Glaucoma: Symptoms, treatment and prevention

 

Glaucoma is often called the “silent thief of sight,” because most of its types typically cause no pain and produce no symptoms until noticeable vision loss occurs.

For this reason, glaucoma often progresses undetected until the optic nerve already has been irreversibly damaged.

What is glaucoma?

Glaucoma is a group of related eye disorders that cause damage to the optic nerve that carries information from the eye to the brain.

In most cases, glaucoma is associated with higher-than-normal pressure inside the eye — a condition called ocular hypertension. But it can also occur when intraocular pressure (IOP) is normal. If untreated or uncontrolled, glaucoma first causes peripheral vision loss and eventually can lead to blindness.

Glaucoma is the second-leading cause of blindness worldwide (behind cataracts).

Types of glaucoma

The two major categories of glaucoma are open-angle glaucoma and closed angle glaucoma. The “angle” in both cases refers to the drainage angle inside the eye that controls the outflow of the watery fluid (aqueous) which is continually being produced inside the eye.

If the aqueous can access the drainage angle, the glaucoma is known as open angle glaucoma. If the drainage angle is blocked and the aqueous cannot reach it, the glaucoma is known as closed angle glaucoma.

Glaucoma symptoms

Most types of glaucoma typically cause no pain and produce no symptoms until noticeable vision loss occurs, but with acute angle-closure glaucoma, one experiences sudden symptoms like blurry vision, halos around lights, intense eye pain, nausea and vomiting.

If you have these symptoms, see an optician so steps can be taken to prevent permanent vision loss.

Diagnosis, screening and tests for glaucoma

During routine eye exams, a tonometer is used to measure your intraocular pressure, or IOP. Your eye typically is numbed with eye drops, and a small probe gently rests against your eye’s surface. Other tonometers send a puff of air onto your eye’s surface.

An abnormally high IOP reading indicates a problem with the amount of fluid (aqueous humour) in the eye. Either the eye is producing too much fluid, or it’s not draining properly.

Normally, IOP should be below 21 mmHg (millimeters of mercury) — a unit of measurement based on how much force is exerted within a certain defined area.

If your IOP is higher than 30 mmHg, your risk of vision loss from glaucoma is 40 times greater than someone with intraocular pressure of 15 mmHg or lower. This is why glaucoma treatments such as eye drops are designed to keep IOP low.

Other methods of monitoring glaucoma involve the use of sophisticated imaging technology to create baseline images and measurements of the eye’s optic nerve and internal structures.

Then, at specified intervals, additional images and measurements are taken to make sure no changes have occurred that might indicate progressive glaucoma damage.

Glaucoma treatments

Treatment for glaucoma can involve surgery, laser treatment or medication, depending on the severity. Eye drops with medication aimed at lowering IOP are usually tried first to control glaucoma.

Because glaucoma is often painless, people may become careless about strict use of eye drops that can control eye pressure and help to prevent permanent eye damage.

In fact, not complying to prescribed glaucoma medication program one of the major reasons for blindness caused by glaucoma.

If you find that the eye drops you are using for glaucoma are uncomfortable or inconvenient, never discontinue them without first consulting your optician about a possible alternative therapy.

Exercise may cut glaucoma risk

Can you reduce the glaucoma risk? According to a recent European study, exercise lessens the chance that some people will develop glaucoma because it helps improve blood flow in your body and your eyes.

In addition to regular exercise and an active lifestyle, you also can reduce your risk for glaucoma by not smoking, maintaining a healthy weight, and eating a varied and healthy diet.

Source:

allaboutvision.com/en-gb/conditions/glaucoma/

 


Covid19 safety measures in practice update

As the COVID 19 regulations have now eased, we are able to offer routine examinations in addition to examinations for those who may have specific concerns about their vision.

Please contact the practice on 020 7222 0066 or email info@uniaopticians.co.uk to book an appointment.

We are currently available on Monday, Tuesday, Wednesday and Thursday, from 9:30 am to 4.30pm, but please check our website & contact us as these are due to change to allow for more appointments.

We are operating a closed door system, so we can control the number of customers in the practice at any time. All staff are wearing full PPE, and we would request all customers entering the practice to wear a face covering. (This can be provided if patients do not already have one) There are hand sanitiser stations both at the door and throughout the store.

We are able to dispense spectacle frames from our complete range, for prescriptions to be made up, and are sanitising any frames that are tried on after each customer. All equipment & surfaces are also sanitised after each customer visit.

In order to limit face to face contact we are able to carry out OCT scanning & retinal imaging. This enables us to have a fully detailed view of the retina and to detect the potential for many ocular diseases.

We look forward to seeing you soon.

The Unia Team.

 


Cataracts: Types, symptoms and treatments

Cataract is the clouding of the eye’s natural lens. It is the most common cause of vision loss in people over age 40 and is also the principal cause of blindness in the world. Types of cataracts include:

  • A subcapsular cataract occurs at the back of the lens. People with diabetes or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract.
  • A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with ageing.
  • A cortical cataract is characterised by white, wedge-like opacities that start in the periphery of the lens and work their way to the centre in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.
Cataract symptoms and signs

At first, a cataract has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting.

Hazy, blurred vision may mean you have a cataract.

A cataract may make light from the sun or a lamp seem too bright or glaring. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colours may not appear as bright as they once did.

The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can bring about a temporary improvement in your near vision, called “second sight.”

Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. On the other hand, a subcapsular cataract may not produce any symptoms until it’s well-developed.

If you think you have a cataract, see an optician for an exam to find out for sure.

What causes cataracts?

The lens inside the eye works much like a camera lens, focusing light onto the retina for clear vision. It also adjusts the eye’s focus, letting us see things clearly both up close and far away.

The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it.

But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.

No one knows for sure why the eye’s lens changes as we age, forming cataracts. But researchers worldwide have identified factors that may cause cataracts or are associated with cataract development.

Besides advancing age, cataract risk factors include:

  • Ultraviolet radiation
  • Diabetes
  • Hypertension
  • Obesity
  • Smoking
  • Prolonged use of corticosteroid medications
  • Statin medicines used to reduce cholesterol
  • Previous eye injury or inflammation
  • Previous eye surgery
  • Hormone replacement therapy
  • Significant alcohol consumption
  • High myopia (short sightedness)
  • Family history

One theory of cataract formation is that many cataracts are caused by oxidative changes in the human lens. This is supported by nutrition studies that show fruits and vegetables high in antioxidants may help prevent certain types of cataracts.

Cataract prevention

Though there is significant controversy about whether cataracts can be prevented, a number of studies suggest certain nutrients and nutritional supplements may reduce your risk of cataracts.

One 10-year study of female health professionals found that higher dietary intakes of vitamin E and the carotenoids lutein and zeaxanthin from food and supplements were associated with significantly decreased risks of cataract.

Good food sources of vitamin E include sunflower seeds, almonds and spinach. Good sources of lutein and zeaxanthin include spinach, kale and other green, leafy vegetables.

Other studies have shown antioxidant vitamins such as vitamin C and foods containing omega-3 fatty acids may reduce cataract risk.

Another step you can take to reduce your risk of cataracts is to wear sunglasses that block 100 percent of the sun’s UV rays when you are outdoors.

Cataract treatment

When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids.

Think about surgery when your cataracts have progressed enough to seriously impair your vision and affect your daily life.

Many people consider poor vision an inevitable fact of ageing, but cataract surgery is a simple, relatively painless procedure to regain vision.

During surgery, the surgeon will remove your clouded lens and in most cases replace it with a clear, plastic intraocular lens (IOL).

New IOLs are being developed to make the surgery less complicated for surgeons and the lenses more helpful to patients. Presbyopia-correcting IOLs potentially help you see at all distances, not just one. Another new type of IOL blocks both ultraviolet radiation and high-energy visible blue light, which research indicates may damage the retina.

Eyewear after cataract surgery

In most cases, unless you choose presbyopia-correcting IOLs, you will still need reading glasses after cataract surgery. You may also need progressive lenses to correct mild residual refractive errors as well as presbyopia.

For the best vision and comfort possible with glasses prescribed after cataract surgery, ask your optician to explain the benefits of anti-reflective coating and photochromic lenses.

 

Source:

www.allaboutvision.com/en-gb/conditions/cataracts/


Why do my eyes hurt?

Summary

Mild eye pain can be a symptom of eyestrain or tiredness. The area around the eyes may also hurt during a migraine headache or sinus infection. In some cases, eye pain can also be a symptom of a more serious condition, such as uveitis.

The eyes can hurt in many different ways. A person may feel that their eyes are sore, aching, burning, or stinging, or that they have an object or other foreign body stuck in them.

This article will look at the potential causes of eye pain, some treatments and remedies, and when to see a doctor.

 

Causes

Looking at screens for an extended period of time may cause eyestrain.
Eyestrain
Eyestrain develops when the eyes get tired. This often occurs when someone is completing a task that involves focusing the eyes for long periods of time. This can result in aching, watery, or dry eyes.

Some potential causes of eyestrain include:

  • looking at screens
  • driving
  • reading
  • having exposure to bright lights

Resting the eyes can improve eyestrain. The National Eye Institute (NEI) recommend taking breaks from tasks such as reading every 20 minutes by looking at an object 20 feet away for 20 seconds.

Adjusting the brightness of screens, reducing glare from lights and windows, and taking regular breaks from driving may also help.

An incorrect prescription for eyeglasses can also cause eyestrain and headaches. Vision changes over time, so it is a good idea to undergo regular checkups with an eye doctor.

Dry eye

Dry eye is a common condition. It occurs when the tear ducts do not produce enough tears to keep the eyes moist.

Some symptoms of dry eye include:

  • scratchy eyes
  • burning or stinging eyes
  • sensitivity to light
  • blurry vision
  • redness

Dry eye is most likely to affect older adults, females, and people who do not get enough vitamin A or omega-3 fatty acids in their diet. People with certain autoimmune conditions, such as lupus or Sjogren’s syndrome, are also likely to develop dry eye.

Dry eye can also occur if someone spends a long time looking at a screen, as they may not blink as often. Air conditioning, smoke, and wind can also exacerbate this condition.

Treatment for dry eye includes hydrating eye drops and prescription medication that causes the body to make more tears. Undergoing a medical procedure to block the tear ducts can help if the cause of dry eye is tear ducts that drain too quickly.

Pink eye

Pink eye, or conjunctivitis, results from a virus or bacterium. The most common symptoms are:

  • pink or red eyes
  • itching or burning
  • watery eyes
  • discharge, which could be white, yellow, or green

Viral conjunctivitis usually resolves on its own without treatment. However, people with bacterial conjunctivitis may need antibiotic eye drops or eye ointment.

People with severe or persistent symptoms, and those who notice conjunctivitis symptoms in a newborn baby, should see a doctor.

It is easy to pass pink eye to other people. Therefore, anyone with symptoms of conjunctivitis should wash their hands regularly, especially after touching the eye area. It is also a good idea to temporarily:

  • stop wearing contact lenses
  • stop wearing eye makeup
  • stop sharing towels and other personal items
  • avoid swimming pools

People will be able to resume these activities when the infection has cleared up.

Fungal infection

Fungi can also cause eye infections.

People who work on farms or in gardens, plus those who wear contact lenses, have a higher risk of developing fungal eye infections. People with weaker immune systems, diabetes, and conditions that require corticosteroid treatment may also be more susceptible.

A fungal eye infection can cause:

  • eye pain
  • redness
  • blurred vision
  • sensitivity to light
  • tearing
  • discharge

It is important to seek medical treatment right away for these symptoms. According to the Centers for Disease Control and Prevention (CDC), all types of fungal eye infection require prescription medication. Treatment may involve antifungal eye drops, medication, or, in some cases, surgery.

Scratched cornea

The cornea is the clear layer of film that covers the front of the eye. A person may scratch their cornea when putting in contact lenses, applying makeup, or rubbing their eyes. The result is eye pain, along with:

  • a feeling that something is stuck in the eye
  • red, watery eyes
  • sensitivity to light
  • blurry vision

To treat a scratched cornea, a doctor may prescribe eye drops, a patch to protect the eye, or a special contact lens that can speed up healing.

According to the American Academy of Ophthalmology, mild scratches do not need treatment and will usually heal within 2 days. A larger scratch may take up to 1 week to heal.

Uveitis

According to the NEI, uveitis is a term that describes a range of inflammatory eye conditions. Uveitis can destroy eye tissue and may cause vision loss.

The symptoms include:

  • eye pain
  • blurry vision
  • dark, floating spots in vision
  • sensitivity to light
  • redness

The cause of uveitis is not always clear. It may develop due to an eye injury, infection, tumor, or autoimmune condition. It can be an acute condition that goes away or a chronic condition that reoccurs.

Uveitis needs medical attention. Treatment is usually with prescription eye drops or medication. The aim is to reduce pain and inflammation, prevent tissue damage, and restore vision.

 

Eye pain and other symptoms

If eye pain occurs alongside other symptoms, it may indicate that the person has a different condition causing their eye pain.

Potential conditions include:

  • Sinus infection: Pain that affects the cheeks, forehead, and eyes, along with a blocked nose and fever, may indicate a sinus infection. A doctor can treat a sinus infection with antibiotics.
  • Migraine: Migraine is a condition that causes severe headaches, often on one side of the head. Migraine may cause a sharp pain in or behind the eyes or brow bone, sensitivity to light, and nausea or vomiting.
  • Cervicogenic headache: This type of headache can cause pain around the eyes, on one side of the face or head, and in the neck or shoulders. Nausea, blurred vision, and sensitivity to light or sound can also occur.
Home remedies

Home remedies cannot cure serious eye conditions or infections, such as a fungal infection or uveitis. However, they can provide symptom relief for people with tired, sore, or dry eyes.

Some home remedies include:

  • Resting: Eye pain due to strain and an incorrect prescription can ease when a person rests their eyes. Taking regular breaks from reading or screen work may prevent eyestrain.
  • Using a humidifier: Humidifiers can increase the moisture in the air, which can help people with dry eyes and those who live in dry climates.
  • Trying over-the-counter drops: Hydrating eye drops add moisture to the eyes and can help people with tired or dry eyes feel better.
  • Reducing exposure to irritants: Smoke, high winds, and air conditioning can exacerbate eye dryness. If possible, it may help someone to reduce their exposure to these irritants.
    Stopping smoking: Cigarette smoke irritates the eyes. According to the NEI, smoking also increases the risk of eye disease and optic nerve damage.

The NEI recommend reducing the risk of eye conditions by eating dark, leafy greens, oily fish such as salmon and halibut, and foods that contain vitamin A, such as carrots and broccoli.

 

When to see a doctor

If a person’s eye pain is severe, persistent, or accompanied by other symptoms — such as pus or sensitivity to light — they should see a doctor. Any loss of vision is also a reason to seek medical advice.

People at risk of developing eye disease or complications should also see an optician if they experience any eye pain. This includes people with diabetes, high blood pressure, and conditions that weaken the immune system.

Newborn babies can develop serious conditions as a result of eye infections. Parents and caregivers should take infants with puffy eyelids, red eyes, or eye discharge to a doctor right away.

Summary

Mild eye pain and discomfort are common. These symptoms can develop due to eyestrain or dryness, both of which can occur when someone spends a long period of time focusing the eyes on screens or books.

More severe eye pain may occur due to migraine, a scratched cornea, or an infection. If possible, a person should speak to a doctor about their symptoms.

 

Sources:

https://www.medicalnewstoday.com/articles/why-do-my-eyes-hurt#seeing-a-doctor

Dry EyeEye Health / BlindnessHeadache / Migraine
9 sourcesexpanded

Boyd, K. (2020). Corneal abrasion and erosion.
https://www.aao.org/eye-health/diseases/what-is-corneal-abrasion
Conjunctivitis (pink eye). (2019).
https://www.cdc.gov/conjunctivitis/
Dry eye. (2019).
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye
Fungal eye infections. (2017).
https://www.cdc.gov/fungal/diseases/fungal-eye-infections/index.html
Keep your eyes healthy. (2020).
https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/keep-your-eyes-healthy
Pink eye. (2019).
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/pink-eye
The complete headache chart. (n.d.).

Uveitis. (2019).
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/uveitis
Vimont, C. (2020). Eye strain: How to prevent tired eyes.
https://www.aao.org/eye-health/diseases/what-is-eye-strain


Hayfever – a guide to looking after your eyes

The hay fever season runs from spring through to autumn and affects nearly 18 million people in the UK. Hay fever sufferers have allergic reactions to different types of pollen, which include itchy eyes and nose, sneezing, runny or blocked nose and difficulty in breathing. Pollen grains can set off an allergic reaction as the conjunctiva (the transparent membrane covering the white of the eye) becomes inflamed causing watery, red, itchy eyes. The whites of your eyes may swell up and you may also experience a gritty feeling in your eyes.

Managing your hay fever:
  • Stay indoors – when there is a high pollen count, keep windows and doors closed and keep surfaces clear with a damp duster. Avoid going out in the early evening and midmorning when the pollen count is at its highest.
  • Wear sunglasses when you are outdoors – wraparound glasses offer more protection from pollen.
  • Wear glasses rather than your contact lenses – especially when the pollen count is high.
  • Change your clothes and have a shower – if you have been outside for a while, you may have pollen on your clothes, skin and hair. Taking a shower and changing your clothes can help.
    Bathe your eyes regularly in cold water.
  • Apply petroleum jelly to your nostrils – this will trap pollen.

 

Treating your hay fever:
  • Anti-allergy eye drops – these act as a protective defence. If you wear contact lenses remember to check if you can use the drops while your lenses are in. The College has produced an infographic which gives guidance on the best time to start taking eye drops depending on your allergy.
  • Antihistamines – in people with allergies, the body mistakes something harmless, such as pollen, for a threat and produces histamine, which causes symptoms such as rashes, a runny nose and/or sneezing. Taking Antihistamines before you come into contact with pollen can prevent this happening or can help reduce the severity of the symptoms if taken afterwards.
  • Steroid eye drops – these are very effective but can have serious side effects, such as glaucoma, cataracts and damage to the cornea. They are only available on prescription.

Source:

College of Optometrists website . Lookafter your eyes – Hay fever