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Should We Treat Our Eyes During a Panic?
Coronavirus and others
An Interview with Doctor Arthur Benjamin
– Let’s say I’m going to see a doctor. Do I need to wear a mask?
– Depending on what country you are in. In Asia, it is considered impolite to go without a mask. Not so much to protect yourself, but others from yourself. If a person is infected and wears a mask, then they are less dangerous. The problem is that the masks do not fit tightly on the face. If you are wearing a mask and communicate with an infected person who is not wearing a mask, then there is a risk.
– For example, I have dry eyes, and I also caught a cold. I watched a lot of TV, and now I’m worried: what if I have this? I’m sitting at home, rubbing my eyes, and I don’t know whether to go to the doctor. What is the incubation period?
– It is believed that in 14 days the virus will manifest itself clinically. If there is nothing during this time, then you can go. Much is still unknown, but there are already companies that will soon begin testing the vaccine. It will take another year or two. Now tobacco companies have been revived, because it turns out that tobacco plants can be used to grow vaccines. So in the future tobacco companies will become partly pharmaceutical.
– Has your practice changed in light of events?
– There are no careless people in our office. We have up to forty patients a day; someone may come with mild symptoms of a cold. By the way, when you see someone coughing or sneezing on the street, this is most likely a common cold or flu. Vaccination prepares the body for the battle with all sorts of viruses. Please take the flu vaccine every year, which continues to kill more people than the coronavirus. Every half an hour we wipe the entire office: waiting rooms, door handles, iPads, and of course – equipment, i.e. everything that people touch. We always do this – epidemic or not, winter or summer, we wipe the apparatus, let alone wash our hands. But now all this is being done even more intensively. The office is constantly being disinfected.
– What other influence did the virus have on everyday medicine?
– Many doctors find it more difficult to fulfill their mission, since there is a shortage of necessities. Doctors sterilize their hands with a special solution, and now even this solution is becoming difficult to buy. Due to the quarantine in China, many parts of the Chinese industry have stopped operating, and this has affected medical equipment in the USA. We have enough operational stocks, sanitizers, etc. in our office. But at our Surgical Center we are asked not to waste masks, gloves, etc. Deficiency can also affect the lenses. Last Thursday I had an operation that few ophthalmologists perform, and I needed a rarely used lens. When they gave me this lens, they said: “Doctor, congratulations, this is the last one!” I was lucky, because there are simply no more lenses of this type and diopter.
– Well, lucky not only for you.
– It was an emergency operation: phacolytic glaucoma. The patient had sudden pain in the eye, and a sharp deterioration in vision. As fate would have it, this often happens on Friday, but Monday morning she was already in our office. The cataract began to decompose and leak, intraocular pressure jumped to 70 (normal pressure being 10-20), I almost could not see the eye. In such a situation, the doctor must lower the pressure with drops or tablets, relieve inflammation in the eye and immediately operate. This is the only way to save the eye. And when we started this operation, we didn’t even have time to debate, this lens or that lens. If there weren’t a lens that was ideal for her situation, I would have done it with another – with some fine-tuning, but this would greatly complicate the procedure. Instead of an hour and a half, it would have lasted four hours.
– And it is precisely such options that you are likely to face now?
– In a few weeks I have another operation planned with a patient who had cataracts 15 years ago, but now has pseudoexfoliation syndrome. The lens is loose, and it will need to be replaced with a new one. And again we may need a certain lens, but it may not be available. The fact is that the source material, packaging – all this often has Chinese origins. Say the lens is made in the Netherlands, but the raw materials or packaging is Chinese. Up to 90% of everything that is produced in the world, in one way or another, has a relationship to China.
– Is this new virus portable on such surfaces?
– We have to remember that the virus enters the body only through mucous membranes. If there are no cuts, then the virus cannot get through the skin. Viruses are not living things, but some kind of structure between living and nonliving. It is DNA or RNA in a protein envelope that is introduced into the cell to produce its copies. The cell then breaks, and all the viruses that were copied in it spill out and invade new cells. The virus itself cannot be active outside this cell factory.
– But can it survive outside the mucous membrane?
– The infectious ability of the virus, i.e. virulence, is how long it can “survive” on the surfaces: buttons in the elevator, door handles, or telephones. How does it happen? Someone sneezes, out of habit puts a finger to their nose, and with the same finger presses the elevator button. Half an hour later, some poor fellow presses the same button, after which he rubs his eye.
– Because he, for example, has dry eye syndrome, and is afraid to go to the ophthalmologist.
– So the virus moves from an inanimate surface to the mucous membrane, where it immediately penetrates the cell. This is not a “lone wolf”, there are millions of them. While everyone is so passionate about the coronavirus, they forget about the rest. Adenovirus, which causes the common cold, is highly contagious and can affect different organs. A man with conjunctivitis comes to us, I ask: “Have you had to fly lately?” “Oh, how did you guess?” But guessing was easy. The plane is hermetically sealed, the same air circulates, and the surfaces are not cleaned. As soon as someone leaves a seat, another person is already sitting in it. From the point of view of infection, the aircraft is an ideal place. In people with conjunctivitis, so to speak, air travel is usually present in the medical history. Other effects of adenovirus – someone loses their voice, someone starts having bronchitis, another has gastritis, a third has colitis, and someone has pneumonia. The virus is transmitted from one system to another: two weeks ago you had bronchitis, and now conjunctivitis.
– Do vaccinations help?
– Sometimes you hear: “I got mine last year, and still got sick! ” Yes, you got the flu shot, but you caught a cold. You sneezed, coughed, and in three days you felt better. If you didn’t get the vaccine, you would get the same adenovirus, but the disease would be more serious since your immune system was not activated by the vaccine. And if you had also contracted the flu, then there would have been severe chills, an overwhelming temperature, pneumonia or pneumonitis, from which 2% of people die. Therefore, “vaccinations do not work” is the argument of ignorant people.
– How to avoid the coronavirus without ignoring eye diseases?
– To reduce the chances you need to wash your hands often with hot water and soap, for at least 20 seconds. If this is not possible, then at least try not to touch your (or someone else’s) face, and not rub your eyes. Plus some basic care. My family and I are soon flying to Africa. I take wipes with me that kill 99.99% of all viruses and bacteria that we use to disinfect seats on the plane, door handles, tables, all kinds of buttons, etc.
– And where can ordinary people buy such magic wipes?
– Ordinary people have already bought the wipes in such quantities that now you can’t find them anywhere, and are 10 times more expensive. Amazon has a shortage of masks, gloves, and wipes. I could not even order an extra hand sanitizer
– Doesn’t it seem to you that in the wake of the panic, many people won’t be leaving their home at all, exacerbating cataracts, glaucoma, pseudoexfoliation syndrome, or even being afraid to order necessary glasses for a long time?
– Glasses, by the way, also protect against airborne infection. Life does not stop, and you need to go to the doctors. Firstly, the scale of this panic is unfounded. Secondly, we take all measures in our office: the air is filtered, and we constantly wipe everything, so it’s safer than at home.
Vadim Avrukin
