Guide to better eye health

Contents Glaucoma… …………………………………………………………4 Cataracts………………………………………………………………5 Macular Degeneration… ……………………………………………6 Diabetic Retinopathy… ………………………………………………7 Blepharitis… …………………………………………………………9 Eye Floaters… …………………………………………………… 11

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Glaucoma

Cataracts

Eyesight Problems: Glaucoma

Eyesight Problems: Cataracts

To function properly, the human eyeball requires a certain amount of internal pressure, which is provided by a flow of liquid. Too much or too little pressure can cause damage to the optic nerve at the back of the eye (though problems also arise if the nerve itself is flawed). This is a disease called glaucoma and it irreparably damages the optic nerve, which carries information from your eye to your brain.

The most common cause of treatable vision loss in the United Kingdom, cataracts are largely age-related. Some 26% of cases of eye degeneration and sight loss in people over 75 are estimated to be due to cataracts, which can be successfully treated in over 90% of cases. In younger people, cataracts may be caused by diabetes or other eyesight problems.

There are four types of glaucoma: chronic, acute, secondary and developmental. The latter is very rare, affecting only babies. Chronic glaucoma becomes more common with increasing age. Uncommon in under-40s it affects 1% of people over this age and 5% over 65. Points to note: • Peripheral vision is affected after creating a ‘tunnel’ effect • Consequences include difficulty with mobility and physical hazards • Early detection is essential to inhibit damage and protect vision

Contrary to popular belief, cataracts are not created by skin growing over the eye: they are a clouding of the lens of the eye and form inside the eye, not on it. The symptoms: • Eyesight problems including poor, blurry or ‘misty’ vision • Being dazzled by lights such as car headlamps or sunlight • Colour vision becoming faded or washed out • Difficulty seeing in dim light conditions It’s worth noting that gradually failing sight and eye degeneration are often disregarded and dismissed as a natural consequence of old age, and as such aren’t reported.

• Existing damage cannot be repaired. Improving Eyesight with Cataracts Visioncall Eye Tests To maximise protection, it is recommended that tests are taken every two years. There are three specialist tests, all painless, and for best results all three should be taken. Visioncall’s optometrists are trained in identifying glaucoma and in conducting the tests with the most advanced equipment. Treatments vary, and may include eye drops and laser surgery.

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The treatment for improving eyesight with cataracts is a simple, relatively quick operation and it is usually very successful. A local anaesthetic is normally required. If spectacles are worn beforehand, they will still be required and probably with a revised prescription because the eye lens(es) will have been altered. As you’d expect with fairly common eyesight problems, Visioncall’s optometrists are well versed in spotting the signs of eye degeneration at the earliest stages, and have all the equipment to help them do it, which means peace of mind for all concerned and better maintenance of sight, confidence, independence and quality of life for the patient. Our optometrists are able to refer patients to their GP or hospital for cataract treatment. Improving eyesight is easy with Visioncall.

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Macular Degeneration

Diabetic Retinopathy

Eyesight Problems: Macular Degeneration (AMD)

Eyesight Problems: Diabetic Retinopathy

Age-related macular degeneration (often called AMD) is the greatest cause of visual loss in older people. It is prompted by progressive damage to the central part of the retina, called the macula.

Diabetic retinopathy can affect anyone who has diabetes, whether they are being treated with insulin, tablets or diet only. Generally, retinopathy has no obvious symptoms until it is well advanced. This is why annual eye examinations are so important for everyone with diabetes. Early detection is the key to successful treatment.

AMD can result in a profound loss of detailed vision, causing eyesight problems and taking with it the ability to read, cook, see food, spot hazards, recognise faces and other actions most of us take for granted. The condition isn’t painful, though, and seldom leads to total sight loss, since only central vision is restricted. More than likely, enough side vision will be left to allow mobility and preserve independence.

What is retinopathy? Diabetic retinopathy affects the blood vessels supplying the retina - the ‘seeing’ part of the eye. Blood vessels can become blocked, leak or grow haphazardly. This affects the way the retina receives the things you see and, if left untreated, can damage vision.

AMD symptoms:

Why is my vision blurred?

• Blurring of central vision

Blurred vision is not usually a sign of retinopathy, but is common at the time you are diagnosed with diabetes or just afterwards. Blurred vision is usually caused by the high level of glucose (sugar) in your blood at this time. Your blood glucose levels may take some weeks to settle down, but once they are under control your vision will return to normal. If this does not happen, see your doctor.

• Objects appear odd sizes and shapes • Straight lines may appear curvy or fuzzed • Lights, colours and shapes may appear to be there when they aren’t • Advanced AMD can cause a blank or dark patch in the middle of your sight • Reading, watching TV and identifying faces become difficult

How can I protect my eyes?

Examination for AMD:

Your best defense against retinopathy is to have an eye examination when your diabetes is diagnosed and once a year after that, as part of your annual diabetes review.

Both eyes are assessed – frequently only one is affected, or one is more affected than the other. Eye drops are used to dilate the pupils and allow your optometrist to see more clearly into the eyes. Drops may cause blurring and sensitivity to light, but that is normal. Macular Degeneration Treatment Visioncall optometrists are qualified to carry out the examinations and will advise on subsequent referrals. Do not hesitate to ask for advice on this or any other eye health matters.

Don’t wait until you notice a change in your vision. Retinopathy often has no symptoms until it is well advanced, and by this time treatment is more difficult. What does an eye examination involve? A proper eye examination involves more than reading letters off a wall chart. People with diabetes need to have both retinas examined. This can be done by a diabetologist, an optometrist, an ophthalmologist, or a family doctor with a special interest and knowledge of diabetes. In this eye examination, the person checking your eyes uses an ophthalmoscope to view the retina. They will first dilate (widen) your pupils using special eye drops. This allows them a clear view of the retina. They may also use a larger instrument with a bright light, together with a small hand-held lens. The drops used to dilate your pupils can sting a little. If you find your vision is affected, you should avoid driving for a few hours afterwards. Your eyes will also be sensitive to bright light for a while, so wearing sunglasses may help. Remember - people with diabetes can have free eye examinations by their optometrist.

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Diabetic Retinopathy

Blepharitis

What is the treatment for retinopathy?

Eyesight Problems: Blepharitis

Diabetic retinopathy can affect anyone A laser is used to stabilise the retina and the leaking blood vessels.

Blepharitis is a mild, bacterial infection of the lids. It must be treated or it will not go away. What causes it? It may be associated with some scalp conditions, such as very dry or oily skin and dandruff.

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What does it look like? • Eyelid edges are red • Whitish scales may stick to the roots of eyelashes • Eyes may be burning, sore or itchy How can I make it better? The treatment has three steps: Bathing the eyelids: Hold a face flannel soaked in warm mild shampoo solution against the eyelids. The warmth helps the oils in the glands of the eyelids to start flowing freely again. The warmer the water the better, but be careful it is not too hot. Baby shampoo is good, however, if the infection has been present for some time, then use an anti-dandruff shampoo. Swabbing the lid margins: Dip a cotton bud into the mild shampoo solution. Gently wipe along the strip between the eyelashes and the white part of the eye. This should be done to both the upper and lower lids. This part of the treatment is very important, because it removes the dead bacteria. Using brolene eye ointment: Smear brolene ointment onto the eyelashes and put a small drop of the ointment into the eye. The ointment will kill off any remaining bacteria. Without the first steps of bathing and swabbing, the ointment will have no good effect. This is because the dead bacteria will soak up the ointment and leave the live bacteria unaffected. Brolene eye ointment can be purchased at a chemist without a prescription. It is possible to use brolene drops in the morning instead of ointment.

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Blepharitis

Eye Floaters

What happens next?

Eyesight Problems: Floaters

Continue the treatment twice a day at first, then less as it starts to get better. Treatment of this condition is a long-term matter. You may not see any improvement for several weeks.

Often, people who have healthy eyes see floaters. They appear as spots, lines or cobweb effects, usually when you look at a plain surface such as a white wall or a clear blue sky. They often appear when the clear jelly in the main part of your eye gets older.

If the condition persists you should consult your GP.

When should I be concerned about floaters?

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If you suddenly notice a shower of new floaters, or floaters together with flashing lights or a dark ‘curtain’ in your vision, then you should seek further advice urgently. These symptoms can mean that the retina is tearing. Go to an Accident & Emergency department if necessary. Look out for: • flashes or floaters getting worse • a black shadow in your vision • a sudden cloud of spots • a curtain or veil over your vision • any sudden loss of vision. What will happen if the retina tears? The retina is at the back of the eye. It receives the images and sends them to the brain. This is part of the process that is involved in ‘seeing’. If the retina tears, it may strip away from the back wall of the eye. This is called retinal detachment. It can result in partial or complete loss of vision. What is the treatment for retinal detachment? A tear may be treated by using a laser. If treated quickly you may have a better chance of full recovery. However, if your retina has become detached, you will need surgery. The operation may restore most of your vision but may come too late for a full recovery.