Haze and Eye Health

Eye Health

By Dr S.S. Gill

Ipoh Echo’s EYE HEALTH series continues with Consultant Eye Surgeon Dr S.S. GILL talking to us about AIR POLLUTION, our eyes and general health implications.

It is undeniable that the current haze situation has reached catastrophic proportions regionally.

Sadly, the long-term HEALTH IMPLICATIONS of air pollution have not been highlighted enough. Most people have been looking at the API readings to determine if they would avoid outdoor activities, with children enjoying the unexpected school holidays (my newly coined word is “haze holiday”) with orders to stay indoors. So, does the haze affect the eyes and if yes, then how?

The American Academy of Ophthalmology reported a study that showed a link between air pollution and dry eye syndrome. Dry Eye Syndrome is very troublesome and does reduce the quality of life of a person. It mainly affects people in the age group above 40 years of age. If you already suffer from Dry Eyes, then you can expect it to worsen when you are exposed to such pollutants. Air pollution in itself causes eye irritation, acute (or subacute) corneal (superficial keratitis) and conjunctival inflammation (conjunctivitis) by altering the pH of the tears.


– Discomfort or stinging                – Redness            – Photophobia in some cases

– Tearing (lacrimation)                  – Dryness             – Inability to tolerate contact lens wear


  1. Keep track of latest air quality updates regularly to plan your activities.
  2. Avoid OUTDOOR sports and exercises.
  3. Keep windows and doors closed.
  4. Use an air purifier if you have one. Keep the air conditioner running.
  5. Drink lots of water; eat lots of fresh fruits and vegetables.


  • Flush the eyes out with artificial tear lubricant eye drops if they get irritated.
  • Avoid contact lens wear if it is too hazy.
  • Minimise exposure to the irritants by modifying your activities appropriately.
  • See an eye doctor if the symptoms persist.

Knowing about air quality is important. How is air quality measured? Air quality in Malaysia is reported as API (Air Pollution Index) and this measures carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3) and PM10 (particles that are 10 micrometers or less in width. The gold standard today is PSI (Pollutant Standards Index) which also measures PM2.5 or particles that are 2.5 micrometers in width. Why is it important to measure the particles that measure 2.5 micrometers? The World Health Organisation (WHO) says that such particles affect more people worldwide than any other pollutant. These smaller particles of 2.5 micrometer don’t get filtered and affect the respiratory and cardiovascular systems because they can penetrate the deepest parts of the lungs where gas exchange into blood occurs. In contrast, the larger particles of 10 micrometers just irritate the eyes, nose, and throat but eventually mostly get filtered off.

The IARC (International Agency for Research on Cancer) under WHO, after much research  have classified outdoor air pollution as a carcinogen (cancer-causing). I shudder when I think of the fact that every person and creature has been exposed to large quantities of all of these unnecessary avoidable pollutants 24-hours a day, to various levels for the last 3 months!

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