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Eye Care

an eye chart

Here is some information relating to common eye problems and conditions, and some steps you can take to deal with each.

NHS Sight Tests

The NHS has recently issued guidelines as to how often, in the normal course of events, people are entitled to have an NHS sight test. These guidelines are listed below.

Children under 16 years old, in the absence of any binocular vision anomaly 1 year
Children under 7 years with binocular vision anomaly or corrected refractive error 6 months
Children aged 7-16 years with rapidly progressing myopia (short sight) 6 months
Patients 16-70 years old 2 years
Patients over 70 years old 1 year
Patents over 40 with a family history of glaucoma, or with aocular hypertension and not in a monitoring scheme 1 year
Diabetic patients 1 year

If you are worried about your eyesight or have any symptoms that may indicate an eye problem, and you are an NHS patient, your optometrist can examine your eyes more frequently that this if he or she thinks it is necessary. However, you may be asked to explain why you would like to have your eyes examined. This does not apply if your optometrist has suggested an earlier recall, as in this case or she will already have reasons for this decision.

You do not necessarily have to have your eyes examined as frequently as in the table above (the recommended interval for many people is 2 years), as it all depends on individual circumstances.

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Conjunctivitis

This is an inflammation of the clear protective skin over the eyeball. Another name for it is ‘pink eye’. It can be caused by an infection e.g. rubbing a finger or flannel near the eye, or by being irritated by a draught, dust or excessive exposure to sunlight. It generally feels rather sore and maybe painful, but generally looks worse than the condition warrants. Most episodes of conjunctivitis clear up. Antiseptic drops such as Optrex are a way of helping the condition clear, but it may require stronger antibiotic drops or ointment if persistent. Spectacles worn regularly can prevent conjunctivitis by offering a protection to the eye. Sunglasses or tinted lenses can further help by protecting the eye from harmful rays that cause conjunctivitis.

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Long and Short Sighted-ness

R L long sightedness or hypermetropia occurs in about 3 out of 4 people. It can occur at any age. The eyeball being too small causes it. The perfectly sighted eyeball is 22 millimetres in diameter and a longsighted eye is perhaps one or two millimetres smaller than this. There are small muscles attached to the crystalline lens in the eye that can pull on this lens to make the focus of the eyes correct. In small amounts of long-sightedness and early life, these muscles find little problem in correcting this fault. As we age, or if the long sightedness increases, these muscles tire and become uncomfortable. The symptoms may be headaches, tiredness of the eyes, red eyes, loss of sharp focus of the eyes, a sensation of pulling in the eyes and head and other symptoms of discomfort. Depending upon the amount of long-sightedness and the age of the person, they may or may not be able to see far or near.

R L short sightedness or myopia is less common than long-sightedness but can be more disabling, as the muscles that can correct long-sightedness have no effect in correcting short-sightedness. More than 80% of all short-sightedness is inherited. A short-sighted eye is an eye that has grown too large. It has grown larger than the perfect 22 millimetres that gives a perfect eye focus. As growth of the eye is implicated in this, it develops rather early in life. The most risky years are between six and sixteen years of age, but it can be present at birth or develop later in life. Children may be born with perfect sight, but can develop this disablement by their teens. Small amounts of myopia cause rapid loss of focus of the eye and lenses are needed to give a sharp distance focus. Keeping the prescription up to date is helpful in keeping the amount of myopia to a minimum. Myopes can see things close-by without glasses.

R L The eye not having the correct shape causes astigmatism. The front or back for the eye is not completely round and has the shape of a rugby ball. This causes the eye to have two focuses, which confuses us and causes blurred vision or other symptoms of eyestrain. Astigmats may be long or short-sighted and it can occur at any age.

R L Near-sightedness or presbyopia is a result of ageing of the eye. The eye fails to focus on near objects and needs the help of magnifying lenses to enable a sharp focus for reading etc. This condition develops at or about forty years of ages and increases thereafter. Presbyopes can be longsighted, short-sighted or astigmatic and may need two pairs of glasses to cope with the two different problems of a sharp distance and sharp nears sight. These glasses can be combined as multifocals or bifocals.

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Age-Related Macular Degeneration

AMD is an eye condition that causes blurred central vision, leaving the side vision intact. AMD may develop into partial sightedness.

The central vision may be reduced but sideways vision remains, so the individual as little difficult moving from place to place, but may have difficulty seeing small details; e.g. Reading. It may also cause distortion of straight lines; e.g. doorframes may seem twisted.

AMD is often related to ageing and has two forms. The dry form is the most common and has a gradual onset. Wet AMD is less common and can cause a more sudden loss of central sight.

Both these conditions cause irreversible scarring and blind spots in the centre of the eye.

The cause of AMD is unknown but risk factors include: smoking, family inheritance, cataracts, high blood pressure, sun exposure, long-sightedness, light skin colour, a diet low in vitamins, minerals and antioxidants.

The wet form may respond to laser or photodynamic therapy. This is an expensive treatment that has only recently been approved for the NHS.

There are no similar treatments for the dry form but you can reduce the risk and effects of AMD by giving up smoking, and eating correctly, particularly fresh fruit, vegetables and oily fish.

If you are over 50 years of age, it is also recommended that you take a daily dose of tablets contain vitamins A, C and E. These nutrients are not a cure for AMD, nor will they restore vision already lost, but they help slow the progression f the disease.

If you have AMD, do not panic. It is very rare that a sufferer will go completely blind, and many people can manage with the help of magnifying aids and other help.

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Blepharitis

This is an inflammation of the eyelids and is similar to dandruff on the scalp. Flakes of skin falling from the scalp and infecting the eyelids can cause it. The lids become itchy, pink and swollen. A good long-term treatment is to regularly use an anti-dandruff shampoo [Voscene] when washing the hair and allowing the shampoo suds to fall over the face and lids. Do not rub the shampoo directly into the eyes. This treatment may be necessary for some months and even years as the eyelash roots are much deeper than the normal scalp hair roots and requires a persistent approach to clear the condition. Very often conjunctivitis and belpharitis occur at the same time.

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Keratitis

This is a condition affecting the clear window on the front of the eye called the cornea. It can be quite sore, irritating and occasionally quite painful. The mild form of it may require only an antiseptic, antibiotic or lubricant [artificial tears] to alleviate it. The more severe forms require prescribed drops.

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Sub-conjunctival haemorrhage

This is a rather frightening, bright red patch that appears suddenly on the white of the eye. Other people are often more concerned than the person suffering the haemorrhage! It occurs when a brittle artery or vein bursts beneath the transparent skin that covers the white of the eye. It is often painless. It can be regarded as being a bruise on the eye. This condition normally needs no treatment. The redness gives way to a smaller browner spot that further reduces in size to a yellow patch and it eventually clears in 10-15 days. Some ocular lubricant [artificial tears] may give a certain relief if discomfort is felt, and a routine check of blood pressure may be indicated if the condition repeats.

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