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 some tips for how to best protect your eyes in times of stress.
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.
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
Cortisol is part of the problem. This is the hormone that the brain releases 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 grey 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.
Conditions such as computer vision syndrome (CVS) are also becoming more common as screentime 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.
Tips for protecting your eyes right now
Taking steps to reduce your overall stress, such as getting more exercise and practising your favourite self-care activities, can do wonders for your health, including your eyes.
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.”
Cut down on screentime. 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.
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.
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