How Delhi's air pollution can turn cancerous and impact one's vision

The air quality in Northern India is poor, but this is particularly the case in the national capital, New Delhi, which has reached the severe plus category with smog shrouding the city, reducing visibility and worsening air pollution to touch an alarmingly high level of poor AQI. According to the Central Pollution Control Board (CPCB) data, Delhi’s overall air quality index (AQI) has been over 450 in the last few days and even touched 488 recently - the worst in the country. The stubble burning in neighboring states, overpopulation of automobiles, factories, and the heavy fog in the capital are seen as causes for the poor air quality. This certainly impacts the lungs and cardio – but heavy smoke and fog, smog, impacts the eyes too. A study in the British Journal of Ophthalmology has found that residents of highly polluted areas were at least 8% more likely to be diagnosed with Age-related Macular Degeneration (AMD – blurring of the central vision) than residents of less polluted areas. According to studies in the iScience, eye disease possibility rises 1.48% for a 10 μg/m 3 increase in four-week average PM 2.5 concentration, which is the case in New Delhi. While visibility and clear sight dips sharply, what are the other consequences of poor air quality imbued with smoke and fog?The eyes experience lot of dryness and discomfort at times leading to serious eye infections.The eye is a sensitive and delicate organ and has the largest moistened part of the body in the line of the outside atmosphere and this makes it highly susceptible to air pollution than any other organ in the body. And people wearing contact lens wearers are prone to these conditions as the eyes are not protected even behind the lenses. Microscopic particles like PM2.5, NO2, SO2, among others impact the eyes negatively.A major consequence is the Dry Eye Syndrome (DES), which has seen a significant rise in urban areas with high pollution levels, resulting in redness and irritation. This condition arises when the eyes fail to generate sufficient tears for lubrication, leading to discomfort, itching, and a burning sensation. Prolonged exposure to pollutionis also linked to accelerated cataract formation. Many studies have indicated that the prevalence of cataracts in people aged over fifty years increases as a result of chronic exposure to urban smog. The studies also suggest that fine particulate matter may elevate intraocular pressure, increasing the risk of glaucoma. Conjunctivitis, also known as pink eye, is considered one of the common infections during this period and can easily be transmitted from one person to another. Also, excessive exposure to polluted sunlight can cause photokeratitis,- which is brief loss of eye sight, pain, redness, photophobia and excess tear production.The structures and tissue located on the surface of your eyes are directly exposed to air pollution. This includes the eye lids, cornea (the clear, protective layer), sclera (the white part of the eye) and the eye’s natural lens. Each of these parts is sensitive to harsh irritants found in the environment, both inside and outside. When exposed, you may experience discomfort, inflammation, blurry vision and other symptoms.In long time, it may cause retinal degeneration, ocular hypertension, and may increase the frequency of eye cancer.How do you protect your eyes in the context of poor air qualityDue to the increasing levels of air pollution during the winter months, it is advisable to take certain precautions with regard to the eyes. UV blocking sunglasses can help protect the eyes from both pollutants and the sun. In environments where there is substantial pollution, the use of wrap-around sunglasses is convenient and helps protect individuals from dust and other particles. Other ways of minimizing the availability of environmental irritants would be to use air purifiers with HEPA filters and maintaining a clean and humidified house. If there are patients suffering from dry eyes, lubricants such as eye drops or artificial tears can be used for relief. This is precisely why doctors usually recommend that such patients use preservative-free eye drops to avoid causing more irritation. There is also need to blink the eye frequently to keep the eyes moist and nourished. Sometimes very basic habits like refraining from rubbing eyes helps prevent dirt, polluted airand allergens owing to poor quality present in the hands from contacting the eyes.People should also use warm compresses to get relief from eye inflammation caused due to exposure to air pollution. Regular and frequent intake of water helps the body alright, but it also helps the eye as it keeps one hydrated and flushes out harmful toxins and waste from the body. Along with all these measures, regular eye appointments are also helpful in preventing and managing vision defects caused by environmental pollution as eye care specialists would recommend measures to be taken to prevent abrasions, infraction and damage to the eyes.Authored by: Dr Puneet Johri, Chief Medical Officer, Paediatric Ophthalmologist & Strabismologist, Sankara Eye Hospital, Kanpur