Worth keeping your eye on

EYE tests aren’t just about assessing whether we need glasses. They can also help detect a range of health problems, such as tumours and diabetes, and prevent long-term sight loss.

However, many of us are failing to take our eye health seriously. A recent Simplyhealth Advisory Research Panel report revealed that more than half of the 40-75-year-olds surveyed had not had a checkup for up to five years.

‘‘Some eye diseases give warning signs that we can detect in our vision, but several treatable diseases, like glaucoma, have no symptoms in the early stages,’’ says Nigel Davies, consultant ophthalmologist at the Bupa Cromwell Hospital. ‘‘Taking simple steps, like having an annual eye check and reporting any persistent vision problems to your optician or GP, can help identify significant problems early.’’ Regular checks are especially important if you have a close family history of eye diseases or you have diabetes.

Here’s an outline of some of the main sight-zappers to keep your eye on.

Glaucoma

‘‘Glaucoma’s a set of conditions where the optic nerve’s damaged because of pressure in the eyeball, resulting in a reduced field of vision,’’ says Davies. ‘‘There are no warning signs.’’ Often, no problems are caused in the short-term, but over time, continued high pressure causes damage to peripheral vision, in a way that can’t be detected by the individual. Early warning signs of some types of glaucoma include seeing haloes around lights in the early evening, accompanied by a mild headache or ache around the eyeball.

‘‘Another type, called ‘angle closure’, occurs when pressure becomes very high, very quickly, resulting in severe pain, nausea, vomiting and very blurred vision. This tends to affect the elderly and those who are very long-sighted,’’ says Davies.

Glaucoma can be treated by lowering the pressure in the eye, which is achieved most frequently by drops. Other treatments include laser therapy and some people require surgical procedures.

‘‘Age is a significant risk factor,’’ says Davies. ‘‘It affects around one per cent of people in their 40s and up to 15 per cent in their 80s. The main additional risk factor is having a parent with glaucoma.’’ Certain types are also more common in people of black-African or black-Caribbean origin, while other types are more common among Asian people.

Having diabetes can also put you at increased risk.

Macular degeneration

‘‘Age-related macular degeneration (AMD) is a degenerative process that affects many individuals in later life,’’ says Davies. ‘‘Early signs include difficulty with detailed vision, especially reading, and the major warning is distortion in the central vision.

There are two main types, ‘dry’ and ‘wet’. Dry’s the most common – 90 per cent of cases – and results in very slow vision change. The wet type results in a fairly rapid vision change, with distortion caused by the accumulation of fluid in the macula area. This arises from a cluster of new blood vessels that grow underneath the macula and leak fluid. These vessels are fragile and can bleed and cause scarring, leading to severe vision damage. ‘‘Dry macular degeneration can’t be treated, but studies have shown a particular combination of vitamins and antioxidants (vitamin C, E, zinc, omega- 3 and lutein) can reduce rates of progression,’’ says Davies.

For the wet type, a therapeutic agent is administered directly into the eye under local anaesthetic, which can be very effective, especially if the disease is caught early.

Age is the main risk factor, but having a parent with the condition, smoking, obesity, and high blood pressure and cholesterol are all also recognised factors, and it’s more common in women. ‘‘It’s possible that overall lifetime exposure to light also plays a part, so wearing sunglasses or a cap in bright light may be helpful,’’ Davies adds.

Hypertensive retinopathy

This is caused when the fine blood vessels in the retina are damaged by the effect of high blood pressure.

The small blood vessels burst and cause little haemorrhages (called ‘flame haemorrhages’ because of their shape). Nerve function in the retina becomes damaged and small white spots appear, called ‘cotton wool spots’. Blood vessels become leaky and cholesterol deposits appear, and if blood pressure’s very high, the optic nerve can become swollen.

An eye exam can flag up conditions that may not have any obvious symptoms

Often, treating the high blood pressure will help things settle down, though sometimes laser treatment is needed.

‘‘Just as we can’t feel the pressure in our eyes, we can’t feel our blood pressure. The key preventative measure is to have this measured once a year,’’ says Davies.

People with diabetes are also at risk of developing diabetic retinopathy. Symptoms include blurred vision, reduced night vision and sudden blindness.

Cataracts

Cataracts can range from mild to very severe, and cause a gradual clouding of the lens leading to blurred vision. Despite being a leading cause of sight-loss worldwide, it’s also very easily treatable.

Glasses may help with mild symptoms, but surgery’s usually required in serious cases. This involves replacing the cloudy lens with an artificial one and is usually done on a day patient basis.

‘‘There isn’t much you can do to prevent cataracts, although it’s one of the most treatable eye diseases,’’ says Davies. ‘‘Age, genetics and light exposure are all risk factors, as is diabetes and other pre-existing eye diseases. If an individual’s had an eye injury, this can also make them more susceptible.”

Cataract surgery is relatively straightforward and has proved to be very effective treatment with low complication rates.

• For more information on the above conditions, visit bupa.co.uk