Treasure your greatest gift: your sight

30 October 2015

ARTICLE

Words: Lisa Heald & Dr Marcel Niemandt, ophthalmologist

Health | Fitness

Sight is one of the greatest gifts and with October being Eye Care Awareness Month, leading healthcare provider Intercare has emphasized the importance of regular eye tests and screenings for optimal eye health.

According to the South African National Council for the Blind, millions of people around the world are walking around with a sight-threatening disease. “Unless you have your eyes checked regularly by a professional, you might not even be aware that your sight is in danger," says Dr Marcel Niemandt, an ophthalmologist working in private practice in Hazeldean and the Intercare Day Hospital." The good news is that many eye problems and diseases can be treated if detected early."

“The most common causes of blindness in South Africa currently are cataracts, glaucoma, age-related macular degeneration (AMD) and diabetic eye disease. Most of these potentially blinding conditions can be treated if detected early through the proper diagnostic tests.”

“Specific symptoms to look out for include blurry vision, a sudden loss of vision, double vision, flashes and floaters and halos and glare around lights. These symptoms may indicate a very serious problem.”

Cataracts form when the clear human crystalline lens becomes hazy or opaque. This prevents light entering the eye and forming a clear image in the brain. Cataracts can be treated by removing the human lens and replacing this with a clear synthetic lens.

Patients with diabetes are at an increased risk of developing cataracts. Even more serious is the development of diabetic retinopathy. This is when the retina (light sensitive back lining of the eye) develops bleeding and/or swelling. This is a potentially very serious condition and for this reason diabetics should undergo annual dilated eye examinations.

Glaucoma is diagnosed when the pressure inside the eye (intra ocular pressure) is raised to such an extent, that it causes damage on the optic nerve (nerve leading from the eye to the brain). This damage causes peripheral loss of vision and eventually irreversible complete blindness. Glaucoma can be treated in the early stages by using medication or drops to lower the intra-ocular pressure.

AMD is an irreversible loss of central vision due to damage in the cells lining the back of the eye at the macula (area responsible for sharp central vision). Treatment is limited in the early stages but in advanced stages injections can dramatically improve central vision and limit the progression of vision loss.

Child eye health

The most common eye conditions that present in childhood include near or farsightedness, astigmatism, eye infections, strabismus (crossed eyes) and amblyopia (decreased vision in one eye due to abnormal visual development during infancy).

“It is never too soon,” says Dr Niemandt, “to have your eyes checked. A newborn’s eyes are usually checked by the pediatrician soon after birth. Referral to an eye specialist is only needed if there is an obvious problem. It is always a good idea to screen a child at age three to four for obvious problems, but mostly a full optometric evaluation (done by an optometrist) is required prior to school going age. If there are however any concerns, an eye specialist (ophthalmologist) should be consulted.”

Just as one would prepare your child for a doctor's visit, it's advisable to prepare them ahead of an eye examination. "Schedule the appointment at a time that is convenient for your child (when they are happiest - in the morning or after nap time in the afternoon)," says Dr Niemandt. "It is also preferable to take things like toys or coloring books with to keep them busy while waiting. Be sure to bring a list of concerns to ensure that all questions are answered during the examination. It is important to stay calm during the examination and keep the event playful and upbeat. The eye specialist will make use of special equipment that is designed specifically for use with smaller children. Several tests will be done to ensure that the necessary milestones are met for your child’s age."

Long gone are the days when spectacles were frowned upon.

Long gone are the days when spectacles were frowned upon.

When working on a computer, protect your eyes by using anti-glare computer screen or anti-glare spectacles.

Constant eye rubbing is extremely bad for the cornea.

It is never too soon to have your eyes checked

It is never too soon to have your eyes checked.

Pain in the eye could signal an infection.

Pain in the eye could signal an infection.

The health of children’s eyes is equally important to that of adults.

Spectacles and contact lenses

“There are different eye care practitioners who are qualified to treat different eye conditions’’, says Dr Niemandt. An ophthalmologist is a medical doctor / specialist providing comprehensive eye care either medically or surgically, an optometrist does the necessary tests and provide spectacles or contact lenses for better vision (they are not qualified to do surgery or make any diagnoses), while an optician fits and adjusts spectacles.

“The most common refractive errors that cause blurred vision include farsightedness (hyperopia), nearsightedness (myopia) and astigmatism. Astigmatism is when the cornea (clear front part of the eye) has an irregular shape that prevents light from focusing on the retina (the light sensitive back part of the eye).In most cases these refractive errors can be corrected with either spectacles or contact lenses. These can be prescribed by an optometrist. “

Another common “refractive” problem (commonly seen in patients over the age of 45) is Presbyopia. This is caused by changes in the crystalline lens. The lens becomes less elastic and the patient’s accommodation is affected. This causes the inability to focus clearly on near objects. Treatment mostly include reading glasses, but surgical and laser options can be discussed with the ophthalmologist. This is however only an option in certain patients.

"Long gone are the days when spectacles were frowned upon. In the 21st century they are as much fashion accessories as they are necessities," says Dr Niemandt. Specific points to consider when choosing a pair of spectacles should carefully be discussed with your optometrist"

For some, contact lenses are a preferred option. It is important to take note that special care is required when wearing contact lenses. "There is a greater risk for getting eye infections and hygiene is of utmost importance," adds Dr Niemandt.

And even another option includes surgical refractive correction. "In some cases surgery provides a permanent solution but there are certain anatomical features that need to be determined before this decision can be made. Laser refractive surgery has evolved over the years and has become an excellent alternative for patients who want to become spectacle and/or contact lens independent. Careful considerations should be made and every patient should undergo very specific tests in order to determine if they are suitable candidates for laser refractive surgery.

Did you know: your eye is the fastest muscle in your body, hence when something happens quickly, we say ‘in the blink of an eye!’

Eye care tips

Here are some eye-care tips from Dr Niemandt.

1. Busy professionals spending prolonged periods of time in front of a computer may suffer from computer vision syndrome (“CVS”). CVS is characterised by eyestrain associated with prolonged computer use. This condition affects up to 60 million people worldwide. It is mostly caused by infrequent blinking. Solutions to this problem may include:
i. Better positioning,
ii. Take frequent breaks,
iii. Blink frequently or use good quality tear supplements, and
iv. Use anti-glare computer screen or anti-glare spectacles.

2. Constant eye rubbing can either be habitual or be caused by eye allergies or infections. Constant eye rubbing is extremely bad for the cornea (outer clear part of the eye) and can even cause or worsen extreme forms of astigmatism.

3. Eye protection in the form of sunglasses is not only good for the inner parts of the eye but can also protect against sun-related eyelid cancers.

4. It is never useful to use eye drops that are bought over the counter, unless it is specifically used for lubrication of the eyes (tear supplements). Most eye drops contain preservatives that may be harmful to the eye.

5. Experiencing any of the following symptoms may be an indication of an eye infection:
• Pain in the eye;
• A feeling that something is in the eye (foreign body sensation);
• Increased sensitivity to light (photophobia);
• Yellow or watery discharge from the eye;
• Increasing redness of the eye or eyelids; and
• Blurred or decreased vision.

Eye protection in the form of sunglasses

Should you experience any of these symptoms it is advised to consult with an ophthalmologist (medical eye specialist), who will provide a prescription for the correct medication. Always be aware that eye infections can easily be transferred from one individual to another, especially within families.

6. Never share medication with a friend or relative, especially prescribed medication. The medication might be suitable for your eyes, but not for that of another person. This is also a common method of transferring infections from one individual to another.

7. It is advised to have your eyes tested at least once every 18 months. Vision often decreases very slowly and it then goes unnoticed. An optometrist will also be able to identify conditions that may necessitate a consultation with a specialist. If, like most individuals, the problem lies in not wanting to wear spectacles, there is a wide range of alternative options that can be considered to suit your personal needs.

8. Employees should always have protective eyewear available in work conditions, areas and activities where they may be exposed to factors which may easily result in an eye injury. Once the appropriate eyewear is provided it should always be worn in order to prevent the eyes from pieces of material going into the eye as well as to protect the eyes during activities like welding.

9. The health of children’s eyes is equally important to that of adults. It is important that a child is examined by an ophthalmologist at a fairly young age to determine whether all the ocular milestones are met. During the school years regular visits to the optometrist is encouraged to ensure that the ocular development takes place normally and to ensure that no spectacles are required at that point. CHILD 2 PIC

10. The most common causes of blindness in South Africa currently are cataracts, glaucoma, age-related macular degeneration (AMD) and diabetic eye disease. Most of these potentially blinding conditions can be treated if detected early through the proper diagnostic tests by an eye specialist. Specific symptoms to look out for include blurry vision, a sudden loss of vision, double vision, flashes and floaters and halos and glare around lights. These symptoms may indicate a very serious problem.

More information
For more information, visit http://www.intercare.co.za/patient-guide