An Eye on Travel: An Overview of Travel-Related Ocular Complications

Document Type: Perspective

Authors

1 School of Medicine, National University of Ireland Galway, Ireland

2 School of Medicine, International Medical University, Kuala Lumpur, Malaysia

Abstract

Travellers are at risk of a diverse range of environmental and infectious conditions, some of which may affect the eyes and lead to blindness in severe cases. Travel-related ocular infections include onchocerciasis, leishmaniasis, cysticercosis, trachoma, dengue, loiasis, and leptospirosis. The travel medicine adviser should also recognise other hazards encountered during travel which may adversely affect the eye. These include recreational activities such as high altitude trekking, bungee jumping, skiing, scuba diving, and sun exposure. There is a subset of travellers who have underlying eye conditions, which predispose them to complications during international travel, including angle-closure glaucoma, and expansion of intraocular gas from previous vitreoretinal surgery. Contact lens wearers have a greater risk of ocular infection and corneal erosion during travel, especially where hygiene standards are low. Despite the susceptibility of the eye to infection, traumatic injury and environmental damage during international travel, this topic is not frequently discussed in the context of pre-travel consultations. Travel medicine professionals should have a reasonable knowledge of the major ocular risks associated with travel overseas.

Keywords


  1. Willman G, Ivanov I, Fischer M, et al. Effects on colour discrimination during long term exposure to high altitudes on Mt Everest. Br J Ophthalmol. 2010; 94(10):1393-1397. doi: 10.1136/bjo.2009.178491.
  2. Bosch M, Barthelmes D, Merz T, et al. High Incidence of optic disc swelling at very high altitudes. Arch Ophthalmol. 2008; 126(5):644-650. doi: 10.1001/archopht.126.5.644.
  3. Hassan H, Mariatos G, Papanikolaou T, et al. Ocular complications of bungee jumping. Clin Ophthalmol. 2012; 6:1619-1622. doi: 10.2147/OPTH.S33169.
  4. Van Rens E. Traumatic ocular haemorrhage related to bungee jumping. Br J Ophthalmol. 1994;78(12):948. doi: 10.1136/bjo.78.12.948.
  5. Yeoh R, Yeoh R, Singh M. Barotraumatic ocular haemorrhage sustained while scuba diving. Clin Experiment Ophthalmol. 2008;36(6):581-582. doi: 10.1111/j.1442-9071.2008.01835.x.
  6. Moran S, O’Donoghue E. Solar retinopathy secondary to sungazing. BMJ Case Rep. 2013:2013. doi: 10.1136/bcr-2012-008402.
  7. Turnbull A, Smith M, Ramchandani M. Angle-closure glaucoma on long-haul flights. JAMA Ophthalmol. 2014;132(12):1474-1475. doi: 10.1001/jamaophthalmol.2014.3501.
  8. Houston S, Graf J, Sharkey J. Commercial air travel after intraocular gas injection. Aviat Space Environ Med. 2012;83(8):809-810. doi: 10.3357/ASEM.3393.2012.
  9. Bauer I. Contact lens wearers’ experiences while trekking in the Khumbu region/Nepal: A cross-sectional survey. Travel Med Infec Dis. 2015;13(2):178-184. doi: 10.1016/j.tmaid.2014.12.005.
  10. Centers for Disease Control. Onchocerciasis. Available at: http://www.cdc.gov/parasites/onchocerciasis (accessed 12 May 2017).
  11. Lim WK, Mathur R, Koh A, et al. Ocular manifestations of dengue fever. Ophthalmology. 2004;111(11):2057-2064. doi: 10.1016/j.ophtha.2004.03.038.
  12. Mahendradas P, Avadhani K, Shetty R. Chikungunya and the eye: a review. J Ophthalmic Inflamm Infect. 2013;3(1):35. doi: 10.1186/1869-5760-3-35.
  13. Beare N, Taylor T, Harding S, et al. Malarial retinopathy: A newly established diagnostic sign in severe malaria. Am J Trop Med Hyg. 2006;75(5):790-797.
  14. Tan S, Kumar G, Surrun S, et al. Dengue maculopathy: A case report. Travel Med Infect Dis. 2007;5(1):62-63. doi: 10.1016/j.tmaid.2006.01.017.
  15. Schneider C, Adamcova M, Jick S, et al. Use of anti-malarial drugs and the risk of developing eye disorders. Travel Med Infect Dis. 2014;12(1):40-47. doi: 10.1016/j.tmaid.2013.07.007.
  16. Morris D, Mella S, Depla D. Eye problems on expeditions. Travel Med Infect Dis. 2013;11(3):152-158. doi: 10.1016/j.tmaid.2013.03.009.
  17. Guly H. Snow blindness and other eye problems during the heroic age of Antarctic exploration. Wilderness Environ Med. 2012; 23(1):77-82. doi: 10.1016/j.wem.2011.10.006.
  18. Izadi M, Pourazizi M, Alemzadeh-Ansari M-H. Ocular problems in high-altitude traveling: a review with focus on management. Int J Travel Med Glob Health. 2017;5(2):41-45. doi: 10.15171/ijtmgh.2017.09.
  19. Tingay DG1, Tsimnadis P, Basnyat B. A blurred view from Everest. Lancet. 2003;362(9400):1978. doi: 10.1016/S0140-6736(03)15017-9.
  20. Morris D, Somner J, Donald M, et al. The eye at altitude. Adv Exp Med Biol. 2006;588:249-270. doi: 10.1007/978-0-387-34817-9_21.
  21. Mader T, Tabin G. Going to high altitude with preexisting ocular conditions. High Alt Med Biol. 2003; 4(4):419-430. doi: 10.1089/152702903322616173.
  22. Mieske K, Flaherty G, O'Brien T. Journeys to high altitude - risks and recommendations for travelers with pre-existing medical conditions. J Travel Med. 2010;17(1):48-62. doi: 10.1111/j.1708-8305.2009.00369.x.
  23. Jain B, Talbot E. Bungee jumping and intraocular haemorrhage. Br J Ophthalmol. 1994;78(3):236-237. doi: 10.1136/bjo.78.3.236.
  24. Aldave A, Gertner G, Davis G, et al. Bungee cord-associated ocular trauma. Ophthalmology. 2001;108(4):788-792. doi: 10.1016/S0161-6420(00)00656-4.
  25. Muzychuk A, Adatia F, Ford B, et al. Commercial air travel with a small intravitreous gas bubble. Arch Ophthalmol. 2011;129(6):805-820. doi: 10.1001/archophthalmol.2011.144.
  26. Weissman BA, Mondino BJ. Risk factors for contact lens associated microbial keratitis. Cont Lens Anterior Eye. 2002;25(1):3-9. doi: 0.1016/S1367-0484(01)00002-9.