in the pandemic was that people were delaying their eye care, some conditions that were not urgent could wait a few weeks became vision threatening when they were, you know, waiting a few months instead, macular degeneration getting much worse. So it was a real challenge in many ways. With many of us spending so much time now looking at a screen, either our phone or computer or some other monitor. Many of us are experiencing eye fatigue at a different level than we've had before. Do you have any advice for us and preventing and treating that eye fatigue, one of the most common causes of eye fatigue is just dry eye because when we are reading, we're on a on a computer screen, uh those sorts of things. We tend not to blink as much. And so um our eyes become dry and we sense that um as fatigue using artificial tear drops periodically will help and just taking breaks periodically will help. A real concern, especially with young people is that with all these devices it's increasing the rate of nearsightedness. That's an increasing concern. And you know, the pediatric ophthalmology space, doctor harbor much of your research is focused on evil melanoma and retinoblastoma, the most common i cancers in both Children and adults. Tell us about your research. My research in in You viel melanoma, which is the ocular form of melanoma has led to some important discoveries that allow us to number one identify which patients are at higher risk for having their cancer spread so that we can do things to try to reduce that chance genetic testing that that my lab developed is now commercially available and widely used around the United States. We followed that up with research to identify potential therapies for these high risk patients. We've identified a number of proteins that get abnormally expressed in the cancer cells. And this has led to several clinical trials. What types of people are at risk for cancer of the eye for ocular melanoma or you viel melanoma. The greatest risk is for white individuals, particularly fair skinned light colored eyes. The other common cancer which is in Children, retinoblastoma really has no racial or sex predilections? So we see it equally, you know, across the board. But there do seem to be some environmental factors that we are still trying to understand when we talk about ocular cancers, what components of the eye are involved? The iris can develop melanoma and other types of cancer. And then the iris is connected behind the eye to what's called the core. Oid in the silly everybody. And those can also develop melanoma. Now, the retina, which is like the film in the camera that sees the light coming in, that's where retinoblastoma develops. And then on the surface of your eye, your eye surfaces has a skin like material called conjunctivitis. And the convective a can have cancer associated with it as well. What type of symptoms do patients have who develop eye cancer? Sometimes they have no symptoms at all. Uh particularly if if the cancer is on the inside of the eye and it's not where you can see it and it's not affecting the division. Often times it will affect the vision. Either flashing lights, blurred vision, a blind spot and the vision, that sort of thing on the surface of the eye, Maybe a foreign body sensation when you blink, you feel there's something rubbing there or you might be able to actually see the lesion when it's on the surface of the eye? Ophthalmology has always been an exciting field in terms of innovation. What are the I've been coming things in the field of ophthalmology right now, we now have imaging that allows us to see the entire inside of the eye all at once. And in fact you have three D imaging that makes the surgeon feel like they're inside of the eye and you can see exquisite detail of the retina, the lens, all of the structures of the eye that might uh need to be um treated. What are some simple things we can do to improve our eye health. Number one, I think certainly it is a good idea to see an ophthalmologist periodically when we're young. Probably every few years as we get older, probably once a year. Really, really important is to where I protection when we're doing things that could result in a foreign body getting into our eyes such as mowing the lawn or hammering. It's very important to think about eye protection um when we're doing those kind of activities outside of an annual visit. What type of Simpson should stimulate one to someone to see an ophthalmologist. Certainly if you have flashing lights, the most common reason for flashing lights is not cancer fortunately, but it it can be where the vitreous the gel inside of the eyes, pulling on the retina and could tear a hole in the retina, Most of us will develop little floaters in our vision as we get older. But if you were to notice a large new floater that was very different than one that you had had before, that would be something important that you would want to get checked out. How often should parents take their kids to have their vision checked? It depends on if there's a family history of any number of diseases that can run in families. If there is a positive family history, then you know, those visits to the pediatric ophthalmologist should start fairly young. Uh maybe when the child is a year old or even younger, depending on what the disease is for a child that doesn't have any family history. The things to look for. Uh one of the most important things is that if an eye is deviating if it's turning in or turning out, um that's called stra business. The most common way that retinoblastoma has picked up is that a family member will notice that the pupil is not dark. Uh the way that, that it normally is, but it looks white or when you're taking uh pictures. Sometimes the pupil looks red. You see that red reflex, but instead of red, it looks either white or black um because the light is not being transmitted Well, dr harper, we very much appreciate you joining us today and telling us a little bit more about ophthalmology and we're certainly glad to welcome you here to Dallas into. Ut Southwestern. So thanks for your time today. Thank you so much. It was my pleasure. Thank you for joining us until next episode. Stay safe and stay healthy.