Sights for Sore Eyes

If you look around you, you can easily find something that falls under the category of an endocrine disrupting chemical (EDC). They are everywhere. Thousands of EDCs have been identified, particularly in plastics, food storage devices, detergents, flame-retardants, toys, cosmetics, pesticides, food stabilizers, food dyes, fungicides, pharmaceuticals, and even in cash register receipts. We are exposed to EDCs daily – by inhalation, skin penetration, and oral ingestion. And they even pass through the placenta and breast milk…

“Endocrine disruptor” is a relatively new term – only coined in 1991. And the World Health Organization (WHO) first detailed the effects of EDCs on human health in 2002. Common EDCs include Bisphenol A (BPA), DDT, DES, phthalates, polychlorinated biphenyls (PCBs). Unfortunately, only a tiny fraction of EDCs has been banned due to health concerns because awareness is limited. And many of those that are banned, leave “forever chemicals” that persist in the environment and bioaccumulate over time through the food chain.

These chemicals have been implicated in a myriad of health issues, ranging from reproductive disorders to neurodevelopmental abnormalities. One lesser explored but increasingly significant area of concern is the impact of EDCs on ocular health. EDCs are playing an increasing role in ocular diseases through disruption of insulin levels, pituitary function, sex hormone, thyroid hormones, and adrenal function. This hormone disruption has an impact on the eye, potentially resulting in dry eye disease (DED), retinal issues, cataracts, and glaucoma. The chemicals can also directly disrupt peripheral nerves; for example, damaging the sensory nerves of the cornea. Toxins can accumulate on the retina, causing retinal structural alterations and dysfunction. In 2018, Pontelli et al hypothesized that EDCs were contributing to the increase in ocular diseases (1).

Moreover, animal studies have shown that exposure to EDCs during critical periods of development can result in structural and functional changes in the eye, affecting visual acuity and overall eye health. EDCs have been associated with heightened inflammatory responses in various tissues. In the eye, this could manifest as increased susceptibility to allergies and inflammatory conditions, and chronic exposure could be making these issues worse.

Though there is a great deal of research necessary in the field of EDCs, it is important to make changes now for better ocular health. For example, advocate for plastic dropper bottles and contact lenses made from biodegradable plastics. Recycle old glasses and discard glasses and eyewear made before BPA was banned in plastics. Avoid using cosmetics that contain EDCs, including synthetic eyelashes with adhesives, cosmetics that contain microplastics, which are particularly found in metallics and glitter eyeshadows, and lash extenders made from microfibers. These substances are almost impossible to filter out of our water supply. Wear eye protection to decrease direct exposure from air pollutants.

The mushrooming impact of EDCs has many intricacies that need further research and awareness. I have used my work as an endocrinologist and an artist to help bring a visual perspective of this issue through my art. I am currently upcycling non-hazardous medical plastics and print journals to bring attention to the amount of waste that is being produced in the medical industry. I use everything from disposable contact cases to plastic needle sheaths to vial top lids in my work. These are just being disposed of in ordinary trash containers and not recycled at all. The theme of my current exhibition, “Mottenai,” pays tribute to the Japanese tradition of upcycling, so it features Japanese samurai. We all have a role to play in medicine to look at our footprint and help ensure a safer planet for our future.

Malini Gupta, MD, ECNU, FACE has had several exhibitions of her artwork, which can be seen on her social media platforms Meta – @g2endo – and X: @maliniguptamd