Information Sheets

Blepharitis

 

Blepharitis is an inflammation of the eyelids and is very common. It usually affects both eyes on the edge of the eyelids, and although rarely serious, it can be an uncomfortable, persistent and irritating problem.

 

People who suffer from blepharitis often report dry, sore or red eyes. Sometimes, blepharitis can cause burning or itching sensation, or the feeling that something is in your eye. Some people may also notice crusty or greasy debris around their eyelashes.

 

At Total Optical, our Optometrist can determine if you have blepharitis by examining your eyes with a special microscope called a Slitlamp. Careful assessment of your eye surface, tear film and eyelid margins allows your Optometrist to classify the kind of blepharitis present. By knowing the type and cause of blepharitis, the right treatment plan and care regime can be prepared for you.


 

Classification of Blepharitis:
Blepharitis may be subdivided into three groups. Often there is significant overlap of the signs and symptoms among the groups.

  1. Seborrheic Blepharitis
    Seborrheic is just the technical term for ‘oily’, so this kind of blepharitis is associated with overactive sebaceous (oil) glands. People with seborrheic blepharitis also often have dandruff of the scalp, asthma, hay fever, allergies or a skin condition called acne rosacea.
  2. Infective blepharitis
    Is often caused by staphylococcus, a type of bacteria that is normally found on the skin around your eyes. Reduced immune function may allow staphylococcus to set up an infection in the eyelids, resulting in crusty deposits and sticky tears.
  3. Meibomian gland dysfunction
    Meibomian glands are in the back of the eyelids and are usually responsible for secreting an oily substance that forms part of the normal tear film. If the glands are not functioning properly and start producing a secretion that is too thick, they will become clogged. As a result the eyelids can become inflamed and more susceptible to infection.

 

Causes:
Blepharitis can be associated with skin conditions such as acne rosacea (oil gland malfunction) or a bacterial infection (staphylococcus). Sometimes eye make-up can cause blepharitis by initiating an allergic reaction that causes swelling of the eyelids and defective tear formation.

 

Treatment:
If the cause of blepharitis is cosmetics, cessation of use of the offending make-up may be all that is required. Blepharitis is more commonly a long-term condition requiring ongoing maintenance. Usually a simple care regime is all that is required to prevent or reduce the severity of future bouts.

 

Your Cleaning Regime:

Treatment may include applying daily warm compresses (such as a clean, warmed washcloth) to soften the oily, sticky or crusty substances on the eyelids. Cleansing is the next step and is an essential part of blepharitis treatment. Your Optometrist will recommend the solution to use; warm water only, salt water, diluted baby shampoo or special over-the-counter lid cleansing products.

The solution should be gently massaged into the eyelids and lashes using a clean finger or cotton bud, as advised by your Optometrist. Always wash your hand before touching your eyelids.

If eye drops or ointment are necessary, they will be prescribed when the condition is first diagnosed. Drops or ointment should be applied after both the warming and cleansing steps. Your Optometrist may also recommend lubricating eye drops and vitamin supplements to promote ongoing ocular health and comfort.

 

Prevention:

If you are susceptible to blepharitis, conscientious eyelid hygiene can help prevent a reoccurrence.

  • Always wash hands before touching your eyelids
  • Wash your hair and face daily
  • Wash your eyelids nightly
  • Avoid cosmetics

A regular consultation with your Optometrist will prevent untreated conditions becoming worse.

 

 

A nuisance that can be corrected

A substantial portion of the Australian population will suffer from the early symptoms of cataracts, but this is no cause for alarm.

 

The early signs of cataracts, such as slight clouding of vision and increased sensitivity to light, are inevitable as we get older. A thorough eye examination usually reveals the early stages of a cataract forming in one or both eyes.

Cataracts are a cloudiness that can form in the lens of the eye. Poor vision results because the cloudiness interferes with the light entering the eye. In the early stages of cataracts, people report that they can’t see as well as they used to, and that they are looking through a mist as well as noticing an increased sensitivity to light. 

The role of Optometrists in monitoring cataracts is very important. Optometrists monitor the health of the eye, your general health and the expected improvement after surgery (if required) before recommending cataract surgery. It is not unusual for an Optometrist to be monitoring several hundred patients with developing cataracts. 

Today the removal of a cataract is a relatively simple and minor procedure performed under local anaesthetic and does not require an overnight stay in most cases. Cataract surgery improves vision on more than 95% of cases.

Common Optical Terms

Visual Acuity:
Visual Acuity (VA) is a measure of how clearly the eye can see letters, generally at 6 metres away. Reduced VA can cause eye strain, headaches, squinting and difficulties with recognising small print.

Emmetropria
:
Is when eyes are a normal power to perfectly focus at distance

Hyperopia
:
Occurs when the eye is a weaker power than normal, resulting in extra focus effort needed, especially for near visual tasks.

 

Myopia:
Occurs when the eye’s power is too strong, resulting in blurred distance vision.

 

Astigmatism:
Occurs when the front surface of the eye is oval in curvature rather than round. It usually causes blurred vision at distance and near.



Eye Health:

External eye assessment involves the health of the lids and lashes, front surface of the eye and function of the pupils. Internal eye health assessment includes the eye’s lens, retina, blood vessels and optic nerve to detect evidence of eye disease or systemic problems.

 

Eye Movement Skills (Pursuits & Saccades):
Eye movement skills are necessary for a person to accurately point and move their eyes. This skill allows easy shifting of the eyes along the lines of print in a book, a rapid and accurate return to the next line, effective scanning of vertical columns, quick and accurate changes in shifts from the desk to the board and return, and sure tracking in sports.

 

Accommodation:
Accommodation is the ability to easily maintain clear focus for reading and writing, especially for extended periods. The focusing system must also be able to quickly and accurately change focus from distance to near and back many times throughout the day. Problems of accommodation can cause headaches, eyestrain, blurred vision, reduced concentration and comprehension, and reduced reading fluency and accuracy.

 

Binocular Vision:

Binocular vision is the ability to use the two eyes together as a team. A person’s eyes may have a tendency to cross or turn outward. Often they actually do cross or turn outward. Reduced ability to team both eyes can cause double vision, fatigue, avoidance of close work, short attention span and eye strain, or an obvious turned eye.

These binocular vision skills are intimately related to eye movement control and focusing ability:

Phoria:
Is the accuracy of aiming of the two eyes together
Fusion:
Is the strength of teamwork of the two eyes. Difficulty with eye teaming may result in strabismus (turned eye); suppressing (blocking out of the vision of one eye); task rejection (day dreaming, avoidance behaviour) or the use of excessive compensatory effort often causing discomfort, and reduced academic accomplishment in children.
Stereopsis:
Is the ability to use binocular (two-eyed) vision to make three-dimensional judgments and is a measurement of fine depth perception

Colour Vision:
Colour vision is the ability to discriminate and name all colours. It is important when special colour-related educational procedures are used and when career and/or hobby interests involve precise colour coding or specific colour utilisation.



Behavioural Optometrists:

Behavioural Optometrists are particularly interested in the appropriate development of children’s visual systems. Of particular concern is how all the component systems operate once the child begins school. A delay in development of any part of the visual system can have an impact upon the performance of the child at school. This may affect reading performance, concentration and behaviour in the classroom. Behavioural Optometry differs from traditional Optometry in that it takes into account the whole vision process rather than just eyesight.

Conjunctivitis


Conjunctivitis is an inflammation of the conjunctiva, the thin, transparent layer that lines the inner eyelids and covers the white parts of the eye. There are three main types of conjunctivitis – infectious, allergic and toxic.

Common Symptoms are red watery eyes, inflamed inner eyelids, blurred vision, a scratchy feeling in the eyes and, sometimes, a pus-like or watery discharge. Severe conjunctivitis can harm your vision so you should see your optometrist or GP promptly for diagnosis and treatment.



Infectious conjunctivitis:


Infectious conjunctivitis, bacterial or viral, may be in one eye only and is very contagious. If it is caused by bacteria it is usually associated with a sticky, coloured discharge and with the lids sticking together on waking. It can be treated with antibiotic eye drops and ointment.

Other forms of the condition, such as those caused by viruses, are usually associated with a watery, clear discharge and a foreign-body sensation. They cannot be treated with antibiotics but may be relieved by using drops prescribed by your optometrist or GP and must be fought off by your body’s immune system.

To control the spread of infectious conjunctivitis, you should keep your hands away from your eyes, and thoroughly wash your hands before applying eye medications. Do not share towels, face washers, cosmetics, pillows or eye drops with others.


 

Allergic conjunctivitis:
Allergic conjunctivitis usually affects both eyes and is not contagious. It is usually associated with an airborne agent, such as some pollens, cosmetics, animals or fabrics, which causes irritation. Your body’s reaction may cause a swelling of the conjunctiva, which is a thin, glandular membrane.

It can occur alone but is often in conjunction with nasal allergy symptoms such as sneezing, sniffling and a stuffy nose which may be eased by using tablets from the pharmacist.



Toxic conjunctivitis:

Toxic conjunctivitis may occur in one eye and is not contagious.

There is usually immediate irritation after exposure. The eye requires flushing, preferably with fresh water, for at least several minutes in the case of exposure to a chemical.

Irritants like air pollution, noxious fumes and excessive chlorine in swimming pools may produce toxic conjunctivitis, as can excessive use of some eye drops. In the workplace, acids and cleaning chemicals may be the cause.

If you have allergic or chemical conjunctivitis, it is important to consult your optometrist. If the cause of your problem can be identified, you should try to avoid it. In the case of allergic conjunctivitis, successful management should centre on prevention or avoidance of the allergens that trigger symptoms.

Tips to reduce exposure to allergens:

  • Stay indoors when wind is blowing pollen
  • Wear spectacles or sunglasses when outdoors to minimize the amount of pollen that can get into your eyes
  • Avoid rubbing eyes and wearing contact lenses, which will irritate your eyes or make your condition worse
  • Reduce dust mite exposure in your home, especially in the bedroom. Bedding,particularly pillows, should be encased in mite-proof covers. Wash bedding frequently in hot water, at least 55 degrees centigrade. Keep humidity in your home between 30 and 50 per cent.
  • Wash your hands immediately afterpatting

    animals. Remove and wash clothing after visiting friends that have pets

  • If you have a pet to which you are allergic to, keep it out of your house as much as possible. If the pet must be in the house, keep it out of the bedroom so you are not exposed to animal allergens while you sleep
  • Replace carpets with timber flooring, tiles or vinyl, which is easier to keep allergen free.

If these measures do not help to resolve your conjunctivitis, your Optometrist can recommend or prescribe eye drops that will help to relieve discomfort.

Diabetes

 

There are already 450,000 Australians who already have been diagnosed as diabetic; and their Optometrist can play an important role in their ongoing care.

The eye is in many instances an early warning system. It is generally acknowledged that the most common cause of blindness in young and middle aged people throughout the western world is diabetes.

Optometrists regularly detect signs in patients, which leads them to being diagnosed as diabetic. In a typical diagnosis scenario, people visit their Optometrist complaining about double vision, or dramatic changes in their eyesight. Diabetes is often characterised by severe dehydration, which can affect the lens of the eye.

For the diagnosed diabetic, Optometrists play an important health care role by assisting with the vision problems associated with diabetes and provide further information about diabetic vision management.

If diabetes is suspected, patients are referred to their medical practitioner. Once diabetes is stabilised a person’s vision normally recovers over a number of weeks. Ideally, a diabetic’s eyes should be examined every six or twelve months depending on the severity.


 

About diabetes

Diabetes occurs when your body doesn’t produce enough of the hormone “insulin” or because the insulin that is produced has a reduced effect. Insulin regulates the way your body uses the food you have eaten. If you have diabetes your body cannot cope in the usual way with sugar and other carbohydrates that you eat. Some children have diabetes but developing diabetes is much more common later in life. Diabetes can cause complications which affect different parts of your body, including your eye(s). The two main types of diabetes mellitus are known as Type 1 and Type 2 diabetes.

Type 1 diabetes
This type of diabetes commonly occurs before the age of 30 and is the result of the body producing little or no insulin. Type 1 diabetes is primarily controlled by insulin injections so it is sometimes called insulin dependent diabetes.
Type 2 diabetes
This type of diabetes commonly occurs after the age of 40. In this type of diabetes the body does produce some insulin, but the amount is either not sufficient or the body is not able to make proper use of it. Type 2 diabetes is generally controlled by diet, exercise and/or tablets. Although some people in this group will use insulin injections it is sometimes referred to as non-insulin dependant diabetes.
Gestational diabetes mellitus (GDM)
GDM is a type of diabetes that sometimes arises during the second or third trimester of pregnancy. For most women this diabetes goes away after pregnancy but it increases the chances of developing of type 1 or type 2 diabetes in later life.

 

Diabetes and your eye

Diabetes can affect the eye in a number of ways:

  • The most serious eye condition associated with diabetes involves the network of blood vessels supplying the retina. This condition is called diabetic retinopathy.
  • The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye, especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes over the day, depending on your blood sugar levels.
  • A longer term effect of diabetes is that the lens can go cloudy and this is called a cataract. Not everyone who has diabetes develops an eye complication. Of those that do, many people have a very mild form of retinopathy which may never progress to a sight threatening condition.
Diabetic retinopathy
The most serious complication of diabetes for the eye is the development of diabetic retinopathy. Diabetes affects the tiny blood vessels of the eye and if they become blocked or leak then the retina and possibly your vision will be affected. The extent of these changes determines what type of diabetic retinopathy you have. Forty per cent of people with type 1 diabetes and 20 per cent with type 2 diabetes will develop some sort of diabetic retinopathy.
Annual retinal screening

If you have diabetes this does not necessarily mean that your sight will be affected. If your diabetes is well controlled you are less likely to have problems, or they may be less serious. However, if there are complications that affect the eyes, this can sometimes result in serious loss of sight.

Most complications can be treated, but it is vital that they are diagnosed early. They can only be detected by a detailed examination of the eye carried out by your optometrist. At this visit you will have eye drops put into your eyes which dilate the pupil and allow the optometrist a good view of the retina. A picture is taken using a digital retinal camera and this is looked at in detail to see if there are any changes caused by diabetes.

As you may not be aware that there is anything wrong with your eyes until it is too late, having this regular test is essential. Research shows that if retinopathy is identified early, through retinal screening, and treated appropriately, blindness can be prevented in 90 per cent of those at risk.

The importance of early treatment
Although your vision may be good, changes can be taking place in your retina that need treatment. Most sight loss due to diabetes is preventable if treatment is given early. The earlier the treatment is given the more effective it is.

Remember:

  • early diagnosis of diabetic retinopathy is vital
  • have an annual eye examination with your optometrist

The importance of early treatment of diabetic retinopathy cannot be stressed enough. Remember, however, that if your vision is getting worse, this does not necessarily mean you have diabetic retinopathy. It may simply be a problem that can be corrected with glasses. So check it out.


 

Other ways diabetes can affect your eyes

Temporary blurring
The unusual changes in blood sugar levels resulting from diabetes can affect the lens inside the eye, especially when diabetes is uncontrolled. This can result in blurring of vision which comes and goes across the day. This blurring may be one of the first symptoms of diabetes although it may also occur at any time when your diabetes is not well controlled. Once your diabetes is controlled most people find this variable blurring goes away.

 

Cataracts
A cataract is a clouding of the lens of the eye, which causes the vision to become blurred or dim because light cannot pass easily to the back of the eye. This is a very common eye condition that often develops as we get older, but people with diabetes sometimes develop cataracts at an earlier age. An operation can remove the cloudy lens, which is usually replaced by a plastic lens, helping the eye to focus properly again. Your eye clinic will monitor a cataract if it is forming as part of your regular check up.


 

Important points to remember

  • Early diagnosis of diabetic retinopathy is vital.
  • Attend your retinal screening appointment.
  • Don’t wait until your vision has deteriorated to have an eye test.
  • Speak to your diabetic eye clinic if you notice changes to your vision.
  • Most sight-threatening diabetic problems can be managed by laser treatment if it is done early enough.
  • Don’t be afraid to ask questions or express fears about your treatment.
  • Good control of sugar, blood pressure and cholesterol reduces the risk of diabetes-related sight loss.
  • Attend your diabetic clinic or GP surgery for regular diabetes health checks, including blood pressure and cholesterol monitoring.
  • Smoking increases your risk of diabetes-related sight loss. Your GP can tell you about NHS stop smoking services in your area.


Monitoring blood sugar levels
Home testing your blood sugar levels is a very effective way of making sure you are controlling your blood glucose. You prick the side of a finger and place a drop of blood on a testing strip. You put the strip in a glucose meter which displays your blood glucose level on a screen.

If you have a sight problem you might find some meters difficult to read. If you are having difficulties reading your meter at home tell someone involved with your diabetic care. You need to be able to carry out testing at home accurately and your diabetic nurse needs to work with you to ensure that you can use the meter you have chosen effectively.

 

What if my sight cannot be fully restored?
Much can be done to help you use your remaining vision. You should ask your eye specialist or optometrist about low vision aids.

Dry Eye

 

Dry eye affects one in five Australians so it is important to be armed with knowledge about this condition.

The common symptoms of dry eye are usually soreness, grittiness, scratchiness, a foreign body sensation, burning and redness. Dry-eye patients notice these symptoms more when they are in conditions of high evaporation, for example, in air conditioning, central heating, during airline travel and on windy days. They also complain of intermittent blurring while performing near tasks such as reading and computer work.

While most dry-eye conditions are not vision threatening, dry eye can be a very irritating condition and in many cases, can affect a person’s quality of life and their ability to perform day-to-day tasks, particularly in the work environment.

Some people are more susceptible to dry eye. They are older people, women, contact lens wearers and those on medications that can alter or reduce tear production, such as blood pressure medications, antidepressants, the contraceptive pill and antihistamines. There is also an association between dry eye and some autoimmune diseases such as rheumatoid arthritis.

Mild dry eye can be managed with lubricating eye drops and modification to the working environment but chronic or more severe cases may require lid hygiene procedures, ointments, gels, anti-inflammatory eye drops or punctual plugs that are inserted into the tear ducts to restrict drainage of tears from the eyes. Some severe cases may require surgery, although this is very rare.

It is important that dry eye is diagnosed and managed properly because it is a chronic condition and inappropriate treatment can make the problem worse.


 

Tips for dry-eye sufferers

  • Avoid eye drops with preservatives, decongestants and antihistamines (unless prescribed by the optometrist) as these can exacerbate dry eye
  • Make sure that you can instill the drops and understand that non-preserved eye drops need to be discarded within 24 hours
  • Consult your optometrist so that the dry eye can be diagnosed and an appropriate management plan may be put in place
  • Use of humidifiers in the home and workplace may improve comfort
  • Modify air-conditioners so that the amount of dry air blowing directly on your face is reduced
  • Wear wrap-around sunglasses or side-shields on your glasses to protect your eyes from the drying wind
  • Take frequent breaks when working on the computer and try to blink more frequently
  • For temporary relief, use cold compresses periodically or bath your eyes with non-preserved saline

Glaucoma


Around 300,000 Australians currently suffer from Glaucoma and around a half of these do not even know they have it.

 

Glaucoma is caused by a build-up of fluid pressure within the eye. This fluid is constantly being replenished and if the eye’s drainage system fails or builds up with fluid, the resultant increase in pressure can destroy the nerve fibres of the optic nerve. The destruction of these nerve fibres reduces the eye’s peripheral vision.

 

There are three types of glaucoma – primary, congenital, and acute (sudden). Treatments include: Drops, Pills, Laser surgery and surgery. Diabetics are at particular risk of developing glaucoma.

 

Many people have Glaucoma and may not be aware of their condition until significant vision loss occurs and unfortunately once damage has occurred to the optic nerve it cannot be repaired. Regular eye examinations are essential to detect Glaucoma in its early stages.

 

Although everyone is at risk of developing Glaucoma, those at a higher risk include those over 40 years of age, those with a family history of the condition and people suffering from diabetes.

 

The test for Glaucoma is simple and painless. So don’t wait until it’s too late. State of the art testing facilities are used at Total Optical and you may be tested without the need for dilation.

Headaches

 

A headache is a symptom of an underlying condition. In Australia about 15% of the population takes painkillers for a headache at any given time. There are many types of headache, ranging from a sensation of mild pressure to severe migraine. Most headaches are caused by a combination of triggers including stress, poor diet, muscle tension and eyestrain.

 

Headaches occur when tissues or structures in and around the brain such as blood vessels, nerve fibres and sinuses are irritated, compressed or inflamed. Headache can result from referred pain from tooth, neck or eye problems.


 

What is the difference between migraines and other headaches?

A migraine often involves a long-lasting headache with other symptoms that do not seem to fit with a headache, such as:

  • Nausea and vomiting
  • Blurred vision or zigzag lights
  • Sensitivity to smell, touch, lights and sound

Migraine is very common in women (20% of women experience migraine during their life) and there is often a family history of migraine.

 

The distinction between headache and migraine is not always obvious. Migraine frequently has a pattern of features and recurrence that helps to diagnose it and to warn sufferers of an impending attack.


 

What should I do if I get headaches?
All severe or frequent headaches should be investigated. It is not always easy to tell if your headaches are ‘severe’, as this depends very much on your tolerance to pain. If you experience headaches that make you bedridden or unable to attend work, medical advice should be sought.

 

For the majority of annoying, niggling headaches, you should still try to find a cause so that you may prevent their recurrence or reduce your dependence on painkillers.

Ruling out contributing health problems is an important step.


 

HEADACHE QUESTIONNAIRE

In an effort to determine the cause of your headache, please start a diary in which you record the following information:

  1. Date of the headache
    • Time of day
    • Location in the head
    • How long it lasted
    • Type (steady, throbbing etc)
    • What did you do to relieve it?
    • Was the ‘treatment’ successful?
    • Does coughing make the headache worse?
    • What were you doing when the headache began?
    • What were the contents of the two meals preceding the headache?
    • How was this food prepared? (eg. fried, boiled, wine sauce etc)
    • Were you mentally and/or physically disabled during the headache?
    • Had you had any arguments or other annoying, frightening or emotional experiences during the 3 or 4 hours before the headache?
  2. Please answer the following questions:
    • For how many years or months have you had this type of headache?
    • Does your headache seem to be related to the pressure of your work, social commitments, menstrual cycle?
    • Has the character of the headache changed?
  3. Do you experience any of the following either with or without your headache:-
    • Numbness or tingling anywhere on your body
    • Mental confusion, Unsteadiness, Tremors
    • Stiffness of the neck or back
    • Weakness in arms or legs
    • Slurred speech, Nausea, Dizziness
    • Bowel Upset
    • Visual aura (zigzag lines, wavy vision, flashes etc)
    • Discomfort around the eyes due to bright lights
    • Hearing loss or ringing in the ears
    • Blurred vision at any distance
    • Visual blackouts (particular or total)
    • Unaccountable mood changes
  4. Do you have any allergies?
    • List any medications or drugs you take together with the dosages of each
  5. Any other information or comments which should include history of headaches in any other member of your family.

    Please bring this information with you to your next appointment or present your diary to your Doctor for further investigation.

 

Keratoconus


Keratoconus is a thinning of the central zone of the cornea (the front surface of the eye). As a result of the thinning, the normally round shape of the cornea is distorted and a cone-like bulge develops, resulting in significant visual impairment.

 

The cornea is similar, structurally, to the crystal of a watch. If this crystal is not smooth, the light will not bend evenly and an irregular image will be formed, like looking through a bumpy piece of glass.

 

Keratoconus is a slowly progressive condition often presenting in the teen or early twenties with decreased vision or visual distortion. However, many people have been diagnosed in their mid to late thirties; this is usually a more mild form of the disease.

 

This condition is not typically associated with redness, inflammation or other acute symptoms and therefore may go undetected for long periods of times.


 

What causes keratoconus?
The cause of keratoconus remains unknown, although recent research seems to suggest that it may be genetic in origin. Certainly some cases of keratoconus have a hereditary component and studies indicate that about 8% of patients have affected relatives. Excessive eye rubbing has also been implicated as a causative factor.


 

How common is keratoconus?
Keratoconus is estimated to occur in 1 out of every 2000 persons in the population, equally in both males and females. Over 90% of patients have keratoconus of both eyes, though it is not uncommon to experience more changes in one eye only.


 

What are the signs and symptoms?
The only clue to a keratoconus diagnosis may be from corneal measurements or a corneal topography map (See below). A topographical map of the cornea will show the high and low spots on the cornea, much like a topographical map of the earth shows mountains and oceans.

 


 
How is keratoconus treated?

The initial symptoms of keratoconus are usually a blurring and distortion of vision that may be corrected with spectacles in the early stages of the condition. Frequent changes to the spectacle correction may be required as the cornea becomes progressively thinner.

 

As this conditions progresses, vision will no longer be correctable with glasses as the cornea becomes highly irregular. Keratoconic rigid contact lenses are then required to provide optimal visual acuity. Soft contact lenses are usually not an option as they cannot correct for the irregular astigmatism associated with keratoconus. In about 15% of cases, the keratoconus progresses to the stage where corneal transplants may be considered if other treatment methods fail. There are new treatments being developed which can halt the progression of Keratoconus.

 

Most people with keratoconus will have a mild or moderate form of keratoconus. Less than 10% of keratoconics will develop the most severe form.

 

Macula Degeneration

 

What is Macular Degeneration (MD)?

 

The macula is the central part of the retina, the light sensitive tissue at the back of the eye. The retina processes all visual images. It is responsible for your ability to read, recognize faces, drive and see colours clearly. You read using your macula.

 

MD causes progressive macular damage resulting in loss of central vision. This loss of vision may be severe. Fortunately the side vision is not affected.


 

How Common is MD?


MD is the leading cause of blindness and severe vision impairment in Australia. Its incidence is increasing.

 

More than 800,000 Australians have some form of MD. It affects one in seven people over the age of 50 years and one in three over the age of 75*. *The Blue Mountains Eye Study. 1996


 

What are the types of MD?


There are two types of MD – Wet and Dry. The Dry form results in a gradual loss of central vision.

 

The Wet form is caused by abnormal blood vessels growing into the retina. Sudden loss of vision is characteristic and vision loss may be severe. Up to 75% of people with untreated Wet MD end up legally blind within two years.


 

What are the risk factors?

MD is thought to be caused by a combination of genetic and environmental factors. People over the age of 50 are at risk.

If you smoke or have a family history of MD, your risk of developing the disease is much greater.


 
What can you do to reduce your risk?
  • Have your macula examined every five years
  • Eat fish two to three times a week
  • Eat dark green leafy vegetables and fresh fruit
  • Eat a handful of nuts a week
  • Limit your intake of fats and oils
  • Keep a healthy lifestyle – don’t smoke, control your weight and exercise regularly
  • In consultation with your doctor, consider taking a zinc and antioxidant supplement
  • Provide adequate protection for your eyes from sunlight exposure, particularly when young

 

What treatments are available?


MD is a progressive disease. Treatment options are dependent on the stage and type of the disease. Current treatments aim to preserve as much vision as possible and halt or slow the progression of MD. There is presently no cure.


 

What help is available?
People with varying degrees of visual loss continue to lead independent lives with the support of low-vision services and visual aids.

 

Low-vision services are designed to help people use the vision they have in the most effective way.

Low-vision aids can help with everyday activities in the home, the workplace and the community. Low vision technology is rapidly increasing to benefit people with low vision.


 

The Amsler Test

 

This is an Amsler Grid, which can be used to test for symptoms of MD. DO NOT DEPEND ON THIS FOR ANY DIAGNOSIS.

 

Directions:

  1. Do not remove glasses or contacts you normally wear for reading
  2. Stand approximately 35cm from the grid in a well lit room.
  3. Cover one eye with your hand and focus on the centre dot with your uncovered eye. Repeat with the other eye.
  4. If you see wavy, broken or distorted lines, or blurred or missing areas of vision you may be displaying symptoms of MD and should contact your eye care provider immediately.

 

Pterygium


A pterygium is an overgrowth of tissue from the white of the eye over onto the cornea (the crystal window of the eye). It normally presents on the ‘nose’ side of the eye although occasionally, in less than 1 per cent of cases, it may come on the ‘ear’ side. Two ptergyiums are known as ‘pterygia’.

It usually presents in young patients over the age of 20 or 30 years although it has been known to occur during teenage years. This is NOT a cancer and is a localised disturbance on the surface of the eye. Usually a pterygium will remain stationary after a period of growth during which time it may extend 1, 2, 3 millimetres or more onto the cornea which is 12mm wide and covers the iris (the coloured part of the eye). Very occasionally it may grow further and cross the line of vision.

How common are pterygia?
Pterygia of all shapes and sizes are extremely common and are estimated to occur in up to 10 per cent of all Queenslanders and are probably less frequent in southern states.

 



What causes pterygia?

Although the exact cause is not known, an extremely strong relationship has been identified with how much sunlight one is exposed to in the first 10 years of life and also ongoing sunlight exposure after that time. It is very important to wear sunglasses to protect the eyes from UV exposure.

 



 What is the treatment for pterygia?

Most pterygia can be left alone and just watched. Patients can do this quite adequately themselves by just looking in the mirror. It is probably useful for most patients with a pterygium to have an eye examination with their Optometrist every couple of years to check that the pterygium is not growing.

In a small percentage of cases, surgery may be the appropriate to treat this condition. This is usually the case for patients in whom the vision is either affected already or may be affected by the continued growth of the pterygium.

There are at least a dozen different methods of removing a pterygium. The most common is the removal of the pterygium and filling the resultant defect on the surface of the eye with a piece of membrane (conjunctiva) taken from another place on the surface of the eye. This technique is associated with the least risk and the highest success rate in preventing a recurrence

 



How to prevent the occurrence of pterygia

Prevention is better than cure and there are strong reasons to believe that the use of adequate protection of the eyes against sunlight may reduce the rate of this disease occurring.

It is essential that children before kindergarten and primary school age should be kept out of the midday sun and if this is not possible, they should wear wide brimmed hats or bonnets, be wheeled in a stroller with an awning and wear appropriate sunglasses from a young age.

When purchasing sunglasses, it is important that they meet Australian standards. This standard means that they offer protection from ultraviolet radiation. Wrap-around sunglasses are the most effective type. Consult your Optometrist for help in selecting the most appropriate sunglasses.

 
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