Eye Problems

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Regular tests can nip eye problems in the bud

Eye tests are an important way of identifying any problems with your vision early on. Have a regular check-up, and wear glasses or contact lenses if you need them, so that you can help prevent future problems.

You should have a test at least every two years (more often depending on age and certain medical conditions). The test takes between 20 and 30 minutes, and can identify many health problems which can then be treated.

You can have an eye test at home if that is easier for you.

Click to go straight to more information on some common eye conditions:

Macular Degeneration

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Macular Degeneration

Macular degeneration is the most common cause of sight loss in people aged over 60, and occurs when the central part of the retina – the macular – becomes damaged. This area is responsible for fine central vision and viewing colours.

Early symptoms of age-related macular degeneration (AMD) include:

• Distortion of straight lines, which become wavy
• Blurring of central vision
• A blank patch or dark spot in the centre of the field of view
• Fading of colours
• Difficulty with activities like reading, sewing, writing, seeing small objects

Macular degeneration is not painful and doesn’t lead to total loss of sight. Nearly everyone with the condition should retain enough peripheral vision to remain mobile, though probably not sufficient to continue driving.

There are two types of macular degeneration:

• Ninety percent of people have “dry macular degeneration”, for which there is currently no treatment
• The remainder have “wet macular degeneration”, and a small percentage of these can be helped with laser treatment

People with macular degeneration can be helped to use their remaining vision as fully as possible with advice about lighting, contrast and low vision aids, such as magnifiers or stronger glasses.

At the moment the exact cause for AMD is not known. However there are a number of risk factors, apart from the key one of increasing age.

Increased risk factors for AMD

• Gender – it is more common amongst women than men.

• Genetics – a number of genes which can be passed through families seem to have an impact on whether or not someone develops AMD.

• Smoking – has been linked by a number of studies to the development of AMD. It has also been shown that stopping smoking can reduce the risk of AMD developing.

• Sunlight – research suggests that lifetime exposure to sunlight may affect the retina.

• Nutrition – some vitamins and minerals seem to help protect against AMD.

You can’t do anything about your genes or your gender, but you can make sure that you eat a well-balanced diet with plenty of fresh fruit and vegetables, protect your eyes from the sun with sunglasses and stop smoking: these steps can all help to delay the progress of AMD.

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Cataracts are very common in people over 65, significantly affecting around a quarter. This rises to a half in those over 75. Effects range from a slight blurring to very poor sight, which slowly gets worse.

Cataracts are not, as many people think, a growth across the front of the eye, but changes in the transparency of the lens, through which passes all the light that the eye sees. Cataracts make the lens more opaque, thus diminishing the quality of vision.

The most common types develop slowly with age, starting from a slight mistiness and developing eventually to an opaque mass that obliterates the light completely. Sometimes cataracts are a secondary result of other problems: injuries, haemorrhages, diabetes etc.

Fortunately, cataracts can now be treated very effectively. First of all spectacles can be prescribed which improve vision. When these no longer help, the patient can be referred to an eye clinic for surgery to remove and replace the natural lens. Thanks to improvements in technology, this surgery is now quick and commonplace. Usually one eye is treated at a time, under local anaesthetic. The new, plastic lens allows light back into the eye, usually restoring good vision without the need for strong spectacles.

Most people notice an improvement straight after the operation, though complete healing may take several months. You may still need glasses, especially for reading, because the new intraocular lens implant is normally set up for distance vision and not close-up vision.

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Glaucoma is a general name for a group of eye conditions which damage sight due to raised pressure within the eye. Over the age of 65, about 5% of people develop glaucoma, but early detection and proper treatment can satisfactorily prevent blindness.

It is necessary to have a certain amount of pressure within the eye, to keep it properly inflated (like a football). In glaucoma, either too much of the fluid which maintains this pressure is produced, or its outflow is restricted – so the pressure rises.

As the rise is small and gradual, with no pain or blurred vision resulting, you may well not notice. Gradually the pressure attacks the small blood vessels which feed the optic nerve head and in turn the nerves which conduct the sight to the brain are destroyed and loss of vision results. It is the longest nerves which are affected first: these control the peripheral vision. The result of untreated glaucoma is tunnel vision.

People at higher risk of developing glaucoma:

• if a close relative has it
• people who are very short-sighted
• people of African origin
• if you have diabetes, you may be more likely to develop glaucoma

If you are over 40 and have any of these other factors, it is really important to get an annual check. You are entitled to a free annual eye test on the NHS if an immediate family member has been diagnosed with glaucoma. A lot of vision can be lost gradually if the condition is undetected. An optician can see the changes by looking into the eye, and the diagnosis can be verified by measuring the eye pressure (tonometry) and visual field testing.

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As well as being at higher risk of cataract and glaucoma, particularly over the age of 40, people with diabetes can develop retinopathy, when the fine network of blood vessels in the retina become damaged. Early diagnosis of these changes is vital, so people with diabetes need to have their eyes examined at least every year.

There are two types of diabetic retinopathy:

• Background diabetic retinopathy occurs when some of the retinal capillaries become blocked and leaky. As time passes, they become more fragile and tend to haemorrhage. Usually, in the early stages, there are no symptoms and the condition is not sight-threatening. Regular eye tests mean that changes can be monitored, and action taken when necessary.

• Proliferative diabetic retinopathy is rarer. Damaged blood vessels reduce the blood supply to the retina, causing fragile new blood vessels to develop on its surface. These can haemorrhage very easily, leading to the formation of scar tissue. This contracting scar tissue can detach the retina, causing sudden worsening of vision, or blurred and patchy sight loss. If detected, scar tissue contraction can be avoided.

Laser treatment is often effective in preventing further sight loss for most diabetic eye problems, if carried out early enough. However, it will not make the sight better. It is important to control the diabetes well, by managing blood sugar levels properly, in order to minimise your chances of developing diabetic retinopathy.

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