Digital media has increased the accessibility of health information, empowering patients to take a more active role in their care. However, it also facilitates the spread of misinformation, which can lead to self-diagnosis and inappropriate treatments. Though eyecare myths have existed for years, the digital age is presenting new challenges in addressing them.
Misinformation is often spread due to a combination of factors, such as bias, lack of knowledge, or emotional appeal. In some cases, it stems from misunderstandings or limited information, while in others, it is fueled by sensationalism or deliberate manipulation for personal or political gain.
Understanding these driving factors can help evaluate and distinguish reliable information and misinformation.
The role of social media in misinformation
Though studies specifically examining social media and eyecare misinformation are limited, some notable research exists. For example, Sampige et al. analyzed 723 ophthalmology-related videos posted on TikTok from April 16 to May 22, 2023, which generated 3.8 billion views.1
Of these, 55% were created by non-healthcare providers and 39 (5.4%) contained misinformation on topics ranging from dry eye to blepharoplasty and trabeculectomy. Additionally, 15% of the top 20 most-liked #EyeHealth hashtag videos in August 2023 contained misinformation, showing an increase from earlier searches.1
This study underscores the growing influence of social media in the eyecare field, demonstrating both its potential as a tool for reaching more patients while also revealing the prevalence of misinformation. It identifies the types of videos that engaged viewers the most—educational videos were the most bookmarked, while patient experiences received the highest number of likes and comments.1
It is essential for eyecare providers to actively participate, whether by enhancing their professional online presence or, more importantly, equipping patients with the skills to navigate digital media and distinguish reliable information from misinformation.
Examining the top 10 vision myths
There are basic beliefs that directly diminish eye health by dissuading patients from scheduling the appropriate exams with an eyecare professional.
Myth #1: Patients don't need regular eye exams if they have good vision.
The “if it ain’t broke, don’t fix it” mentality is all too common, but visual acuity is just one aspect of the vision system. Comprehensive eye exams identify sight-threatening conditions that may be asymptomatic initially, which is key to preserving vision. They also uncover signs of systemic conditions (i.e., high blood pressure and diabetes), leading to earlier diagnosis and better health outcomes.
Pearl: The AOA website outlines what is in a comprehensive exam and why they are important.
Myth #2: Online eye exams are sufficient.
Online eye exams are plentiful and offer a convenient, affordable, and increasingly popular option, but their limited scope cannot fully assess overall eye health. This can lead to a false sense of security and, in many cases, cause more harm than good.
In contrast, in-person comprehensive eye exams provide personalized care that meets the standard of practice, leading to better-informed patients with improved overall vision and health.
Pearl: AOA’s helpful infographic compares online eye tests to comprehensive exams.
Myth #3: Eating carrots can improve vision.
Interestingly, this myth originates from World War II and an earlier era of misinformation spread. A British propaganda campaign promoted that eating carrots helped pilots spot enemy aircraft at night to disguise a newly developed, highly effective radar technology, which was kept secret from the public.2
Carrots are a good source of vitamin A (in the form of beta-carotene), which supports eye health and can help protect against or slow the progression of conditions like age-related macular degeneration.
However, carrots will not correct refractive errors or reverse damage, and consuming too much can be damaging. It is important for patients to be familiar with the recommended dietary allowances (RDA) of vitamin A as well as other main dietary sources:
Table 1: RDA of vitamin A, by age:3,4
- *According to the Food and Nutrition Board at the National Academies of Sciences
- **750 and 1,200mcg RAE during pregnancy and lactation, respectively
- ***770 and 1,300mcg RAE during pregnancy and lactation, respectively
| Age | Male | Female | Upper Limit* |
|---|---|---|---|
| Birth to 6 Months | 400mcg RAE | 400mcg RAE | 600mcg RAE |
| 7 to 12 Months | 500mcg RAE | 500mcg RAE | 600mcg RAE |
| 1 to 3 Years | 300mcg RAE | 300mcg RAE | 600mcg RAE |
| 4 to 8 Years | 400mcg RAE | 400mcg RAE | 900mcg RAE |
| 9 to 13 Years | 600mcg RAE | 600mcg RAE | 1,700mcg RAE |
| 14 to 18 Years | 900mcg RAE | 700mcg RAE** | 2,800mcg RAE |
| 19 to 50 Years | 900mcg RAE | 700mcg RAE*** | 3,000mcg RAE |
| 50+ Years | 900mcg RAE | 700mcg RAE | 3,000mcg RAE |
Table 1: Adapted from the National Institutes of Health.
Table 2: Select foods with vitamin A levels above 100mcg RAE per serving.4
| Food | Mcg RAE/Serving | % Daily Value |
|---|---|---|
| Beef liver, pan fried, 3 oz | 6,582 | 731 |
| 1 sweet potato, baked in skin | 1,403 | 156 |
| Spinach, frozen, boiled, ½ cup | 573 | 64 |
| 1 piece pumpkin pie | 488 | 54 |
| Carrots, raw, ½ cup | 459 | 51 |
| Herring, Atlantic, pickled, 3 oz | 219 | 24 |
| French vanilla soft serve ice cream, ⅔ cup | 185 | 21 |
| Skim milk with added vit A and vit D, 1 cup | 149 | 17 |
| Cantaloupe, raw, ½ cup | 135 | 15 |
| Cheese, ricotta, part skim, ½ cup | 133 | 15 |
| Peppers, sweet, red, raw, ½ cup | 117 | 13 |
| Mangos, raw, 1 whole | 112 | 12 |
Table 2: Adapted from the National Institutes of Health.
Myth #4: Eye exercises can replace corrective lenses.
Healing eyesight naturally is widely discussed on social media. Patients must understand that corrective lenses treat refractive errors (i.e., myopia, hyperopia, astigmatism), which result from a combination of factors, including the shape of the cornea, the lens, and axial length, which eye exercises can’t change.
Eye exercises can strengthen the eye muscles, improve binocularity, enhance accommodation, and treat issues like eye fatigue and coordination.
Myth #5: If I wear glasses, I will become more dependent on them.
Introducing glasses to most patients can be a challenge and is often met with reluctance. We need to make sure patients understand that wearing glasses does not lead to "dependency;" they are a non-invasive solution for refractive errors that improve your vision without affecting the underlying structure of your eyes.
Glasses simply enhance vision while wearing them, and eyesight returns to its previous state once they are removed. Often, the clarity provided by a new prescription makes you realize just how blurry your vision had been before.
Pearl: The National Eye Institute (NEI) has great patient resources about refractive errors.
Myth #6: Sitting too close to the TV will make my eyesight worse.
In my experience, parents often ask this question in front of their children to emphasize a point. While sitting too close to the TV will not permanently damage your eyesight, it is a habit worth being mindful of. Some people sit close to the screen because they have difficulty seeing from a distance and may need corrective lenses.
For others, digital eye strain can lead to ocular strain, discomfort, headaches, and/or blurred vision. Remember the 20-20-20 rule, and to ensure proper lighting and distance from the screen.
Myth #7: Myopia progression is determined solely by genetics.
The prevalence of myopia is rising, and while patients are becoming more aware, in-office education and access to reliable information on risk factors as well as the latest research and treatment options, is more crucial than ever.
- Age: Myopia onset at a young age is the highest independent risk
- Ethnicity: East Asian > Caucasian > African
- Environmental: Too much time indoors
- 76 minutes a day outdoors is associated with a 50% reduction in myopia incidence.6
- Parental myopia: Increased if both parents are myopic
The National Institutes of Health (NIH) recently produced a consensus study report detailing the latest information on myopia prevalence and progression, diagnostic testing, and treatment options. A key finding is that environmental factors play a larger role in myopia progression than genetics.7
Specifically, increased time spent outdoors is strongly correlated to lower risk of myopia onset; conversely, data on the correlation with near work is less consistent.7 Further, there is not enough data to determine if electronic device use increases myopia risk beyond other near-work activities.
However, electronic devices do contribute to children spending less time outdoors and more time on close-up tasks for extended periods, often starting at younger ages.7
For more information on educating patients and parents about myopia and myopia control, check out The Myopia Talk: How To Craft Patient Communication with Parents/Guardians!
Myth #8: Contacts can disappear behind the eyes.
This fear often makes people hesitant to try contact lenses. With education and reassurance, they typically become more comfortable. Using diagrams or showing the inferior fornix while explaining that the palpebral conjunctiva forms a complete barrier around the eye, preventing anything from getting behind it, often helps ease their concerns.
Myth #9: It's okay to swim while wearing soft contact lenses.
This common misconception is challenging to address. People routinely swim wearing their contact lenses too often. Many have done it, almost all have known someone who has, without experiencing problems. However, it’s important for patients to understand the severity of potential infections, although relatively rare.
Water (i.e., pools, lakes, oceans, hot tubs) can introduce bacteria and other harmful microorganisms into the eyes. Contact lens wear, regardless of its modality (monthly, biweekly, daily), prolongs eye exposure, raising the risk of serious eye infections. Therefore, they should not be worn while swimming.
Myth #10: It’s fine to keep my contact lenses in while I sleep.
Complications from sleeping in contact lenses are frequently seen in optometric practices, including giant papillary conjunctivitis (GPC), neovascularization, subepithelial infiltrates, and corneal ulcers.
Although it can feel like an uphill struggle, especially since patients may not experience symptoms right away, educating them about the risks and reasons behind the harm caused by sleeping in contact lenses is a vital step forward.
It’s essential for patients to understand that contact lenses limit the oxygen supply to the cornea, which can compromise eye health and lead to serious problems. Even lenses designed for 30-day continuous wear can still cause issues and should be removed nightly.
It's also important to emphasize that extended lens wear, coupled with poor lens hygiene, can lead to GPC, a condition that causes significant symptoms and often prevents patients from wearing contact lenses for extended periods of time—or even permanently—if left untreated.
Bonus Myth: Cataracts can be removed with LASIK.
In the realm of refractive surgery, the public seems to hold one major misconception—cataracts can be removed with a laser procedure. Different conditions and types of ocular surgery are easily confused by patients, in this case, primary vs. secondary cataracts and LASIK vs. YAG laser capsulotomy.
Education on basic anatomy, where and why certain conditions affect the eye, as well as how the appropriate surgery treats the problem, often clarifies the confusion.
Educating patients on fact-checking
Patients should be informed that misinformation is rampant and urged to double-check anything they read online. Optometrists can help by taking a moment during their exam to engage with patients regarding misinformation.8
By embracing these principles, ODs can mitigate myths:
- Be curious: Ask questions to better understand the source of misinformation and assess the patient's experience as well as their knowledge, beliefs, and values.
- Listen with empathy: Validate the patient’s feelings and/or concerns without judgement. Build trust and create a supportive environment where patients feel safe to ask questions.
- Convey your message effectively: Address misinformation in a way that is tailored to each patient. Simplify your language to ensure clear communication.
- Empower patients with health literacy: Consistently encourage and promote health literacy, starting in-office with engaging educational tools, supported by patient handouts, and follow-up discussions.
Reliable resources can be found on the following websites:
- National Eye Health Education Program (NEHEP)
- US Centers for Disease Control and Prevention (CDC)
- The American Academy of Ophthalmology (AAO)
- The American Optometric Association (AOA)
- The US Department of Veterans Affairs
Tips for identifying reliable sources
In today’s world, recognizing credible sources by looking for the key indicators is an important skill for every individual and one that can be shared to empower patients.Here are five key steps to finding and validating sources:
1. Use the website address (URL) to identify the type of site.
The URL domain name can provide insights into the site's purpose and the motivations of its owners, helping to better evaluate the information presented. For example, commercial sites are primarily focused on marketing, with advertisements often subtly integrated and sometimes distorting information.
Recognizing the following domain names can help identify the type of organization behind the site:
- .gov: US government agency
- .edu: Educational institution, such as a school, college, or university
- .org: Nonprofit organizations, such as medical or research societies and advocacy groups
- .com: Commercial websites, i.e., businesses and pharmaceutical companies
2. Understand the author and article review process.
Seek information from peer-reviewed articles and knowledgeable authors who have expertise on the topic, as this enhances the reliability of the content. If the author is associated with an organization, consider the organization's objectives.
Be cautious of blogs, testimonials, and social media posts, as these are often based on personal opinions or experiences. While they can provide some insight, they should not be trusted for medical advice or accurate information.
3. Be mindful of the information's timeliness.
The medical field is constantly evolving with new technologies and discoveries. To make well-informed decisions, ensure you use the most current information. Publication dates are typically included in article descriptions, and the timing of content creation or updates is often reflected at the bottom of the page.
4. Be cautious of your online privacy.
Most reputable websites have a privacy policy, accessible via a “Privacy Policy” or “Our Policies” link. Many websites use “cookies” to improve your browsing experience, but this means your information may not remain private, as the site collects and stores details about your visit.
It’s important to understand how cookies are used and that you can disable them through your browser settings.
5. Protect your health information.
Avoid sharing personal information, especially your Social Security number, unless you understand why it is being requested and can confirm that the site is secure. Secure websites that collect personal data responsibly begin with "https" (vs. “http”) and typically require a password.
Final thoughts
Digital media has made health information more accessible, but also plays a significant role in spreading misinformation, where myths about eyecare often mislead patients.
Addressing these misconceptions requires promoting health literacy through education, encouraging regular in-person eye exams, providing reliable resources, and advising patients in understanding the underlying factors of misinformation.
Eyecare providers can empower patients by fostering a supportive environment, addressing their concerns with empathy, and guiding them to trusted sources, ensuring they make well-informed decisions about their eye health.
