July 26, 2023 – Summer is a time of fun and delight, vacations, camping and family outings. But many popular summer activities like swimming can pose safety risks, especially for the eyes and ears.
Usiwoma Abugo, MD, an ophthalmologist in Norfolk, VA, and spokesperson for the American Academy of Ophthalmology, tells the story of “Linda,” a 16-year-old who recently got here to see her because her right eye was red and irritated and really painful in sunlight. (Abugo modified the patient's name and identifying information to guard her privacy.) Linda had no history of trauma, and nothing like this had ever happened to her before. Nor did she have any medical conditions that may explain these symptoms.
“When we stained the eye with a special dye that detects defects on the surface of the eye, we found that they had a Corneal ulcer”, said Abugo.
Linda often wore contact lenses but was unable to place them in resulting from the pain in her right eye. She told Abugo that she occasionally went swimming along with her contact lenses because she was “blind without them.”
Swimming with contact lenses is dangerous, Abugo said. Bacteria can form on the lenses and cause serious infections. Linda needed to do further tests to search out out which organism was causing the issue.
“Because she had a central corneal ulcer that threatened her vision, she had to use eye drops every hour until she saw improvement. She also had to go to the clinic daily to make sure she was getting better – or, more importantly, that her condition was not getting worse,” Abugo said.
Linda has a scar along a part of her visual axis. “We are continuing to evaluate whether she needs a corneal transplant to restore her vision,” Abugo said.
This injury might have been prevented by not swimming with contact lenses. Instead, Abugo said, people should wear goggles – in the event that they can afford them.
Eye care in summer
A new study published within the August issue of Ophthalmic epidemiology examined patterns of web searches for eye symptoms reminiscent of redness, dryness, conjunctivitis, and pain. The researchers analyzed publicly available Google Trends data from the United States from January 1, 2015, to December 31, 2019. Nearly half of searchers (45%) exhibited seasonal patterns. For example, searches for eye redness peaked within the spring, which the authors say could also be related to the height time for allergies. Searches for eye pain were highest in the summertime, which the authors say could also be related to eye trauma.
Fireworks are a standard reason for eye injuries, Abugo said. “Fireworks are beautiful, but they can also cause blindness as they can cause eye lacerations, superficial scratches and burns. So it's best to leave them to the professionals,” she said.
“Whenever you are near fireworks, even as a spectator, you should wear eye protection,” she continued.
The American Academy of Ophthalmology recommends keeping a distance of at the least 10.5 meters from ground fireworks and about 45 meters from aerial fireworks.
Abugo recommends wearing sunglasses that provide 100% protection from UV rays when outdoors. “This is the best way to prevent future eye problems such as cataracts or growths in the eye.”
She said when sunlight reflects off highly reflective surfaces like water and sand (or ice and snow in winter), “the sun's UV rays burn the surface of the eye, causing pain, redness, blurred vision and even temporary vision loss.” Wearing the best sunglasses and a wide-brimmed hat for added eye protection may also help.
Whether you're playing sports, gardening or doing repairs, all the time wear appropriate safety glasses. According to Abugo, greater than half of all eye injuries occur at home, but only about one in three people wear eye protection, despite the fact that they need to.
Protecting children’s eyes
Abugo said there are “horrifying statistics” on eye injuries in children under 18, a lot of them related to fireworks. But along with summer fireworks, one other perpetrator is all-terrain vehicles (ATVs). Children under 16 make up at the least 30% of hospitalizations for ATV injuries, which might range from lacerations to the eyelids and broken bones across the eye to everlasting blindness from optic nerve damage. “Because of these risks, ATV operators, especially children, must wear protective eyewear and helmets,” she said.
She said there may be “a common misconception that babies and young children do not need to wear sunglasses,” but everyone, no matter age, should wear 100% UV-protective sunglasses, sunscreen and a hat when outdoors.
The sounds of summer
Jennifer Schumacher, a physician of audiology and manager of medical communications for a corporation that makes hearing aids, said summer brings plenty of problems that could lead on to ear damage.
“One of the most common dangers is noise,” she said. This includes the noise from fireworks, but additionally the noise from concert events and music festivals, which often feature very loud music and are more common in the summertime.
“If you listen to sounds that not only exceed a certain volume — usually around 85 decibels — but also last for a long time, as is the case at a music festival, that combination of volume and duration can cause permanent damage to your hearing,” she said. The damage might not be immediate, but can accumulate over time. “Overall, we're seeing young people — even as young as teenagers — developing hearing loss from noise,” she said.
She recommends wearing earplugs. “Certain types of earplugs are available at any drugstore and come with instructions on how to insert them properly,” she said.
However, most of those earplugs are product of foam, and while they make loud noises safer, they may also muffle or distort the sound of the music. “Listening to muffled or distorted music defeats the whole purpose of going to a concert because the music is less fun,” Schumacher said.
She advisable buying earplugs which can be specifically designed to suit your ears, which is able to reduce the general volume but is not going to distort the frequency or muffle the sound.
She admitted that these earplugs – which might be purchased from an audiologist, an ear, nose and throat (ENT) doctor or sometimes on the hospital – are “not cheap,” but they’re definitely worth the money if you need to preserve your hearing while having fun with music.
Ear care in water and air
According to Schumacher, swimming also poses risks for the ears. One of those is Float tubeoften a bacterial infection (but will also be brought on by a fungus) within the ear canal or outer ear. Symptoms may include itching within the ear, pain (often severe), hearing problems (sounds could seem muffled), or fluid or pus drainage from the ear.
A less common disease is Surfer earthrough which bone growth can form within the ear canal after repeated and prolonged contact with cold water.
“Because surfers spend time in cold water year-round, this condition is associated with them, but it can also happen to other people and occur in the summer,” Schumacher said.
To avoid each conditions, it's helpful to wear earplugs. Over-the-counter swimming earplugs may also help, but when you're really liable to ear infections or swim so much, it's value having earplugs which can be molded to your ears, she said. These are different from earplugs designed to scale back noise levels. Rather, they're specifically designed to guard the ears when involved with water. You may also get them from audiologists, ENT doctors and sometimes hospitals.
Air travel might be difficult for the ears, especially during takeoff and landing. “Air pressure changes with altitude,” Schumacher said. “It's the job of the Eustachian tubes, which run from the eardrum to the throat, to equalize that pressure. But if that doesn't happen, the ears can feel blocked or even quite painful.”
When you progress your jaw by yawning, swallowing, chewing gum or sucking candy, you’ll be able to equalize the pressureSometimes you hear a “pop,” which is the opening of the Eustachian tube and the equalization of pressure in the center ear. “For most people, that should be enough,” said Schumacher.
But if those jaw movements don't work, she recommends special earplugs called EarPlanes which can be designed for this purpose. They're available at pharmacies, often in airport gift shops, and online.
If none of those measures are enough, you’ll be able to see a physician who may recommend or prescribe a nasal spray or other medication.
Schumacher said altitude problems can occur not only when flying, but additionally when climbing mountains. “When you change altitude, stop, take breaks and do jaw movements. And it doesn't hurt to try EarPlanes either. Once you get to your altitude and get used to it, the pressure should hopefully equalize and you won't feel any more discomfort.”
During deep-sea or recreational diving, people may also experience barotrauma of the ear, brought on by the pressure changes. “You should work with an experienced and well-trained instructor who can help you avoid this type of damage to the ear – and other parts of the body as well,” she advises.
By taking easy but thorough precautions, you’ll be able to make sure that you’ve gotten a secure summer without injury or long-term damage and that you simply take home many wonderful memories.