Protect eyes at higher elevation

Ophthalmologist Dr. Nathan Hamburger (right) works with patient Rusty Kossler at the Helm Eye Center in Steamboat Springs. In addition to checking vision, Hamburger screens patients’ eyes for damage from UV rays.

As the father of three children aged 10 and under, Dr. Nathan Hamburger that keeping active kids dressed in protective sunglasses is a tough job. His family begins a walk with sunscreen applied and hats and sunglasses, and halfway through the walk he notices that a few of the children’s sunglasses have disappeared.

But as a physician and busy ophthalmologist in Steamboat Springs, Hamburger also knows how important it is for people who recreate at higher altitudes to protect their eyes from short- and long-term damage by blocking as much of the sun’s ultraviolet rays as possible. He said eye conditions that affect people who spend a lot of time outdoors without sunglasses can develop earlier in life in higher elevations, such as Routt County.

The best cure for eye damage is prevention. Hamburger said the main causes of increased eye problems at higher altitudes are UV exposure and dry air.

“Sunglasses aren’t a bad idea for babies. The sooner the better because it’s all about cumulative exposure,” says Hamburger, 40, who also worked as an ophthalmologist at a lower elevation in Michigan. occur because the UV is more intense.”

The Hamburger family, from Routt County, which includes father, Nathan, an ophthalmologist, and mother, Allison, a physician assistant, try to keep sunscreen, hats and sunglasses on their three children during walks. Courtesy photo

Wes Richey, director of Steamboat Resort Ski Patrol, which has been on patrol for 42 years, said skiers at the resort are generally well prepared, but visitors sometimes lose sunglasses and googles. So, patrol personnel try to keep loaner glasses handy at the patrol stations in the higher mountains. Safety glasses are also highly recommended to protect against hazards such as tree branches and ski poles. Hamburger said he treated a father who suffered an eye injury.

One eye condition Hamburger sees almost every day is pterygium, also known as surfer’s eye. Pterygium is a growth of pink, fleshy tissue on the conjunctiva (the clear covering over the white part of the eye) caused by exposure to UV light. This tissue takes a long time to grow, usually starting on the side of the eye closest to the nose and growing toward the pupillary area, but Hamburger sees the condition during examinations of patients as young as their late twenties.

Pterygium develops in people who spend a lot of time outdoors without sunglasses, from farmers to mountain bikers to old skiers. The doctor said the condition is irritating to the eye and can cause blurred vision or astigmatism, which may require corrective lenses or replacement.

When pterygium is problematic, it can be surgically removed and covered with a conjunctiva chart, but the condition can recur after surgery. Hamburger said he performs up to 10 of those surgeries each year.

The second most common high-altitude problem that Hamburger helps identify is facial skin cancer, especially on the lower eyelids. Other common areas for skin cancer on the face and head include the nose, tops of the ears, and scalp for people with shorter or less hair. The cancer ranges from basal cell carcinoma that is unlikely to spread but can cause local damage to squamous cell carcinoma that can spread to melanoma, which is more severe and can spread to other parts of the body.

The ophthalmologist can excise skin cancer from the lower eyelid, or have more extensive work, including reconstruction, performed by an eyelid plastic surgeon in Denver.

The third most common condition Hamburger diagnoses in the lower humidity mountain climate is dry eye syndrome. The symptoms include a burning sensation, foreign body sensation, blurred vision, eye strain and redness. Lubricating eye drops are an important treatment, followed by staying hydrated and eye protection, as well as “some evidence that omega-3 fatty acids may be helpful,” he said.

Patients with dry eye syndrome can use preservative-free lubricant drops up to four to six times a day and even more often preservative-free drops.

“Most people do one to two drops a day and ask me why it doesn’t work,” says Hamburger, an ophthalmologist for 13 years and working locally at Helm Eye Center for nearly four years.

Local residents may also suffer from contact lens-related problems and irritation from dehydration, so the doctor advises reducing the length of time you wear contact lenses.

Hamburger said he sees “many” visitors to the ski resort with a painful, temporary eye condition called photokeratitis, which is caused by exposure to UV rays or acute dryness from wind. The condition can be compared to sunburn or windburn on the corneas.

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