Common Eye Diseases

Cataracts
Over half of those over 65 have some cataract development and most cases can be treated successfully with surgery. A cataract is not a skin that grows over the eye but a clouding of part of the eye called the lens. Vision becomes blurred or dim because light cannot pass through the clouded lens to the back of the eye.

What causes a cataract?
Cataracts can form at any age, but most often are a natural consequence of getting older. They develop slowly and are painless. In younger people they can result from an injury, taking certain medication, long-standing inflammation, or illnesses such as diabetes.

What are the symptoms?
Common symptoms may include the following complaints:

'I'm not seeing as well as I used to'
You may notice that your vision is blurred, or that your glasses seem dirty or scratched

'I sometimes see double'
The cloudiness in the lens may occur in more than one place, causing a double image.

'My vision is poor in bright light'
Bright light or very sunny days may make it more difficult to see.

'I've noticed a change in colours'
As the cataract develops, its centre becomes more and more yellow, giving everything you see a yellowish tinge

Experiencing these symptoms can also be a sign of other eye problems so it is important to consult your optometrist for an eye examination.

What can be done?
Early cataracts often make you more short-sighted, which in the early stages can be compensated for by altering the prescription of your glasses. Tinted lenses or shielding your eyes from the sun may also help. However, the benefit is usually only short-lived as the cataract continues to progress and the symptoms increase. At this stage the most effective treatment for cataracts is a simple operation to remove the cloudy lens. Your optometrist will advise you when you need to be referred to your GP or hospital. Cataract surgery is one of the most common surgical procedures and in most cases can be carried out under local anaesthetic on a day-case basis, without an overnight stay in hospital. Diets or drugs have not been shown to slow or stop the development of cataracts.

What is a lens implant?
When the cloudy lens has been surgically removed it is replaced by a plastic lens implanted in the eye so that it can focus properly. Once the eye has healed a change of spectacles is usually required. Occasionally your doctor will decide the eye is not suitable for a lens implant. In these cases, contact lenses or special glasses will be prescribed instead

Glaucoma
Glaucoma is the name for a group of eye conditions in which the optic nerve (the nerve at the back of the eye) is damaged, often in association with raised pressure within the eye. This leads to a reduction in the field of vision and in the ability to see clearly. In most cases glaucoma sufferers will experience no symptoms until significant damage has occurred.

Who is at risk from glaucoma?
People aged 40 and over are at greater risk from glaucoma and there is an increasing risk with every decade of life. Those with a family history of glaucoma in close relatives, or in certain ethnic groups (e.g. African-Caribbean people) are considered to have a greater than average risk. People who diabetic or very short- sighted are also more prone to glaucoma.

How do optometrists check for glaucoma?
Most new cases of glaucoma are identified through referrals from optometrists, whose training equips them to recognise the early signs of the disease. There are three main tests that may be carried out by an optometrist to check for glaucoma:

Ophthalmoscopy: checking the appearance of the optic disc (where the optic nerve joins the eye) using an ophthalmoscope, a special torch for looking into the eyes.
Visual field assessment: testing the field of vision using small points of light to check for blind spots.
Tonometry: measuring the pressure within the eye, either using an instrument that emits a small puff of air onto the surface of the eye, or placing a probe against the eye after it has been numbed with anaesthetic drops.

Other instruments are now available for detecting and monitoring glaucoma but these are the most commonly used tests.

What can be done?
If detected early enough, glaucoma can usually be treated. In most cases eye drops to reduce the pressure in the eye will be prescribed, although in some cases an operation is needed. To aid detection of glaucoma, the College of Optometrists recommends an eye examination every two years, or more frequently if there is a family history of the condition. If glaucoma is suspected, your optometrist will advise you whether you need to be referred to a GP or hospital. Once treatment is underway, you may be referred back to your optometrist for monitoring

Glaucoma sufferers and certain close relatives are entitled to a free eye examination provided by the NHS. Those diagnosed as being at risk of developing glaucoma are also eligible.

Detached Retina
Retinal detachment is a rare but serious and sight-threatening event which occurs when the retina the light-sensitive inner lining of the back of the eye becomes separated from the underlying tissue. This may be caused by a hole or tear in the retina which allows fluid to get underneath, weakening the attachment of the retina which then becomes detached - rather like wallpaper peeling off a damp wall. Detached retina can also be caused by an injury or may be a consequence of other eye conditions or surgery.

What are the symptoms?
The most common symptom is a shadow or curtain spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful. Many people experience flashes or floaters and these are not necessarily a cause for alarm. However, if they are severe and seem to be getting worse, and/or vision is being lost, a doctor should be seen urgently. Prompt treatment can often minimise the damage to the eye

Who is at risk from a detached retina?
Although detached retina affects only about one person per 10,000, it is more common in middle-aged people and those who are very short-sighted. If you have a detached retina in one eye, the risk of developing one in the other eye is increased. Very rarely, younger people can have a weakness of the retina, or it can be detached as a result of a blow to the eye or head. Retinal detachment can also occur as a result of laser refractive surgery (LASIK) but this is a rare complication. Cataract surgery, ocular tumours and diabetic eye disease are other possible causes

What can be done?
A detached retina needs urgent medical attention. The sooner the retina is reattached, the better the chances of regaining vision. With early help, it may only be necessary to have laser or freezing treatment. This is a simple procedure usually performed under a local anaesthetic. Often, however, an operation to repair the hole in the retina will be needed. This does not usually cause pain, but the eye will be sore and swollen afterwards. You will usually need to stay in hospital for two or three days after the operation.

Age Related Macular Degeneration
Age-related macular degeneration (AMD) is the leading cause of vision loss for people over the age of 50 in the Western world. It occurs when the delicate cells of the macula the small, central part of the retina responsible for the centre of our field of vision - become damaged and stop working.
There are two types of AMD: the 'dry' form and the more severe 'wet' form. Dry AMD is the more common, develops gradually over time and usually causes only mild loss of vision. The wet form accounts for only 10-15% of all AMD but the risk of sight loss is much greater. Because macular degeneration is an age-related process it usually involves both eyes, although they may not be affected at the same time.

Children and young people can also suffer from an inherited form of macular degeneration called macular dystrophy, Sometimes several members of a family will suffer from this condition and, if this is the case, it is very important that their eyes are checked regularly.

What are the symptoms?
AMD is not painful and never leads to total blindness because it is only the central vision that is affected. This means that almost everyone with AMD will have enough side (or peripheral) vision to get around and keep their independence

In the early stages of AMD, central vision may be blurred or distorted and things may look an unusual size or shape. This may happen quickly or develop over several months, although if only one eye is affected it may not be noticed. People with AMD may become sensitive to light or find it harder to distinguish colours. The macula enables people to see fine detail so those with the advanced condition will often notice a blank patch or dark spot in the centre of their sight. This makes activities like reading, writing and recognising faces very difficult.

Who is at risk from AMD?
The cause of AMD is unknown but several factors appear to increase the risk. These include smoking, a high-fat diet and excessive sun exposure. Risk also increases with advancing age and may be more common in those with a family history of AMD. The incidence is higher among women and those with light skin or eye colour.

How can your optometrist help?
Optometrists have an important role to play in detecting and monitoring AMD by checking your standard of vision and examining the macula for signs of the disease at routine eye examinations. If AMD is suspected, your optometrist may put drops into the eyes to widen the pupils and see more of the retina. Early detection is essential to treating some types of AMD. Your optometrist will advise you whether you need to be referred to a GP or hospital for medical advice. If your vision is affected, you may be given stronger glasses or special magnifiers to help you see better.

What can be done?
There is currently no treatment for dry AMD but the wet form can be treated in several ways. Various forms of laser treatment may be used to halt or slow the progression of abnormal blood vessels and prevent further sight loss. These are simple procedures that can be carried out on an outpatient basis. Drugs are also becoming available for treating wet AMD, whether in the early or late stages. Trials are also taking place for new types of drugs and for combination therapies using drugs and laser treatment.
There is evidence that improving your diet by eating fresh fruits and dark green, leafy vegetables may delay or reduce the severity of AMD. Some studies show that taking nutritional supplements may be effective in slowing the progression of AMD although they do not prevent its initial development nor improve vision already lost (AMD Alliance).

Diabetic Eye Problems
Eye problems are among the most significant complications of diabetes, which is the most common cause of blindness in people of working age.
Diabetes affects the eye in a number of ways. The most damaging condition occurs when the fine network of blood vessels in the retina the light-sensitive inner lining of the back of the eye leak fluid. This is known as diabetic retinopathy. Cataracts also develop earlier and progress more rapidly in diabetics than in other people. Untreated diabetes may also make cause frequent or noticeable changes to your eyesight.

Serious eye problems are less likely if the diabetes is well controlled or in its early stages. Most sight loss from diabetic eye disease can be prevented if detected early and treated.
How can your optometrist help?
Optometrists have an important role to play in detecting the disease and in monitoring the eyes of diabetics once diagnosed. Checking the appearance of the retina with an ophthalmoscope, a special torch for looking into the eyes, is the most commonly used test for diabetic eye problems. Photographs of the retina may also be used to detect and monitor any abnormalities.

If diabetes is suspected, your optometrist will refer you to a GP or hospital for medical advice. If diabetes is diagnosed, your eyes will need to be examined regularly for signs of eye problems. You may be referred to a hospital eye clinic or be referred back to your optometrist for regular monitoring. Even though your vision may be good, changes can be taking place to your retina that need treatment.

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 by glasses.

What can be done?
Most sight-threatening diabetic problems can be prevented by laser treatment if it is carried out early enough. It is important to realise, however, that laser treatment aims to save the sight you have - not to make it better. The laser, a beam of high intensity light, can be focused with extreme precision to seal the blood vessels that are leaking fluid into the retina. If new blood vessels grow, more extensive laser treatment may be needed

Diabetics are entitled to a free eye examination provided by the NHS.

All the information on this page was used from the following website
http://www.college-optometrists.org/ (accessed on 8/2/2009).

	Common Eye Diseases Cataracts Over half of those over 65 have some cataract development and most cases can be treated successfully with surgery. A cataract is not a skin that grows over the eye but a clouding of part of the eye called the lens. Vision becomes blurred or dim because light cannot pass through the clouded lens to the back of the eye. *What causes a cataract?* Cataracts can form at any age, but most often are a natural consequence of getting older. They develop slowly and are painless. In younger people they can result from an injury, taking certain medication, long-standing inflammation, or illnesses such as diabetes. *What are the symptoms?* Common symptoms may include the following complaints: *'I'm not seeing as well as I used to'* You may notice that your vision is blurred, or that your glasses seem dirty or scratched *'I sometimes see double'* The cloudiness in the lens may occur in more than one place, causing a double image. *'My vision is poor in bright light'* Bright light or very sunny days may make it more difficult to see. *'I've noticed a change in colours'* As the cataract develops, its centre becomes more and more yellow, giving everything you see a yellowish tinge Experiencing these symptoms can also be a sign of other eye problems so it is important to consult your optometrist for an eye examination. *What can be done?* Early cataracts often make you more short-sighted, which in the early stages can be compensated for by altering the prescription of your glasses. Tinted lenses or shielding your eyes from the sun may also help. However, the benefit is usually only short-lived as the cataract continues to progress and the symptoms increase. At this stage the most effective treatment for cataracts is a simple operation to remove the cloudy lens. Your optometrist will advise you when you need to be referred to your GP or hospital. Cataract surgery is one of the most common surgical procedures and in most cases can be carried out under local anaesthetic on a day-case basis, without an overnight stay in hospital. Diets or drugs have not been shown to slow or stop the development of cataracts. *What is a lens implant?* When the cloudy lens has been surgically removed it is replaced by a plastic lens implanted in the eye so that it can focus properly. Once the eye has healed a change of spectacles is usually required. Occasionally your doctor will decide the eye is not suitable for a lens implant. In these cases, contact lenses or special glasses will be prescribed instead Glaucoma Glaucoma is the name for a group of eye conditions in which the optic nerve (the nerve at the back of the eye) is damaged, often in association with raised pressure within the eye. This leads to a reduction in the field of vision and in the ability to see clearly. In most cases glaucoma sufferers will experience no symptoms until significant damage has occurred. *Who is at risk from glaucoma?* People aged 40 and over are at greater risk from glaucoma and there is an increasing risk with every decade of life. Those with a family history of glaucoma in close relatives, or in certain ethnic groups (e.g. African-Caribbean people) are considered to have a greater than average risk. People who diabetic or very short- sighted are also more prone to glaucoma. *How do optometrists check for glaucoma?* Most new cases of glaucoma are identified through referrals from optometrists, whose training equips them to recognise the early signs of the disease. There are three main tests that may be carried out by an optometrist to check for glaucoma: Ophthalmoscopy: checking the appearance of the optic disc (where the optic nerve joins the eye) using an ophthalmoscope, a special torch for looking into the eyes. Visual field assessment: testing the field of vision using small points of light to check for blind spots. Tonometry: measuring the pressure within the eye, either using an instrument that emits a small puff of air onto the surface of the eye, or placing a probe against the eye after it has been numbed with anaesthetic drops. Other instruments are now available for detecting and monitoring glaucoma but these are the most commonly used tests. *What can be done?* If detected early enough, glaucoma can usually be treated. In most cases eye drops to reduce the pressure in the eye will be prescribed, although in some cases an operation is needed. To aid detection of glaucoma, the College of Optometrists recommends an eye examination every two years, or more frequently if there is a family history of the condition. If glaucoma is suspected, your optometrist will advise you whether you need to be referred to a GP or hospital. Once treatment is underway, you may be referred back to your optometrist for monitoring Glaucoma sufferers and certain close relatives are entitled to a free eye examination provided by the NHS. Those diagnosed as being at risk of developing glaucoma are also eligible. Detached Retina Retinal detachment is a rare but serious and sight-threatening event which occurs when the retina the light-sensitive inner lining of the back of the eye becomes separated from the underlying tissue. This may be caused by a hole or tear in the retina which allows fluid to get underneath, weakening the attachment of the retina which then becomes detached - rather like wallpaper peeling off a damp wall. Detached retina can also be caused by an injury or may be a consequence of other eye conditions or surgery. *What are the symptoms?* The most common symptom is a shadow or curtain spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful. Many people experience flashes or floaters and these are not necessarily a cause for alarm. However, if they are severe and seem to be getting worse, and/or vision is being lost, a doctor should be seen urgently. Prompt treatment can often minimise the damage to the eye *Who is at risk from a detached retina?* Although detached retina affects only about one person per 10,000, it is more common in middle-aged people and those who are very short-sighted. If you have a detached retina in one eye, the risk of developing one in the other eye is increased. Very rarely, younger people can have a weakness of the retina, or it can be detached as a result of a blow to the eye or head. Retinal detachment can also occur as a result of laser refractive surgery (LASIK) but this is a rare complication. Cataract surgery, ocular tumours and diabetic eye disease are other possible causes *What can be done?* A detached retina needs urgent medical attention. The sooner the retina is reattached, the better the chances of regaining vision. With early help, it may only be necessary to have laser or freezing treatment. This is a simple procedure usually performed under a local anaesthetic. Often, however, an operation to repair the hole in the retina will be needed. This does not usually cause pain, but the eye will be sore and swollen afterwards. You will usually need to stay in hospital for two or three days after the operation. Age Related Macular Degeneration Age-related macular degeneration (AMD) is the leading cause of vision loss for people over the age of 50 in the Western world. It occurs when the delicate cells of the macula the small, central part of the retina responsible for the centre of our field of vision - become damaged and stop working. There are two types of AMD: the 'dry' form and the more severe 'wet' form. Dry AMD is the more common, develops gradually over time and usually causes only mild loss of vision. The wet form accounts for only 10-15% of all AMD but the risk of sight loss is much greater. Because macular degeneration is an age-related process it usually involves both eyes, although they may not be affected at the same time. Children and young people can also suffer from an inherited form of macular degeneration called macular dystrophy, Sometimes several members of a family will suffer from this condition and, if this is the case, it is very important that their eyes are checked regularly. *What are the symptoms?* AMD is not painful and never leads to total blindness because it is only the central vision that is affected. This means that almost everyone with AMD will have enough side (or peripheral) vision to get around and keep their independence In the early stages of AMD, central vision may be blurred or distorted and things may look an unusual size or shape. This may happen quickly or develop over several months, although if only one eye is affected it may not be noticed. People with AMD may become sensitive to light or find it harder to distinguish colours. The macula enables people to see fine detail so those with the advanced condition will often notice a blank patch or dark spot in the centre of their sight. This makes activities like reading, writing and recognising faces very difficult. *Who is at risk from AMD?* The cause of AMD is unknown but several factors appear to increase the risk. These include smoking, a high-fat diet and excessive sun exposure. Risk also increases with advancing age and may be more common in those with a family history of AMD. The incidence is higher among women and those with light skin or eye colour. *How can your optometrist help?* Optometrists have an important role to play in detecting and monitoring AMD by checking your standard of vision and examining the macula for signs of the disease at routine eye examinations. If AMD is suspected, your optometrist may put drops into the eyes to widen the pupils and see more of the retina. Early detection is essential to treating some types of AMD. Your optometrist will advise you whether you need to be referred to a GP or hospital for medical advice. If your vision is affected, you may be given stronger glasses or special magnifiers to help you see better. *What can be done?* There is currently no treatment for dry AMD but the wet form can be treated in several ways. Various forms of laser treatment may be used to halt or slow the progression of abnormal blood vessels and prevent further sight loss. These are simple procedures that can be carried out on an outpatient basis. Drugs are also becoming available for treating wet AMD, whether in the early or late stages. Trials are also taking place for new types of drugs and for combination therapies using drugs and laser treatment. There is evidence that improving your diet by eating fresh fruits and dark green, leafy vegetables may delay or reduce the severity of AMD. Some studies show that taking nutritional supplements may be effective in slowing the progression of AMD although they do not prevent its initial development nor improve vision already lost (AMD Alliance). Diabetic Eye Problems Eye problems are among the most significant complications of diabetes, which is the most common cause of blindness in people of working age. Diabetes affects the eye in a number of ways. The most damaging condition occurs when the fine network of blood vessels in the retina the light-sensitive inner lining of the back of the eye leak fluid. This is known as diabetic retinopathy. Cataracts also develop earlier and progress more rapidly in diabetics than in other people. Untreated diabetes may also make cause frequent or noticeable changes to your eyesight. Serious eye problems are less likely if the diabetes is well controlled or in its early stages. Most sight loss from diabetic eye disease can be prevented if detected early and treated. How can your optometrist help? Optometrists have an important role to play in detecting the disease and in monitoring the eyes of diabetics once diagnosed. Checking the appearance of the retina with an ophthalmoscope, a special torch for looking into the eyes, is the most commonly used test for diabetic eye problems. Photographs of the retina may also be used to detect and monitor any abnormalities. If diabetes is suspected, your optometrist will refer you to a GP or hospital for medical advice. If diabetes is diagnosed, your eyes will need to be examined regularly for signs of eye problems. You may be referred to a hospital eye clinic or be referred back to your optometrist for regular monitoring. Even though your vision may be good, changes can be taking place to your retina that need treatment. 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 by glasses. *What can be done?* Most sight-threatening diabetic problems can be prevented by laser treatment if it is carried out early enough. It is important to realise, however, that laser treatment aims to save the sight you have - not to make it better. The laser, a beam of high intensity light, can be focused with extreme precision to seal the blood vessels that are leaking fluid into the retina. If new blood vessels grow, more extensive laser treatment may be needed Diabetics are entitled to a free eye examination provided by the NHS. All the information on this page was used from the following website http://www.college-optometrists.org/ (accessed on 8/2/2009).

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