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Eef@online seriesTranslated from the original version in Dutch ‘Quarantaine-Myopie’

In Dutch we have a saying: ‘Oost-West – Thuis-Best’ – meaning there is nothing quite like home. As an experienced ‘home-worker’ the pros and cons of working from home are not new to me. But the latter (the cons) become extra clear in the current home-quarantine situation. Or as one of my neighbors with small kids exclaimed yesterday: ‘If I could have explained my idea of personal hell before last week, then no sport to watch, no gym, no pub and 2 kids at home all day - comes pretty close to it’.

Pretty much every news item these days is related to the topic ‘virus’. In our profession as eye care providers we are typically mostly worried about cornea-viruses, but that is different now.

At War

While we seem to be at war with a virus in the world-wide pandemic, it is weird to realize we are at war with a non-living creature. Viruses are pretty much non-living packages of DNA; they cannot live outside of a living cell. So the virus invades our cells, uses it – and goes on to the next cell. It cannot survive without ‘us’ basically. That is why the transmission of this virus is mostly via a direct way – e.g. via droplets that are sneezed or coughed on to the next person directly.

These are special times. Not only is there fear, worry and uncertainty, but life has become somewhat more challenging too when it comes to our voluntary or involuntary quarantine (depending on where you live),and it can take its toll. I am used to working from home, so that doesn’t change too much. But with the kids at home – things are surely different. Although not the biggest of our problems right now, this brings  up a new phenomenon: how to stay healthy in a time of a (partial) lockdown: the potential of an increase in ‘quarantine-myopia’.

Digital Pandemic

There is a lot of information out there and we have to be careful not to end up in a digital pandemic. A pandemic includes a disease that is new to the population, something that infects people and causes symptoms – and something that easily spreads. It appears that some of this is happening online in the wake of the real pandemic. In that ‘digital market’ we have to be careful about ‘what to buy’: how reliable is it? A Spanish group started the website ‘Maldito Bulo’ – which easily translates into ‘fake news’ or something related to the faeces of cows and buffalos. No, gargling with saltwater or vinegar cannot eliminate coronavirus, a rumour that spread at the speed of the virus itself over the internet last week.

What has social detachment to do with retinal detachment? At first sight (no pun intended) nothing, but if you look closer, these two can actually be connected in this corona-reality. Our government has summoned citizens to practice social distancing, and to keep 1.5-meter distance. Literally. And in the Netherlands you are not allowed to be together with more than three people (except households) at the same time, at the risk of a fine of €400. This even counts for birthdays and other parties. We have to get used to that for the foreseeing future, with an unknown effect on our social lives and potentially with the risk on social detachment, especially for some of the elderly in our community.


We were just faced with a significant extension of the Corona-measures in our part of the world, which means we are spending way more time together as a family coming weeks. Let’s take the time to combine ‘family’ and ‘extension’ here. ‘Extension’ – quite literally – refers to myopia: axial myopia per definition is just that: an eye length above the norm and too long for the refractive power of the eye’s optical system.

What day this is? This is I-lost-count-of-the-quarantine-day. But we are somewhere in week four of homeschooling. The idea that my kids get on their bikes to their respective schools is a distant memory by now. The teens have locked themselves up in their rooms for the remainder of the day. I have to say, the way they respond to this crisis is impressive. They work; they work hard – and stay up to speed with what the schools dictate. Big thumbs up to the schools as well. This is a Guinness-book ‘turning-physical-schoolinginto-digital-schooling’ record. An achievement that makes me proud: of my kids and the system.

Vision is a beautiful thing. It sounds complex, how our optical system works. And it is. The first part is pretty easy to understand: in an ideal world the focal point of the eye is positioned where the retina is. If the focal point is slightly behind the retina, it’s called hyperopia and if it is in front – its myopia.

It gets slightly more complex when dealing with astigmatism. Because one meridian of the optical system of the eye is different from the other meridian – typically 90 degrees apart – the two focal points are at a different distance from the retina. We can still pretty easily correct this with glasses that have two focal points. Even with contact lenses, there is no ‘stigma’ anymore when it comes to astigmatism. About 1/3 of the people needing an optical correction has astigmatism, and most of that group within the lens wearing population is served with a so called ‘toric lens’ to correct that.

Songwriter Harlan Howard coined the phrase “Three chords and the truth” to describe the necessary ingredients for country music. He stated that you only need three chords to make country music, which shows the basics of the music style and music in general in a simple way.


While the terrible disease keeps spreading, it appears there is a sparkle of light in some parts of the world. It isn’t gone by any means and although it is too soon to draw final conclusions, it appears that in the Netherlands at least we seem to have reached some kind of plateau. That is what they have been calling #flatteningthecurve. We can only hope that this is true and that the rest of the world will follow soon.



This column over the last couple of weeks has covered topics on eyecare and contact lens related topics in COVID-19 times. Sometimes the link between the two was subtle, in others it was quite directly related. This topic is 100% ‘on-topic’. I never seriously considered telemedicine to be honest, until now.


Granted, the US is way ahead of Europe in this regard. Typically, distances are much smaller here. I was following a live webinar recently by the Scleral Lens Education Society – an excellent resource for everything you need to know about scleral lenses by the way. John Gelles from the CLEI Center for Keratoconus in Teaneck New Jersey, Marcus Noyes from the University of IOWA and Clarke Newman from Plaza Vision Center in Dallas, Texas hosted a fantastic, clinically relevant and to-the-point panel discussion on the topic. To illustrate the point above: Marcus mentioned that some of their patients ‘called in’ because they had a six-hour drive ahead of them, to come to their clinic. Six-hour drive? From Amsterdam, if you drive six hours you are not only in a different country: you are in the next country after that.