1. Health Tips 

Eyes are precious: Take good care

“See no evil; see what is good. Only then will your eyes attain the sacred power by which you will be able to visualise the Divine Cosmic Form.”… Sathya Sai Baba¹

“Of all the senses, sight must be the most delightful…the only thing worse than being blind is having sight but no vision”…Helen Keller (Deaf-Blind American Author & Activist)

1. Know your eyes

1.1 The most delicate, complex, and sensitive sense organ in the human body, eyes give us the precious vision, the sense of light, colour, form, and movement, and maintain the biological clock of the body. The two eye balls are situated within bony sockets and protected on the outside by the eyelids, eyebrows and tear film. Each eye is moved by 6 muscles which are attached around the eyeballs. Light rays entering through the pupil are focussed by the cornea and lens to form an image on the retina. The retina contains millions of light-sensitive cells which convert the image into a pattern of nerve impulses. These impulses are transmitted along the optic nerve to the brain where these are processed to form a single image.^2-4

1.2 What is normal eyesight?: A “20/20” (in feet) or “6/6” (in metres) visual acuity indicates normal eyesight, though not a perfect one. The first number (upper one) denotes the distance from which all are examined during an eye test, using the Snellen eye chart. The second number tells us how well someone is able to read the letters on the chart at 6 m. If one has 6/9 visual acuity, he can see details only at 6 m that people with normal eyesight will see at 9 m.^5,6  

1.3 What is normal eye pressure?: Eye pressure—also called intraocular pressure or IOP—is a measurement of the fluid pressure inside the eye. While the average IOP is 15 mmHg, the range of normal eye pressure is much larger, between 10 and 21 for about 90% of the people. This depends on many factors like age, blood pressure, pulse rate, and refractive error. IOP beyond 21 is generally considered as a risk factor.^7,8 

1.4 Eye problems could arise due to infections, genetic disorders or from birth, by neglect or accident, or by incorrect use or abuse of the eyes.

2. Eye infections

2.1 Infections occur when harmful microorganisms (bacteria, fungi, or viruses) or foreign particles invade any part of the eye or its tissues.^9-13 

2.2 Contagious infections: the most common is conjunctivitis (pink eye): It is typically viral, but could be due to bacteria. Common symptoms which tend to appear suddenly are redness, itchiness, sensitivity to light, burning, sticky discharge, gritty feeling of a grain of dust or sand in the eyes, tearing or watering of eyes, swollen eyelids (sometimes painful), and blurred vision. Trachoma is another highly contagious bacterial infection, but sporadic.^9-12 

2.3 Non-contagious infection could be due to allergen like pollen, any chemical splash, noxious vapour, any irritant, or use of contact lens for extended periods. In case of allergic conjunctivitis, inflammation, itching, and tearing may be intense, accompanied by sneezing and watery nasal discharge. Fungal infections are rare. Other possible infections include keratitis (inflammation of cornea due to bacteria, virus, or parasites in water); uveitis (caused by certain viruses like herpes, but more commonly linked to autoimmune disorders like rheumatoid arthritis or lupus); infection of eyelids or its skin which include stye (a painful bump similar to a pimple) and chalazion (an accumulation of secretions, usually painless); and corneal ulcer due to bacterial, viral, or fungal infection.^9,10,13 

3. Eye problems/defects

3.1 Common refractory errors: myopia - inability to see distant objects that mostly starts from childhood; hypermetropia - inability to see nearby objects due to short eyeball; astigmatism - both nearby and faraway objects look distorted due to irregularly curved cornea; presbyopia - hard to see things or read at arm’s length after the age of 40.^14,15 

3.2 Cataract is a gradual clouding of the lens of the eye when it becomes less flexible, less transparent, and more dense with age, leading to a decrease in vision in one or both eyes. Symptoms include fading or yellowing of colours, blurry or double vision, frequent changes in eyeglasses, seeing halos around light, discomfort with bright lights, and difficulty in reading, driving, or seeing clearly at night. Apart from age, nutritional deficiency, genetic disorders, some medical conditions like diabetes or past eye surgery, exposure to radiation, long-term use of steroids, trauma, or addictions may also cause it.¹⁶

3.3 Glaucoma is an eye condition where the optic nerve deteriorates and gets damaged, either due to its sensitivity or less blood supply to it. More often it is because of increased eye pressure when the aqueous humour is overproduced or not drained properly due to clogging. The damage to the eye is gradual without any warning sign. The most common symptom is patchy blind spots appearing frequently in both eyes and tunnel vision in advanced stages. In some cases there is noticeable hazy or blurred vision, appearance of rainbow coloured circles around bright lights, severe eye pain with headache, red eye, nausea or vomiting, and sudden sight loss. As the vision loss is not reversible with treatment or surgery, it is one of the leading causes of blindness in adults above 60.^17,18

3.4 Retinal disorders: Major retinal problems include macular degeneration and retinal tears or detachment. Symptoms are: numerous new floaters (thread like black spots or specks), sudden and rapid flashing lights at the edge of the visual field, distorted vision, and sometimes a grey curtain obstructing vision. Retinal detachment is painless, unless it is due to an injury, and occurs spontaneously within a few hours or days. People with unstable or high sugar levels are at risk of developing diabetic retinopathy.^19,20

3.5 Other eye disorders: Some rare/genetic disorders are night blindness, and colour blindness when one cannot distinguish usually red-green but sometimes blue-yellow shades.^19,21

Squint is an eye defect where eyes do not align properly and point in different directions, unable to look at the same spot at the same time. Exact cause is not known. It may lead to lazy eye as brain ignores signals from the affected eye.²²

“Dry eye” occurs when our tears are not able to lubricate the eyes adequately and worsens with age. It may also be due to an autoimmune disease or some medicine like antihistamine, or exposure to smoke or wind. Typical symptoms are stinging and burning, pink eye, continuous discomfort in the eye or watering of eyes.²³

“Watering eyes” is of concern only when too many tears flow nonstop with pain, change in vision, or a feeling of something in the eye that does not go away.²⁴

Some problems like twitching of eyelids, puffy eyes, and dark circles are due to lack of rest, stress, or inappropriate diet and lifestyle.^25,26

3.6 Digital eye strain - an emerging public health issue: More than 90% of digital device users experience eye strain. Most common ocular symptoms being tearing, tired eyes, dry eye and blurred vision, burning sensation, redness, and double vision. Common non-ocular symptoms include stiff neck, general fatigue, headache and backache. Blink rate comes down to 5-9 per minute as against the normal 10-16.^27-29

4. Protect your eyes from injury

4.1 Eye injuries: Possible injuries are: scratch on the eye (corneal abrasion) by any instrument or by a pet; foreign particle going into the eye; chemical injury due to acid or alkali or eye burns due to direct exposure to steam, fumes, or radiation; black eye or swelling due to any hit or cut on the eye. Common symptoms are pain in or behind the eye, spasm of the eyelids, continuous flow of tears from one eye, reduced or altered vision or even loss of sight, blood visible in the eye or bleeding around the eye.³⁰

4.2 First Aid and medical care: Immediately visit an “eye emergency” clinic but before that, simple steps of First Aid may help.^31-33

• Blinking can get rid of small dust or sand particles. 
• Open eyelids gently and rinse or bathe the eyes with clean water to flush out any foreign object. Pull upper eyelid over lower eyelid to brush away gently any foreign particle.
• In case of chemicals in the eye, immediately remove contact lens. Tilt the head to lower the affected eye, so that while bathing the eyes the diluted chemical liquid does not run over to the other eye or side of the face. After washing for 15-20 minutes, put a clean pad over the eye while taking the patient to the hospital.
• In case of cut, wound or puncture, do not rinse with water. Instead, gently place a protective cover like clean eye pad or wound dressing over the eye without pressing. 
• In case of a hit in the eye, gently apply a small cold pack or compress without applying pressure, to reduce pain and swelling. 

4.3 The Don’ts after injury: Avoid movement of head, don’t roll eyes, and don’t rub or touch them with finger or cotton swab. Don’t self-medicate.^31-33

5. Preventive measures for healthy eyes

5.1 Good hygiene practices like washing hands often, not rubbing the eyes and using clean towels will help prevent infections. ^10-13 

5.2 Strengthen your eyes: Some ways to relax and nurture the eyes are:^26,34-40

• Palming, by placing the hollow part of the palms gently on the closed eyes. Block out all light, sit comfortably, and concentrate on your respiration and relax with eyes closed for 5-10 minutes twice a day or several times for 1-2 minutes.^34,36-38   
• Lightly press the eyes with all four fingers together, hold for a few seconds and slowly let go. Blink and open eyes for a few seconds, repeat 5 times; mild massage of eyebrows with fingers also helps.^36-38
• Sunning with closed eyes, for 5 to 10 minutes early morning or evening when the sun is mild and not too hot.^34,36,37
• Eye movements up and down, and right and left, followed by eye ball rotation, focussing by changing focus between near and far, normal blinking every now and then, and slow blinking by looking straight at a blank wall^36-39.
• Gentle massage with vegetable or almond oil over dark circles, if any, just prior to bed time.²⁶
• Cold compress after eye exercises or when one feels strained. One may use cooled slices of cucumber or raw potato or tea bags.²⁶ Splashing of cold water over the eyelids, with mouth filled with water, preferably in the morning, will improve blood circulation.⁴⁰  
• Swimming, walking, yogasanas, and neck and shoulder exercises under guidance will improve circulation and nourish the eyes. 

5.3 Eye-friendly diet: A balanced diet rich in vitamins A, C, D & E, omega-3 fatty acids, and trace mineral zinc will keep eyes healthy. These are abundantly present in fresh fruits, vegetables, especially leafy greens and nuts and seeds^35,41-43

 6. Tips for eye care: it is never late to improve our vision

• Active lifestyle, sufficient rest, a balanced diet, adequate intake of water, correct posture of sitting upright, especially while using digital gadgets, regular exercise, personal hygiene, fresh air, and above all, a relaxed state of body and mind are the key to prevent eye problems.^{17,34-40,44-45}
• Get a comprehensive dilated eye examination every few years. For children, at 6 months of age, at 3 years, and then every year between 6 and 17 years old. For adults, once every 5-10 years under 40 years of age, every 2-4 years till 54 years, and more frequently as one ages. Early diagnosis is the only way to prevent blindness.^17,44,45
• Know your family history and risks, wear protective glasses where needed, pay immediate attention to visual changes and consult an eye doctor. People with myopia, diabetes, heart problems, or those who had a stroke, and users of contact lens should take extra care.^17,44 
• Practise 20-20-20 rule to prevent digital eye strain: Take a break every 20 minutes and look at something 20 feet away for 20 seconds. Download eye-care apps to remind you! Also take care of proper lighting to minimize glare and adjust the display settings of the digital gadgets.^46-48

References and Links:

1.      Sathya Sai Baba, Divine Discourse on “I and You are One”, Guru Purnima day, 5 July 2001, SSS volume 34, chapter 13, page 182 http://www.sssbpt.info/ssspeaks/volume34/sss34-13.pdf

2.      https://www.merckmanuals.com/home/eye-disorders/biology-of-the-eyes/structure-and-function-of-the-eyes

3.      Structure of eye : https://byjus.com/biology/structure-of-eye/

4.      https://kidshealth.org/en/kids/eyes.html

5.      20/20 vision: https://www.allaboutvision.com/en-in/eye-exam/2020-vision/

6.      20/10 vision: https://www.nvisioncenters.com/lasik/20-10-vision/

7.      Normal eye pressure: https://www.brightfocus.org/glaucoma/question/what-considered-normal-eye-pressure

8.      Study on intraocular pressure: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5957383/

9.      Eye infections: https://www.allaboutvision.com/en-in/conditions/eye-infections/

10.  Conjunctivitis & Prevention: https://www.mayoclinic.org/diseases-conditions/pink-eye/symptoms-causes/syc-20376355

11.  Pink eye & prevention: https://www.allaboutvision.com/en-in/conditions/conjunctivitis/

12.  Trachoma: https://www.who.int/news-room/fact-sheets/detail/trachoma

13.  All eye infections & Prevention: https://www.healthline.com/health/infected-eye;  https://www.healthline.com/health/eye-health/home-remedies-for-eye-infection#overview

14.  Refractive errors: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/refractive-errors

15.  https://www.who.int/news-room/q-a-detail/what-is-a-refractive-error

16.  Cataract: https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790

17.  Glaucoma: https://www.mayoclinic.org/diseases-conditions/glaucoma/symptoms-causes/syc-20372839

18.  https://www.glaucoma.org/gleams/what-are-the-symptoms-of-glaucoma.php

19.  Retinal disorders: https://www.ccteyes.com/retina-problems-warning-signs-you-may-have-a-retinal-disease/

20.  Floaters: https://www.brightfocus.org/macular/article/what-causes-eye-floaters

21.  Colour blindness: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/color-deficiency

22.  Squint & lazy eye: https://www.medicalnewstoday.com/articles/220429

23.  Dry eye: https://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/dry-eye

24.  Watering eyes: https://www.health.com/condition/eye-health/watery-eyes?slide=6f6f7ac5-f902-4822-ab25-fce2aad58c5a#6f6f7ac5-f902-4822-ab25-fce2aad58c5a

25.  Twitching: https://www.allaboutvision.com/en-in/conditions/eye-twitching/; 

26.  Dark circles: https://www.healthline.com/health/how-to-get-rid-of-dark-circles-permanently#remedies; https://www.mapsofindia.com/my-india/health/30-best-home-remedies-to-remove-dark-circles-naturally-and-permanently

27.  Coles-Brennan, C., Sulley, A., & Young, G. (2019), Management of digital eye strain, Clinical and Experimental Optometry, 102, 18-29.

28.  Muniraju, N. M.,  Amarnath, H. K., &  Ashwini, M. J.  (2018), A review on effects of electronic Gadgets on eye, Journal of Ayurveda Physicians & Surgeons, 5(1). 

29.  Digital eye strain: https://medpharm.co.za/eye-strain-the-new-affliction-of-the-digital-generation/

30.  Eye injuries: https://www.allaboutvision.com/en-in/conditions/eye-injuries/

31.  First aid tips: https://www.aao.org/eye-health/tips-prevention/injuries

32.  First aid tips: https://www.stjohn.org.nz/first-aid/first-aid-library/eye-injuries/

33.  Washing chemical in eye: https://www.mayoclinic.org/first-aid/first-aid-eye-emergency/basics/art-20056647

34.  Guide to eye exercises & Bates method: https://seeing.org/techniques/

35.  https://www.bateseyeexercises.com/basicInformation.php

36.  Eye exercises for perfect eyesight: https://eyecare.sriaurobindoashram.org/resources/School_For_Perfect_Eyesight.pdf

37.  Dr Agarwal eye care exercises: https://www.slideshare.net/elsavonlicy/agarwal-the-complete-book-of-eye-care

38.  Rejuvenating eye exercises: https://www.lenspure.com/articles/eye-exercises-alleviate-eye-strain

39.  Prevent eye strain:  https://www.healthline.com/health/eye-health/eye-exercises

40.  Splash eyes along with mouthful water: https://www.youtube.com/watch?v=gs-x4tNIGbw

41.  Nutritive diet for eyes: https://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition

42.  Eye friendly diet: https://www.allaboutvision.com/nutrition/nutrition_summary.htm; https://www.allaboutvision.com/en-in/conditions/cataracts/

43.  Importance of Zinc for vision: https://www.aoa.org/patients-and-public/caring-for-your-vision/diet-and-nutrition/zinc

44.  Protect eyes: https://www.allaboutvision.com/en-in/vision-by-age/ways-to-protect/

45.  Prevent blindness & care for infants: https://www.healthline.com/health/blindness

46.  Prevent digital eye strain: Follow 20-20-20 rule says a study; https://www.medicalnewstoday.com/articles/321536

47.  How to prevent eye strain from gadgets: https://gadgets.ndtv.com/laptops/features/how-to-prevent-eye-strain-when-using-a-computer-575879

48.  Prevent digital eye strain: https://www.mayoclinic.org/diseases-conditions/eyestrain/diagnosis-treatment/drc-20372403

 2. COVID-19 Anecdotes

#1. An inspiring experience from a patient of Practitioner ^{00512…Slovenia}

I am a nurse working in a Retirement Home in Slovenia and have been taking the remedy for Covid-19. On 27 March the first case of the virus appeared in the Home and promptly escalated, infecting 53 residents of which 30 succumbed within weeks. Soon, there was no nursing staff left to work with me! There was a total collapse of the Retirement Home. Five Slovenian health centres and three hospitals came to our rescue. Even medical and nursing students from two towns came to help. Unfortunately, some of them contracted the virus. I offered the Immunity Booster (which I had been taking) to everyone. Some of my colleagues accepted and all got rid of the virus quickly. The authorities at work, in spite of the dire situation, alas, rejected it.  As I was placed in the epicentre of the outbreak, I decided to stay away from my daughters, partner and loved ones and chose to lodge in a nearby hotel. It was very hard but I saw my family only over the phone for almost eight weeks. I had to work with doctors to visit all residents. From my hotel in the evening, I supervised and guided incoming medical staff by phone, text and video calls. I had to oversee their lodging needs such as food and bedding. It was hard, stressful, and exhausting and the schedule was gruelling.

All in all, quite an arduous and unforgettable experience but I survived and the credit goes to the Immunity Booster for protecting me and for supporting my health! As I write now and remember what all I went through, I feel grateful to the practitioner who I could call upon at any time to help me, the word ‘thank you” is just not enough “for everything you did! I love you”.

#2. The email response from an elderly American devotee