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Pandemic stress could be causing your eye problems. Here’s what to know.

(María Alconada Brooks/The Washington Post)
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A previous version of this article mistakenly implied cortisol is released by the brain. It is released by the adrenal glands. This version has been corrected.

The physical manifestations of pandemic stress are well-documented: People have been experiencing increased blood pressure, sleep problems and trouble focusing. But there are other, potentially overlooked, indicators of stress, according to experts — and eye health is a prime example.

“Stress, anxiety, depression and mental health changes can affect our sensory system, especially our vision,” said Raj Maturi, an ophthalmologist and clinical spokesperson for the American Academy of Ophthalmology. “Vision is a complex psychophysical process where we build a model of the world around us — and this is affected by our mental state.”

Eye twitching, for example, is a common stress response. Usually, the twitches, which are triggered when the muscles around the eye spasm, go away in a day or two. But other common issues, including dry eye disease, can have lasting effects if they aren’t addressed.

Eye conditions such as these are “very common pandemic side effects,” Maturi said. This is especially true if you are spending more time on Zoom or are working longer hours on your laptop, because chances are you’re not blinking as much as you should be.

As widespread as they may be, eye problems are too often neglected, Maturi said. But, he added, “vision is one of the most precious things that we have.”

As people’s stress levels soar, it’s crucial to know how anxiety affects your eyes. Here are the basics — and tips for how to best protect your eyes in times of stress.

Eye care comes into focus during coronavirus

What to know about eye problems and stress

Stress can be both a “consequence and cause” of vision problems, according to a literature review published in 2018. In other words, having a regular eye twitch or a more serious eye condition can make you feel more stressed, and stress itself can also cause or worsen eye issues, said Julie Rosenthal, a clinical assistant professor of ophthalmology at the University of Michigan Health.

Cortisol is part of the problem. The adrenal glands, on top of the kidneys, release the hormone during times of stress, and it can dilate the pupils, making it tough for your eyes to focus and causing light sensitivity and blurred vision when you’re anxious.

Elevated cortisol also increases the risk of central serous chorioretinopathy (CSCR), Rosenthal said. The condition occurs when fluid builds up under the retina, and it affects your central vision. Symptoms include a dark or gray spot in your sightline, blurred vision and straight lines that look wavy or curved.

Some people have a single episode of CSCR that resolves on its own within a few months and doesn’t cause long-term vision problems, Rosenthal said. Others can have repeat occurrences, which can damage the retina, causing permanent changes to eyesight, including vision loss. Treatments — including injections, laser therapy and oral medications — can usually help, especially if the condition is caught early, she added.

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Conditions such as computer vision syndrome (CVS) are also becoming more common as screen time increases. CVS can cause headaches, blurred vision, dry eyes and eyestrain. According to Maturi, the condition can be treated with a visit to your ophthalmologist and a corrective lens prescription.

Rare conditions can also result from stress and trauma, including functional neurological disorder, or conversion disorder, which affects someone’s ability to see, walk or hear — without any medical explanation. “There is no ocular dysfunction, but the person is just unable to process the input from the eyes due to overwhelming stress,” Maturi said. Sometimes the symptoms go away quickly and never return, but in other cases, they can persist for months or years and can interfere with someone’s daily functioning. Treatment usually involves psychotherapy and physical therapy.

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Tips for protecting your eyes right now

Taking steps to reduce your overall stress, such as getting more exercise and practicing your favorite self-care activities, can do wonders for your health, including your eyes, experts say.

Most stress-related eye issues, including eye twitching and dry eye, will improve once you reduce your stress, usually within a week or two, Maturi said. (CSCR is an exception; it can become a long-term condition that will require ongoing treatment and monitoring from an ophthalmologist.)

Fundamentally, stress can make it tough to take proper care of yourself, said Michael Ziffra, associate professor of psychiatry at Northwestern University’s Feinberg School of Medicine. But this is key to maintaining eye health, he said: “Just the day-to-day stuff that we would do to promote our eye health, it’s harder to be consistent with those things when you’re under stress.”

Here are some immediate steps you can take to improve eye health:

Cut down on screen time. Taking breaks from your laptop or phone is good for your mental state and your vision, Maturi said. He recommends using the 20-20-20 rule: “Every 20 minutes, look at least 20 feet away for 20 seconds. This allows the eyes to change focus and decreases headaches or eye twitching.”

Use artificial tears. Over-the-counter artificial tears can reduce dryness, refresh the eyes and help with eye twitching, Rosenthal said. Avoid products claiming to reduce redness, she added, because they contain tetrahydrozoline, which can irritate the eyes and cause more problems.

Change your contacts frequently. Wearing contact lenses for too long or failing to clean or disinfect them properly can cause eye infections and irritation. Clean and disinfect your contacts before putting them back in your eyes, don’t sleep in daily contacts, and replace them according to your doctor’s and the lens manufacturer’s instructions.

Get plenty of sleep. Tiredness can cause redness, irritation, dry eyes and blurry vision — along with fatigue and moodiness, which could increase stress. Aiming to get at least seven hours of shut-eye a night will help your stress levels and your eyes. Here are tips for getting a better night’s sleep.

Stay hydrated. Drinking plenty of water will keep your body (and eyes) hydrated, thus reducing irritation. Ziffra also suggests avoiding too much caffeine, which can stimulate eye twitching, and drinking alcohol in moderation.

Know when to call your doctor. Visit your doctor within a week or two if dry eyes or vision changes aren’t improving, especially if the problem is interfering with your daily life, Rosenthal said. If you have sudden vision loss, seek care immediately. Maturi added that everyone should get an eye exam done at least every two years (and once a year if you’re over 50) to keep your eyes healthy.

Erica Sweeney is a writer based in Little Rock. Find her on Twitter: @ericapsweeney.

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