Eye Conditions

Cataracts

'Cataracts are one of the most common eye conditions and affect up to half of people over 60'

What is a cataract?

A cataract happens when the lens within your eye becomes cloudy. It can happen to all of the lens or just part of it. There are different types of cataract, but the most common is age-related cataract, which is more common in people over 65. It can be found to some degree in almost all older people. 

Risk factors

Age is the biggest risk factor for developing cataracts. Apart from age, smoking increases the risk of cataracts and often causes the cataract to develop earlier and more quickly. Excessive exposure to sunlight and ultraviolet light can increase the speed at which cataracts develop. Diabetes is also a common cause of early onset cataract. Other causes include certain drugs, such as steroids, or cataracts may form after an eye injury or surgery. In some cases, people are born with cataracts.

Symptoms

Cataracts can cause your vision to become misty and less clear. You may notice that you are more easily dazzled by vehicle headlights, or that objects appear less colourful. You may need to change the prescription of your glasses more regularly than usual. Cataracts don’t cause eye pain or make your eyes red. If you experience blurred or misty vision, you should see your optometrist. 

Treatment

At first your optometrist may be able to prescribe new glasses that will help with changes to your vision caused by the cataract. When this no longer helps you to see well enough, the only effective treatment is surgery. Surgery is usually only recommended once the cataract is causing problems with everyday activities, such as driving, watching television and reading. 

Cataract surgery improves the vision of nearly all patients and has one of the highest success rates of all surgery. Following surgery, the prescription of your glasses will change and you should see your optometrist after a few weeks for advice.

If you feel you want to have surgery then we can discuss with you the possible options available with the NHS or private basis. 

Macular degeneration

'Age-related macular degeneration (AMD) is an eye condition that affects the central part of your vision'

Age-related macular degeneration (AMD) is the most common cause of visual loss in the UK affecting older people. Some types of AMD need to be treated quickly, so it’s important to see your optometrist urgently if you notice any sudden change in your vision.

What is age-related macular degeneration? 

AMD is a condition that affects the central part of your vision. It is caused by damage to the macular region of the eye, which is the part of the retina that provides detailed, central vision. It doesn’t normally affect your peripheral (side) vision, so while objects in the centre of your vision may become difficult to see, the vision to the side and edges should not be affected.

There are two main types of AMD – dry and wet. Dry AMD, sometimes referred to as wear and tear, is caused by a build-up of waste within the cells of the eye that react to light – these are called drusen. Drusen stop the cells from reacting properly to light. This form of AMD usually develops slowly. 

Wet AMD happens when new blood vessels grow behind the macula. These blood vessels can begin to leak and this can damage the cells in the macular region and stop them from working. This process can start very suddenly.

Risk factors

Age is the main risk factor for developing AMD and the disease is more common in people over 65. Smoking significantly increases the risk of getting macular degeneration. Stopping smoking is the greatest change you can make to protect yourself from AMD. Ultraviolet light may also increase the risk of AMD, so, it’s a good idea to wear glasses that block or absorb UV light, especially in bright light. Getting enough exercise and eating a healthy diet, with lots of fruit and vegetables, can help to protect your eyesight. Kale, spinach and broccoli all contain nutrients that have been shown to help keep the eyes healthy. If you have a close relative with AMD, your risk of developing the condition is higher. You are also more at risk if you already have AMD in the other eye.

Symptoms

To begin with, dry AMD may have little effect on your vision. If the disease develops, your central vision may gradually become more blurred and it may become difficult to recognise faces and read things directly in front of you. Wet AMD will normally cause distorted vision, with straight lines and edges such as door frames becoming wavy and distorted. Some people also see a sudden blank spot in their central vision. Sometimes these changes can happen quickly, so it’s important to see your optometrist urgently if you notice any sudden change in your vision.

Treatment

At the moment, there is no effective treatment for dry AMD, but it may be possible to see better with the help of special magnifiers and good lighting.  Advice from the National Institute for Health and Care Excellence (NICE) states that patients with dry AMD should not normally be referred to the hospital eye service, but should continue to regularly see their optometrist to monitor the condition. If you have dry AMD, you should also take steps to monitor your own vision and can use an Amsler chart to do this. Download an Amsler chart.

Wet AMD can often be treated with injections into the eye, as long as it is diagnosed quickly. The injections work by stopping the growth of new blood vessels and can help to save your vision and reduce the risk of the disease getting any worse. If you notice any recent change in symptoms, you should contact your optometrist immediately. They will arrange for you to be seen by the hospital eye service. 

Living with AMD

If your vision is affected due to AMD, your optometrist can advise you on steps you can take to help you in your daily life. This may include referring you to a clinic which can offer help in the form of magnifiers, or putting you in touch with local support groups. You may be advised to register your sight loss with your local authority. 

If you have lost vision through AMD, you may experience visual hallucinations. This is known as Charles Bonnet Syndrome. Many patients find it reassuring to know that this is a common experience after losing vision, and although it can be quite upsetting, it is unlikely to be a sign of mental illness. If you experience visual hallucinations, you may want to discuss it with your optometrist. 

If you drive, you should discuss your eyesight with your optometrist. 

Glaucoma

'Glaucoma is an eye condition often associated with pressure building up in the eye'

What is glaucoma?

Glaucoma is the name given to a group of eye conditions where the optic nerve at the back of the eye is damaged. It is often linked with raised pressure within the eye, although the eye pressure can sometimes be normal. When the nerve is damaged, it can start to cause problems with the peripheral vision (side vision) and, if left untreated, can cause permanent damage. With early treatment, further damage to vision can be prevented. The condition often happens in both eyes, although sometimes it affects one eye more than the other. Glaucoma is one of the leading causes of severe sight impairment.

There are two main types of glaucoma – open-angle (chronic) glaucoma and closed-angle (acute) glaucoma. Even though there are many different causes of the disease, the outcomes are very similar. Glaucoma may not have symptoms and this is why it is very important to have regular sight tests.

Risk factors

Age is the biggest risk factor for glaucoma. However, your risk also increases if you have family members with glaucoma or if you’re of black African or black Caribbean ethnic origin. Other eye conditions can sometimes cause glaucoma as a side effect. If you are diagnosed with glaucoma, it is important to let your close relatives know as they may be at increased risk of developing the disease.

Symptoms

Open-angle glaucoma

The danger with open-angle or chronic glaucoma (slow onset) is that, in the early stages, your eyesight may seem perfectly normal. There is no pain, but your peripheral vision (side vision) is being damaged. Eventually, your central vision can be affected. This can be described as tunnel vision because it feels like looking down a long tube. It’s important to have regular sight tests as open-angle glaucoma often does not have symptoms.

Closed-angle glaucoma

These symptoms can develop very quickly. Your eye might become very red and painful, you can get headaches and feel sick, and you may notice coloured halos around lights. This is a medical emergency. If you notice any of these symptoms, you should go to an accident and emergency (A&E) department immediately.

Treatment

Open-angle glaucoma is usually treated with eye drops which reduce the pressure in the eye. You will need to use these daily and you will be monitored regularly at the hospital. Occasionally people with open-angle glaucoma need surgery to control the pressure.

Closed-angle glaucoma can damage the eye quickly. It’s treated at first by drops and tablets and sometimes by drugs direct into the bloodstream to quickly reduce the pressure in the eye. Laser treatment is often needed later to allow the fluid to flow through the eye better. People with closed-angle glaucoma may need surgery if laser treatment is not successful.

Blepharitis

'Blepharitis is a common eye condition that causes the eyelids to become sore and inflamed'

What is blepharitis?

Blepharitis causes eyelids to become red, swollen and inflamed. It doesn’t normally cause serious damage to the eyes, but it can be very uncomfortable. It tends to be a long-term condition, which means you’re likely to need ongoing treatment. Severe cases do have a risk of causing long-term damage, but fortunately these are quite rare.

Types of blepharitis

There are two main types of blepharitis – anterior and posterior.

Anterior blepharitis

When the front (anterior) part of the eyelids becomes sore, this can be caused by an infection, allergy or a general sensitivity to bacteria present on the eyelids. It can also be associated with some scalp conditions, such as very dry or oily skin and dandruff.

Posterior blepharitis

Also known as meibomian gland dysfunction (MGD) is when the glands that make the oily part of your tears become blocked. Both types of blepharitis can cause dry eye or make it worse if you already have it. Many people will have a combination of blepharitis, meibomian gland dysfunction and dry eye.

Risk factors

Blepharitis is more common in people over the age of 50, but anyone can develop it. This is often because the glands that make the normal tears, particularly the oily part of the tears, tend to become less effective as you get older.

Symptoms

Blepharitis can cause crusting and white scales may stick to the roots of eyelashes. Your eyelid edges may become red and your eyes will feel gritty, burning, sore or itchy. If you experience these symptoms, make an appointment with your optometrist.

Treatment

There is a range of products designed especially for treating blepharitis, such as sterile pads, individual moist wipes and separate cleaning solutions.

As part of the treatment, you need to remove all the crusting and debris from the edge of your eyelids and from between your eyelashes. You should use your cleaning product. If this is not available, you should use warm water and cotton balls or make-up removal pads. Treatment of blepharitis is a long-term procedure. You may not see any improvement for several weeks.

Continue the treatment twice a day for at least one month, then less often as it starts to get better. You will probably need to continue to clean your lids at least twice a week to help prevent the blepharitis from returning.

Blepharitis treatment method

Wash your hands before and after cleaning your eyelids

Rub the moistened pad or cotton ball firmly but gently along the eyelid edges to remove the crusts and debris

Take care to wipe between the eyelashes of both the upper and lower lids

Use a fresh pad or wipe each time

Dry your eyes gently.