Yoga teacher Jane has a niggling problem - constant dry eyes. She does not have the time to apply eye drops regularly due to her busy schedule.
She wanted to find out if exercise, drinking more water, and taking more flax seed and fish would help.
Another patient, Albert, who is in his 60s, has cataracts and age-related macular degeneration (AMD). He always has questions about exercise and food, and how they would impact his eye health.
It is interesting that the yearning for a more holistic approach to medicine continues to rise. Nutrition, yoga, meditation, detox diets and fruit cleanses have been gaining in popularity.
As ophthalmologists, we are usually fixated on examining the eyes and assessing patients for conditions such as refractive errors, cataracts, glaucoma, retinal disorders and eyelid diseases.
While diet and exercise cannot replace regular eye checks for maintaining eye health, they are topics that many patients are interested in but not adequately informed about.
An online search about nutrition and eye health found more than 10 million results, while a search on exercise and eye health produced more than 11 million results.
What are the websites saying and is the information reliable?
I became more attentive to questions from patients, which I may have brushed aside in the past. I realised they were actually asking: "Is there anything I can or cannot eat in relation to my eye problem?" or "Can I do any exercises to improve my droopy eyelids, shortsightedness or lao hua yan (presbyopia)?"
The good news is that the same diet that helps our body is probably also good for our eyes.
Leafy green vegetables, like kale, are high in lutein and zeaxanthin, two nutrients found in healthy eyes that are believed to lower our risk for AMD and cataracts.
Dark green or brightly-coloured fruit and vegetables contain plenty of antioxidants, which protect our eyes by reducing damage related to free radicals that can cause age-related eye diseases.
Oranges and other citrus fruit are high in vitamin C, an antioxidant that also plays a role in eye health. Peaches, red peppers and tomatoes offer these benefits too.
Vitamin A, vital for healthy vision, is found in orange and yellow vegetables such as carrots and squash. Legumes like kidney beans and peanuts have zinc, an essential trace mineral found in high concentrations in the eyes.
Eating fish rich in omega-3 fatty acids, such as salmon, tuna, mackerel and sardines, also helps lower the risk of AMD.
Omega-3 fatty acids are rich in docosahexaenoic acid (DHA), which is important for eye health and visual function.
People with dry-eye syndrome - when the eyes do not produce enough tears or when tears evaporate too quickly - may benefit from a diet rich in omega-3 fatty acids.
If a person has or is at risk of AMD, vitamin supplements can help to slow down or keep it from getting worse. These are Areds formula supplements, named after the Age-Related Eye Disease Studies that have tested and finetuned the formula.
Consuming eye vitamins and vision supplements is generally safe. But patients should first check with their doctor before doing so, especially if they are smokers or on medication, or are pregnant or nursing.
AVOID EYE EXERCISES IF...
Many programmes claim to strengthen eye muscles, improve focus and eye movements, and stimulate the vision centre of the brain. There may be little harm in trying them, though there is no scientific proof that these exercises will improve one's vision. Most eyecare professionals are sceptical of eye exercises that claim to help you "throw away your glasses".
Avoid these exercises if you have eye conditions like cataracts, blindness in one or both eyes, or a recovering cornea injury.
Recently, Jane came to the clinic for a check-up, visibly happier than she was six months ago.
Besides using eye drops in between yoga classes, she was drinking more water and taking more food rich in omega-3 fatty acids and antioxidants. She felt there was some improvement in her dry eyes.
Meanwhile, Albert also reported that he felt his vision and overall eye health had stabilised after eating more fruit and vegetables, as well as Areds supplements.
He had also started doing eye exercises that he saw online and said they helped his eyes focus better and tire less easily.
Whether these effects are physiological or psychological, one may never know. However, the adage "you are what you eat" rings true for many aspects of health, including that of the eyes.
And even as we continue our rapid pace of sub-specialisation in medicine, nothing can replace a positive, healthy lifestyle that includes regular exercise and a balanced diet.
•Dr Stephanie Ming Young is an associate consultant at the National University Hospital Eye Surgery Centre with an interest in functional and aesthetic oculoplastic surgery of the eyelids, orbits and tear system, as well as general ophthalmology.