Eyesight conditions & complaints

Common Conditions

The eyetest is a vital health check that should be carried out at least once every two years. Apart from ensuring that you are seeing well enough for everyday tasks such as driving and VDU work, it is also important to ensure that your eyes are healthy.

Eyetests help to find certain eye conditions such as Glaucoma and Cataracts, or in finding underlying systematic diseases such as Diabetes and High Blood Pressure. We can improve your eyesight in the early stages and give expert advice on the latest treatment developments.

At Rifkind & Brophy Optometrists, we offer a comprehensive eye examination including screening and diagnostic tests and referrals for medical care if necessary.

Common Eye Conditions

Short-sightedness (myopia)
Short sight occurs when light is focused in front of the retina causing distance vision to become blurred. Near vision, however, is usually clear. Short sight normally develops in childhood or adolescence and is often first noticed at school. Glasses may need to be worn all the time or just for driving, watching TV or sports.

Long-sightedness (hypermetropia)
Long sight occurs when light is focused behind the retina rather than on it, and the eye has to make a compensating effort to re-focus. This can cause discomfort, headaches or problems with near vision. Glasses may need to be worn all the time or just for close work, such as reading, writing or computer use. In older people, as re-focusing becomes more difficult, distance vision may also become blurred.

Astigmatism
Astigmatism occurs when the curvature of the cornea or lens is not perfectly round. It is sometimes described as the eye being shaped like a rugby ball rather than a football. Most people have a small amount of astigmatism, which may not need correcting. If vision is blurred or headaches occur, your optometrist may recommend glasses are worn all the time or just for specific tasks.

Presbyopia
Presbyopia is the loss of focusing ability that occurs naturally with age. In younger people, the lens is very flexible and the eye has a wide range of focus from far distance to close up. As you get older, the lens slowly loses its flexibility leading to a gradual decline in ability to focus on near objects. Presbyopia is not a disease but a normal and expected change which sooner or later affects everyone, whether you already wear glasses or contact lenses or not. Around the age of 40-45, you will begin to notice that you are holding the newspaper further away or need more light to read small print. There is no advantage in delaying using reading glasses, or changing to bifocals or varifocals. They will not make the eyes lazy. Your optometrist will advise you on the best form of vision correction to suit your individual lifestyle and occupation.

Regular examinations are important throughout life, whether or not you are experiencing problems with your eyesight. Your optometrist will not only test your vision and, if necessary, prescribe glasses or contact lenses, but will also check closely for any early signs of eye disease or other medical condition.

Cataracts

Over half of those over 65 have some cataract development and most cases can be treated successfully with surgery. A cataract is not a skin that grows over the eye but a clouding of part of the eye called the lens. Vision becomes blurred or dim because light cannot pass through the clouded lens to the back of the eye.

What causes a cataract?
Cataracts can form at any age, but most often are a natural consequence of getting older. They develop slowly and are painless. In younger people they can result from an injury, taking certain medication, long-standing inflammation, or illnesses such as diabetes.

What are the symptoms?
Common symptoms may include the following complaints:

’I'm not seeing as well as I used to’
You may notice that your vision is blurred, or that your glasses seem dirty or scratched.

’I sometimes see double’
The cloudiness in the lens may occur in more than one place, causing a double image.

’My vision is poor in bright light’
Bright light or very sunny days may make it more difficult to see.

’I’ve noticed a change in colours’
As the cataract develops, its centre becomes more and more yellow, giving everything you see a yellowish tinge.

Experiencing these symptoms can also be a sign of other eye problems so it is important to consult your optometrist for an eye examination.

What can be done?
Early cataracts often make you more short-sighted, which in the early stages can be compensated for by altering the prescription of your glasses. Tinted lenses or shielding your eyes from the sun may also help. However, the benefit is usually only short-lived as the cataract continues to progress and the symptoms increase. At this stage the most effective treatment for cataracts is a simple operation to remove the cloudy lens. Your optometrist will advise you when you need to be referred to your GP or hospital. Cataract surgery is one of the most common surgical procedures and in most cases can be carried out under local anaesthetic on a day-case basis, without an overnight stay in hospital. Diets or drugs have not been shown to slow or stop the development of cataracts.

What is a lens implant?
When the cloudy lens has been surgically removed it is replaced by a plastic lens implanted in the eye so that it can focus properly. Once the eye has healed a change of spectacles is usually required. Occasionally your doctor will decide the eye is not suitable for a lens implant. In these cases, contact lenses or special glasses will be prescribed instead.

For more details of cataract surgery, please follow this link

Where can I get more information about cataracts?
Royal College of Ophthalmologists
Royal National Institute for the Blind

Age Related Macular Degeneration

Age-related macular degeneration (AMD) is the leading cause of vision loss for people over the age of 50 in the Western world. It occurs when the delicate cells of the macula – the small, central part of the retina responsible for the centre of our field of vision - become damaged and stop working.

There are two types of AMD: the ‘dry’ form and the more severe ‘wet’ form. Dry AMD is the more common, develops gradually over time and usually causes only mild loss of vision. The wet form accounts for only 10-15% of all AMD but the risk of sight loss is much greater. Because macular degeneration is an age-related process it usually involves both eyes, although they may not be affected at the same time.

Children and young people can also suffer from an inherited form of macular degeneration called macular dystrophy, Sometimes several members of a family will suffer from this condition and, if this is the case, it is very important that their eyes are checked regularly.

What are the symptoms?
AMD is not painful and never leads to total blindness because it is only the central vision that is affected. This means that almost everyone with AMD will have enough side (or peripheral) vision to get around and keep their independence.

In the early stages of AMD, central vision may be blurred or distorted and things may look an unusual size or shape. This may happen quickly or develop over several months, although if only one eye is affected it may not be noticed. People with AMD may become sensitive to light or find it harder to distinguish colours. The macula enables people to see fine detail so those with the advanced condition will often notice a blank patch or dark spot in the centre of their sight. This makes activities like reading, writing and recognising faces very difficult.

Who is at risk from AMD?
The cause of AMD is unknown but several factors appear to increase the risk. These include smoking, a high-fat diet and excessive sun exposure. Risk also increases with advancing age and may be more common in those with a family history of AMD. The incidence is higher among women and those with light skin or eye colour.

How can your optometrist help?
Optometrists have an important role to play in detecting and monitoring AMD by checking your standard of vision and examining the macula for signs of the disease at routine eye examinations. If AMD is suspected, your optometrist may put drops into the eyes to widen the pupils and see more of the retina. Early detection is essential to treating some types of AMD. Your optometrist will advise you whether you need to be referred to a GP or hospital for medical advice. If your vision is affected, you may be given stronger glasses or special magnifiers to help you see better.

What can be done?
There is currently no treatment for dry AMD but the wet form can be treated in several ways. Various forms of laser treatment may be used to halt or slow the progression of abnormal blood vessels and prevent further sight loss. These are simple procedures that can be carried out on an outpatient basis. Drugs are also becoming available for treating wet AMD, whether in the early or late stages. Trials are also taking place for new types of drugs and for combination therapies using drugs and laser treatment.

There is evidence that improving your diet by eating fresh fruits and dark green, leafy vegetables may delay or reduce the severity of AMD. Some studies show that taking nutritional supplements may be effective in slowing the progression of AMD although they do not prevent its initial development nor improve vision already lost (AMD Alliance).

Where can I get more information about age-related macular degeneration?
http://www.maculardisease.org/
Royal College of Ophthalmologists
Royal National Institute for the Blind
AMD Alliance International

Glaucoma

Glaucoma is the name for a group of eye conditions in which the optic nerve (the nerve at the back of the eye) is damaged, often in association with raised pressure within the eye. This leads to a reduction in the field of vision and in the ability to see clearly. In most cases glaucoma sufferers will experience no symptoms until significant damage has occurred.

Who is at risk from glaucoma?
People aged 40 and over are at greater risk from glaucoma and there is an increasing risk with every decade of life. Those with a family history of glaucoma in close relatives, or in certain ethnic groups (e.g. African-Caribbean people) are considered to have a greater than average risk. People who diabetic or very short- sighted are also more prone to glaucoma.

How do optometrists check for glaucoma?
Most new cases of glaucoma are identified through referrals from optometrists, whose training equips them to recognise the early signs of the disease. There are three main tests that may be carried out by an optometrist to check for glaucoma:

Ophthalmoscopy - checking the appearance of the optic disc (where the optic nerve joins the eye) using an ophthalmoscope, a special torch for looking into the eyes.
Visual field assessment - testing the field of vision using small points of light to check for blind spots.
Tonometry - measuring the pressure within the eye, either using an instrument that emits a small puff of air onto the surface of the eye, or placing a probe against the eye after it has been numbed with anaesthetic drops.

Other instruments are now available for detecting and monitoring glaucoma but these are the most commonly used tests.

What can be done?
If detected early enough, glaucoma can usually be treated. In most cases eye drops to reduce the pressure in the eye will be prescribed, although in some cases an operation is needed. To aid detection of glaucoma, the College of Optometrists recommends an eye examination every two years, or more frequently if there is a family history of the condition. If glaucoma is suspected, your optometrist will advise you whether you need to be referred to a GP or hospital. Once treatment is underway, you may be referred back to your optometrist for monitoring.

Glaucoma sufferers and certain close relatives are entitled to a free eye examination provided by the NHS. Those diagnosed as being at risk of developing glaucoma are also eligible.

Where can I get more information about glaucoma?
Royal College of Ophthalmologists
Royal National Institute for the Blind
International Glaucoma Association