In the past, we looked at the retina by peering into your eye and scanning around with a hand held, illuminated instrument called an Ophthalmoscope. The retina is the light sensitive layer that lines the eyeball, and it’s responsible for relaying the image of what you see to the brain. There are several eye health issues that can affect the retina, so close examination, detection of early signs of disease, and possible treatment are really important. Using the Ophthalmoscope relies on your optician being skilled and experienced, and of course they cannot easily record what they have seen. New imaging systems allow us to study the whole area in minute detail, and we can then consult with colleagues, mail images to consultants, and store them for future comparison.

The capabilities of the different systems vary, but generally 2D images are a photograph that we can zoom in and out of, to study specific areas of interest. 3D are more like a mini MRI, allowing us to examine the layers of the retina, cutting through the image to examine each area in minute detail. This means we can spot the very earliest signs of disease, and suggest treatment. These tests usually incur a private fee, so do check that the optician has experience with their chosen system, and will analyze the images with you.

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There are two forms of ARMD – wet and dry. The wet form is a medical emergency that needs immediate treatment if permanent sight loss is to be prevented. There is treatment that can help if sufferers are caught early. The dry form develops more slowly, and there is no cure at present, although research is ongoing. The latter is the most common form of the disease. Both types are a result of cells dying in and around the macula, a tiny area of the retina that’s responsible for detailed vision. Dry ARMD arises because debris from the dying cells builds up and causes problems with sight. Wet ARMD is more dramatic as blood vessels that form around the macula suddenly rupture, and the flooding of fluid damages the delicate tissues and destroys sight.

You can prevent your risk of the disease by giving up smoking, eating a wide variety of fruit and vegetables, taking moderate exercise, and wearing lenses with full UV protection, even on overcast days. Unfortunately genetics also play a part, so be extra vigilant with check ups if a family member has a history of ARMD. Regular eye examinations, with retinal imaging, will pick up early signs before you notice any symptoms. There are supplements available that provide anti-oxidants, vitamins and minerals to help to protect the retina. If you have light coloured eyes, or have several risk factors, supplements may help you. Your GP, consultant or optician will be able to offer advice.

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Lashes and lids are very important in keeping the eye and entire visual system healthy. The glands which surround them supply vital components which protect the front surface of the eye, sterilizing, lubricating, and providing a smooth surface for optimum vision. Who knew it was all so complicated! Eyebrows, the protruding shape of our brow bone, and our lashes also work towards keeping dust and debris out of the eye.

Eye infections, whether of the surface of the eye itself or the surrounding tissue, can all disrupt the delicate balance of the tears and the lubricants that the lid margins provide. So careful cleansing of the eyelid area is really important – your mother was right! Always remove eye make at night, and if you have lash extensions or use false eyelashes, follow instructions as to which cleanser you should use, and keep a watch on the lid margins.

Some useful little allies called the glands of Zeis and Moll nourish the lash follicles, but if you don’t cleanse carefully you can get a blockage here that can cause styes if they become infected. Not pretty and pretty painful! If you’ve been out partying too hard or have an underlying illness, styes become more common, so prevention is better than cure. If you notice any redness, swelling, or sore areas amid the lashes, seek advice before things get nasty! Note that mascara should be discarded within three months of opening, and always start a fresh one if you’ve had an eye infection.

Besides styes there are other problems that can threaten your hard work at lash loveliness.  Blepharitis is the one we come across most often, a sore and unsightly irritation of the lid margins. The skin around the lashes becomes red, itchy, and flaky – not nice! You can get help from the pharmacist, or for a home remedy, bathe the affected area with a solution of bicarbonate of soda mixed into freshly boiled water – let it cool first! There are products such as lid wipes that will help, but check their compatibility with your eye fashion products!!

If you’re choosing new glasses, make sure the frame fits at a distance that allows lash fluttering behind them.  If you haven’t got enough room you’ll have irritated eyes and constantly smudgy specs! Pull all this together and you’ll have lashes that will make all the hard work worth while. All the girls of TOWIE will be proud of you!

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1. What is Astigmatism? It simply means that your eye is shaped more like a rugby ball than a football. You can’t do anything to make it better or worse, it may fluctuate like all other aspects of your prescription, and by itself, it isn’t anything to worry about.

2. How does it affect my sight? Astigmatism stretches or distorts what you see in one direction, depending on the position of your ‘rugby ball.’ So looking at a row of H’s, some patients would see the uprights as blurry or distorted, some the horizontal bars.

3. How is it corrected? You need one correction for the long axis of the rugby ball, and one for the short, so your lenses are a little more complex than for a non-astigmatic eye. They also have to be held at the correct orientation.

4. How will it affect my options? You can still wear contact lenses, varifocals, photochromics, most lenses in fact. As I mentioned above, they need to be in the right place, so don’t attempt to put lost spec lenses back yourself, and if your contact lenses swivel around go back to your optician for a re-fit!!

5. How will my glasses feel? If you’ve been used to coping with the distortion, and it’s your first time with toric lenses that correct your astigmatism, you might feel a bit strange to start with. Patients sometimes complain of feeling a bit sea-sick, or shelves or door frames looking wonky. This does all settle down and the effects do wear off, so persevere with your new specs.

Your Optician should explain all of this when they prescribe your glasses, but if you have questions later don’t be afraid to go back. People do worry unnecessarily about such terminology, and we’re here to help you – there’s no stigma to specs wear nowadays!

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Diabetic Retinopathy usually occurs when sugar levels are consistently high and unstable, and the longer a patient has had Diabetes, the more likely they are to suffer this complication. It’s also more likely to occur in Insulin Dependant patients. It can lead to small or large leakages of blood vessels within the eye, leakage of fluids, or formation of new blood vessels. These abnormalities can be sight threatening, and laser treatment may be necessary to seal the blood vessels.

As the patient may not be aware of the first signs of Diabetic Retinopathy, regular eye checks are essential. Last year Diabetes UK expressed concern that many patients were at risk of blindness in England and Wales because they weren’t attending check ups. It led them to produce a leaflet highlighting the care that Diabetic patients should expect, which include 15 care measures, ranging from monitoring kidney function, condition of feet, and eye examinations.

Most cases of sight loss could be avoided if symptoms are caught at an early stage. If you are Diabetic, or are a carer for a sufferer, then book to see an Optician, preferably a practice that will also offer Retinal Imaging. This sophisticated screening technique can study the retina for minute signs of problems, and store images for future comparison. Action can then be taken as quickly as possible. So take the time to book an appointment – yearly check ups will give you peace of mind, and may just save your sight.

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The incidence of Macular Degeneration increases with age, and this disease is the leading cause of blindness in the developed world. University College London’s Institute of Ophthalmology have been looking into the use of Vitamin D to help to prevent the disease. Trials have so far suggested that it may be successful in safeguarding blood vessels that supply the retina.

A new camera has been developed for use within the National Screening programme for Diabetic Retinopathy. Diabetes givers rise to many debilitating symptoms, and can also affect sight. Patients should attend for regular eye examinations and retinal screening. The new camera, produced by Haag-Streit UK will offer users a range of screening options and easy transfer of images between eye care professionals.

Stargardt’s disease is a type of macular degeneration that causes sight loss in young people. Moorfields eye hospital has been given permission to perform a trial into retinal stem cell treatment for this debilitating disease. The technology was developed in the USA, and involves injection of stem cells into the retina. Trials are going ahead on 12 patients this year.

Cardiff University are looking at the treatment of clinical depression in patients with visual impairment. The study will examine the results of different treatments on these patients – whose mobility and independence can be severely restricted by their sight problems and their mental health. The study will enlist the help of patients at St Thomas Hospital London, and patients from clinics in Wales.

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1. Rather than promising to visit the gym three times a week, just promise to visit your optician – once every two years for most people. This ensures your sight is as good as possible, and is up to the driving standard. It also checks eye health, and can spot signs of some general health issues too.

2. Give up smoking – if you haven’t already! It’s bad for your sight as well as everything else, and has been implicated in the development of several eye diseases, including cataracts and Macular Degeneration.

3. Take moderate exercise – it doesn’t have to be circuit training or wearing the dog out on weekly half marathons – just some fresh air on brisk walks, swimming or gentle stretches like Pilates or Yoga will get the blood flowing, bringing fresh oxygen to the eyes.

4. Eat a variety of fresh fruit and vet, in a mixture of colours, so munch on all peppers, tomatoes, broccoli and kale, carrots, and blueberries, and all as fresh as possible. The vitamins and minerals safeguard the eye from disease such as Macular degeneration – and it’s all good for your waistline!

5. Wear up to date specs and contact lenses – this prevents eye strain, makes you safe on the roads, and can reduce headaches and fatigue. And there’s no excuse – get online to the IGC for economical specs if you think you can’t afford to update your prescription!

So there you go – easy-peasy, and you can feel virtuous about having a healthy 2012 without breaking into too much of a sweat!

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As both eyes are treated separately, in some patients there will be a time period where the two eyes need different correction. This can lead to you feeling disorientated when it comes to walking around, slight double vision and a problem knowing how far away things are. The key here is to remember that this will be corrected when you are prescribed glasses after the eye has healed, so patience as a patient may be required! Your Optician may be able to prescribe specs for this interim period, and as they’re only temporary, you may need to call on the services of the IGC for an economical pair!

25% of patients suffer glare and distorted sight after surgery due to deposits forming in the ‘lens capsule’. The Cataract forms in the first place due to a lens inside your eye, which becomes gradually opaque, usually due to age or trauma. The surgeon removes the cloudy lens and replaces it with a synthetic one, using the original capsule that held your own lens for the implant. After surgery the capsule can get cloudy itself as deposits form on it. This is treated by a quick zap with a laser, a speedy procedure which solves the problem and restores clear sight again.

People with general health issues such as Diabetes may suffer other complications after surgery, which are thankfully rare and are treatable if caught early. The important things to remember are to follow post-operative instructions carefully, using drops as prescribed and attending all follow up appointments. If you notice any new symptoms, such as blurred or distorted vision, have it checked out immediately by your Optician or GP.

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Dry Eyes – Eyes feel dry, gritty, may sting, sight will be normal, no discharge or stickiness.

Can be due to – hormonal changes, air conditioning or central heating, overuse of contact lenses.

What can you do? – Speak to your Optician or GP to rule out contact lens problems. You may be prescribed artificial tears. Move desks away from vents or radiators, drink plenty of water.

Acute Conjunctivitis – Eyes feel sore and irritated. May be some watery discharge. Vision ok.

Can be due to – Eye strain, smoky or polluted air, lack of sleep and overusing a computer screen.

What can you do? – Speak to your GP to rule out infectious conditions. Rest eyes, drops may help to soothe irritation and restore natural tear function. Avoid contact lens wear until the eye recovers.

Bacterial or Viral Conjunctivitis – Eyes look very pink, lashes stick together, discharge which may be very fluid or sticky. Lashes stuck together when you wake up, vision may be blurry until discharge clears.

Can be due to – Contagious bacterial or viral infection.

What can you do? See your GP for prescribed drops. Take contact lenses out immediately and replace disposable lenses, sterilise any others. Replace mascara and eye make up brushes. Don’t share towels or flannels with other family members. Finish course of prescribed drops.

Irritant in the Eye – Eye slightly pink. Vision ok but eye watery.

Can be due to – foreign body trapped in the eye, i.e. under the lid, or reaction to foreign body after removal.

What can I do? Lift the lid gently away from the eye and look all around you, to let the tear layer wash the eye. Try an eye bath. Seek medical help if problem persists.

If you can’t decide what the problem is yourself, then the general rule is simple for any pink eye condition – take contact lenses out, check things out with your GP, have some specs to hand to allow eyes to rest and recover. Then you’ll be in the pink, and your eyeballs won’t be!!

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Our standard of good vision can decrease with age, and if changes are gradual then it takes the patient a while to notice potential problems. Regular eye examinations are vital to ensure that all is well. The normal process of ageing can lead to drivers not seeing road signs clearly, not recognising hazards, or being able to judge speeds and distance.

How well we can see around us – our peripheral vision can also have a huge impact on our safety. Problems with mobility of the neck and shoulders and eye disease such as Glaucoma can lead to poor judgement when pulling out of junctions, less awareness of cyclists, and is generally considered to be one of the biggest potential problems for older drivers. Again, regular eye exams will spot the earliest signs of visual field loss.

Eye conditions such as cataract, and general health problems such as Parkinson’s disease can lead to problems with contrast sensitivity – this affects our colour perception and depth perception. During day and night driving sufferers may also be less able to see hazards, signage and pedestrians.

Eye health problems related to age such as cataract and macular degeneration can leave patients with clear vision in one eye only, leading to narrower peripheral vision and poor depth perception in some cases. This may not be a huge problem if patients are aware that they need to turn their heads more and their general health and mobility are good.

The key as always is vigilance to potential health problems, and regular assessment for signs that GPS or opticians may spot that the patient has not noticed yet. Then we can all enjoy safer roads and many years of happy motoring!

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