Looking after your eyes

Two million people in the UK are living with sight loss that is severe enough to have a significant impact on their daily lives. Every day 250 people start to lose their sight in the UK, and one in five people will live with sight loss in their lifetime. Currently in Wales there are an estimated 121,000 people living with sight loss, a figure that is set to double by 2050. Scary isn’t it? Sight is held to be the nation’s most precious sense by far. An RNIB report published in 2017 found that 78 per cent of people said that sight was the sense they feared losing the most. On the flip side, half of sight loss is avoidable if it’s caught and treated early enough. So looking after your eyes makes sense, doesn’t it? No-one wants to go blind. But what can you do to look after your eyes and ensure you don’t become part of the statistics?

Regular Eye Examinations

Research suggests that 25 per cent of UK adults haven’t had an eye test in the past two years – or even at all. Everyone should have their eyes tested at least once every two years even if they don’t need glasses. Having an eye examination is an important health check for your eyes. Optometrists are trained to examine your eyes for spectacles and contact lenses but most importantly to detect signs of eye disease and other serious conditions. Early detection of disease increases your chance of successful treatment. Some people should have their eyes tested more frequently, for example, if there is a family history of eye disease.

Eye examinations really are nothing to worry about. Most people don’t have an eye condition. Sight changes naturally with the ageing process, and for many people glasses are all they need to see clearly; most people will require reading and distance spectacles as they get older. Eye examinations are quick and painless, and for some people they’re free.

Any changes you notice in your vision should be checked by your optometrist. So if you can’t see as clearly as you used to, you have difficulty seeing distant objects or you have difficulty reading, you need to go for an eye examination with an optometrist.

If you have developed an eye condition, detecting it early can make a difference to treatments and how your sight may be affected in the future. It doesn’t mean that you’ll lose your sight. Many eye conditions can be treated, and the earlier the treatment starts the better.

Patient undergoing an eye examination

What conditions can an eye test detect?

Many diseases often begin with little or no obvious symptoms, yet they can be picked up in a routine eye test. If spotted early, a diagnosis of one of these devastating illnesses can be life-saving.

Diabetes

Diabetes UK says that an estimated 750,000 people in the UK have diabetes but don’t know it. Undetected, it can eventually cause blindness, cause you to lose a limb, or in most severe cases, it can kill you. It’s easy to miss the silent symptoms; however, a small amount of bleeding on the retina will be picked up in an eye exam. When the blood vessels in the central area of the retina (the macula) are affected, this is termed ‘diabetic maculopathy’ and is one of the most common causes of sight loss.

Brain tumours

Spotting a brain tumour early can be a matter of life and death. Over 5,000 people lose their lives to a brain tumour each year, while over 10,600 people are diagnosed, according to the Brain Tumour Charity.

An eye examination can check for blurred vision and monitor unusual pupil dilation and the colour of the optic nerve. A Visual Fields diagnostic test can assist in the diagnosis. This test is widely available within optometry practices today. If anything looks out of the ordinary, you’ll immediately be referred to a neurologist.

Heart disease

Cardiovascular disease kills someone in the UK every three minutes (Heart Research Institute). An eye exam can spot a white ring around the cornea (the clear surface of your eye), which can be an indicator of high blood cholesterol, a common contributor to coronary heart disease, a heart attack or a stroke.

Multiple Sclerosis

Multiple sclerosis can cause swelling of the optic nerve, which creates a specific visual field defect called a ‘scotoma’. This is straight-forward to pick up during a routine eye examination.

High blood pressure

High blood pressure was responsible for approximately 75,000 deaths in the UK in 2015 (Blood Pressure Association). It contributes to stroke, heart disease and is a risk factor for heart disease, kidney disease and vascular dementia. Many people discover they have high blood pressure following an eye test. It can cause burst blood vessels at the back of the eye – easily spotted during a routine eye exam.

Nutrition

A poor diet can put your sight at risk. Yet, awareness of the link between diet and good eye health is low – a recent survey found 60 per cent of people living in the UK had no idea that what they eat can affect the health of their eyes. (Eyecare Trust ‘Healthy Eyes Report’)

A basket of colourful fruits and vegetablesVitamins, minerals and carotenoids found in many fruits, vegetables and other wholesome foods can help protect your sight and keep your eyes healthy. Here are just some of the foods that are rich in eye-friendly nutrients…

  • Cold water fish like cod, sardines and tuna are excellent sources of DHA, and Omega-3 fatty acids. These provide structural support to cell membranes and may be beneficial for dry eyes, and the maintenance of general eye health. Research has shown that eating just one portion of fish a week may reduce your risk of developing age-related macular degeneration (AMD) – the UK’s leading cause of blindness – by up to 40 per cent. (Dietary Fatty Acids and the 5-Year Incidence of Age-related Maculopathy, Brian Chua et all)
  • Blueberries and grapes contain anthocyanins, which may help improve night vision.
  • Green leafy vegetables spinach or kale, for examples, are rich in carotenoids, especially lutein and zeaxanthin. Lutein and zeaxanthin may help prevent age-related eye diseases such as macular degeneration and cataracts. These carotenoids may also reduce discomfort from glare and enhance visual contrast. (Journal of Food Science)
  • Whole grains and avocados are rich in zinc and Vitamin B. Deficiency in complex B Vitamins may increase your risk of cataracts and retinopathy.
  • Papaya is a good source of beta carotene which can help to prevent ‘free radical’ damage inside the eye.
  • Eggs are rich in cysteine, sulphur, lecithin, amino acids and lutein.
  • Sulphur may also help protect the lens of the eye from cataracts. Garlic, onions, shallots and capers are rich in sulphur, which is necessary for the production of glutathione, an important antioxidant required to help maintain healthy sight.
  • Soy contains essential fatty acids, phytoestrogens, Vitamin E and natural anti- inflammatory agents. Vitamin E is important for the maintenance of good eye health.

Recommended Daily Intake (RDI) for some key eye friendly nutrients (NHS Choices. RDIs for healthy adults):

  • Vitamin A – 0.7mg a day for men and 0.6mg for women
  • Vitamin B6 – 1.4 mg for men and 1.2 mg for women
  • Vitamin C – 40mg a day for all adults
  • Vitamin E – 4mg a day for men, 3mg a day for women
  • Zinc – 5.5-9.5mg for men and 4-7mg for women

No smoking signSmoking

Smoking remains the single largest cause of preventable ill health in Wales, and a significant cause of health inequity. It’s harmful to your eyes and can increase the risk of sight loss. Smokers are much more likely than non-smokers to develop Cataracts and Age-Related Macular Degeneration (the most common cause of sight loss in the UK). Current smokers are two to four times more at risk of developing macular degeneration than people who have never smoked. However, the good news is that if you quit smoking your risk of developing AMD begins to decline.

Stopping smoking is the best thing you can do for your own health – and the health of people around you. It’s never too late to quit. You’ll start seeing the benefits immediately, not just for your health but also your finances. Did you know that if a smoker can quit for 28 days, they are five times more likely to quit for good? For more information on smoking and sight, click here.

Alcohol

Heavy alcohol consumption may increase the risk of developing early age-related macular degeneration. Drinking too much alcohol interferes with your liver functions reducing the levels of glutathione an efficient antioxidant that can help protect against common eye disease. To keep health risks from alcohol to a low level:

  • men and women are advised not to drink more than 14 units a week on a regular basis
  • spread your drinking over three or more days if you regularly drink as much as 14 units a week
  • if you want to cut down, try to have several drink-free days each week

Consuming alcohol within the recommended daily limits is the most sensible way to maintain good health and ultimately healthy eyes and good vision. Keep tabs on your drinking with the Drinkaware alcohol tracker.

Drink plenty of water

The human body is made up of 70 per cent water. Water is essential to the normal working of the body and for keeping your eyes healthy. Dehydration can lead to dry, sore and irritated eyes. The Food Standards Agency recommends that you drink approximately 1.2 litres (6-8 glasses) of water every day and more when you exercise or if the weather is hot.

Protect your eyes from the sun

Getting out in the sun is important for your general health. In the UK we get most of our vitamin D from sunlight exposure from around late March/early April to the end of September. Vitamin D is essential for healthy bones as we need it to help the body absorb calcium and phosphate from our diet. These minerals are important for healthy bones, teeth and muscles, but you need to protect yourself from sun damage.

Never look at the sun directly, even when something exciting such as an eclipse is happening. Doing so can cause irreversible damage to your eyesight and even lead to blindness. Several studies also suggest sunlight exposure is a risk factor for cataracts.

Wearing a wide-brimmed hat or sunglasses can help protect your eyes from UV rays. The College of Optometrists recommends buying good-quality dark sunglasses – these needn’t be expensive. Look for glasses carrying the CE mark or the British Standard BS EN ISO 12312-1:2013, which ensures they offer a safe level of ultraviolet protection.

Obesity

Eating a healthy diet and controlling your weight helps to maintain your general health, preventing conditions such as high blood pressure, type 2 diabetes, heart disease, stroke and some cancers. Taking steps to prevent these conditions as well as reducing your cholesterol and blood triglycerides can, in turn, help prevent you developing diabetic eye conditions, retinal vessel occlusions and eye conditions related to stroke.

Exercise

Combined with a healthy diet and the avoidance of smoking, exercise may reduce the risk of sight loss from narrowing or hardening of the arteries, high blood pressure and diabetes. Exercise may also reduce the risk of sight loss and other complications from these conditions, once they develop (Royal College of Ophthalmologists). The eyes need oxygen to stay healthy and comfortable.

Growing scientific evidence suggests that aerobic exercise can increase crucial oxygen supplies to the optic nerve and lower pressure in the eye. Reducing intraocular ‘eye’ pressure can help control conditions such as glaucoma and ocular hypertension. Aerobic exercise can also prevent the progression of diabetes, which in severe cases can lead to diabetic retinopathy. To gain any health benefit from exercise the Department of Health recommends doing 30 minutes exercise five days a week. Brisk walks, cycling and swimming are all excellent ways to reduce intraocular pressure. Remember to consult your GP before commencing any new exercise programme.

Protect your eyes from injury

DIY activity in the home and garden is the cause of thousands of eye injuries each year. Some of these have led to serious permanent eye damage and loss of sight. Make sure you protect your eyes whenever and wherever you are doing DIY. Always wear the correct safety glasses for the job you are doing to protect your eyes from flying debris and fine particles. Sport (especially racquet-based sports) also causes lots of eye related injuries each year. Investing in a good pair of protective sports goggles will help prevent serious damage to your eyes.

Diabetic Retinopathy Screening

The Diabetic Eye Screening Wales (DESW) Service is an all Wales Service designed to detect sight threatening diabetic retinopathy at an early stage before visual loss occurs; thereby ensuring early treatment and preventing loss of vision in 70-90 per cent of people with sight threatening diabetic retinopathy. (VISION 2020 WHO). Commissioned by the Welsh Assembly Government in July 2002 as part of the Eye Care Initiative risk reduction programme the service is an important element of delivering the Diabetes National Service Framework (NSF, 2002).

Everyone registered with a GP in Wales who has a confirmed diagnosis of diabetes should be referred to the service. Patients meeting the screening criteria will be invited for retinopathy screening within three months of being registered by Diabetic Retinopathy Screening Services for Wales (DRSSW). To ensure equity of service for everyone in Wales, clinics are arranged as close to the patients’ GP surgery as possible.

Retinal screening is a straightforward procedure that should take approximately 40 minutes. Screening teams assess suitability for screening, measuring and recording visual acuity and administer eye drops. Following mydriasis (dilation of the pupil), photographs of the retina are obtained using a specialist retinal camera. The images are then later assessed by Retinal Graders for the presence and severity of diabetic retinopathy. If patients have sufficient levels of diabetic retinopathy, they are then referred to Ophthalmology for further assessment. The patient, GP and other relevant health professionals will receive the results from screening on completion. The retinal graders may detect the presence of other non-diabetic eye disease (e.g. cataracts) that may require referral using local guidelines agreed by the All Wales Ophthalmology Group for further assessment. The screening process does not replace the test with the patients’ Optician (Optometrist). Patients should continue to see regularly for spectacles, contact lenses, etc.

Looking after your child’s vision

Your child’s sight is precious. Good vision helps them to learn, to play and to communicate with the world around them. Yet, there are around 1.6 million school-aged children in the UK who have an undiagnosed vision problem (2016 DfE School Census). Children’s eyes continue to develop until they reach the age of eight. Caring for a child’s eyes in the early years can help lay the foundations for good vision that lasts a lifetime.

Children often do not complain about their sight. However, they may show signs of being unable to see properly. Things to look out for include:

  • sitting close to the TV
  • holding objects very close to their face
  • blinking a lot
  • eye rubbing
  • one eye turning in or out

If you think your child is having any sort of sight problems, take them to an opticians for further investigation. Children do not have to be able to read letters to have their eyes examined.

There are lots of simple things that you can do to help children of all ages keep their eyes and vision healthy. Click here to find out more.