COMMON EYE PROBLEMS
A considerable amount of sight can be lost before you are aware of a problem. Regular eye exams are vital to help detect problems like these:
The following information on common eye problems and diseases is gathered from the NHS.
Floaters
Floaters are shapes which people can see drifting across their vision. The exact form of these is very variable – they may appear as small dots or irregularly shaped strands.
What Causes Floaters?
The eye is filled by a jelly-like substance, the vitreous. As the vitreous ages, strands of a protein called collagen become visible within it. These strands swirl gently when the eye moves, giving rise to the perception of floaters. In some people, usually over the age of 40, the vitreous can separate from the retina. When this happens it tugs on the retina, causing the eye to see flashes of bright white light. A sudden increase (shower) of floaters is usually seen at the same time. This is called posterior vitreous detachment and may lead to retinal detachment.
Are Floaters Serious?
Generally people should not be concerned about seeing one or two floaters in their vision, particularly if they have been there for some time. A sudden increase in the number of floaters, especially if you also see white flashing lights, is seen with posterior vitreous detachment. If you see this you should see an eye doctor urgently to ensure you are not getting a retinal detachment.
Can Floaters be Removed?
It is technically possible to remove floaters by performing an operation to remove the vitreous; a vitrectomy. Unfortunately, this operation carries significant risks to sight because of the possible complications, which include retinal detachment and cataract. Most eye surgeons are therefore reluctant to recommend this surgery unless there is a threat to sight.
Blepharitis
when the rims of the eyelids become inflamed. This can make your eyes red, irritated and itchy. Dandruff-like crusts can appear on your eyelashes. Blepharitis can be caused by bacterial infection or can be a complication of skin conditions such as seborrheic dermatitis (a skin condition that can cause itchy rashes on the skin and scalp). When seborrheic dermatitis affects the scalp, it's called dandruff. Another associated skin condition is rosacea, which causes the face to appear red and blotchy.
Blepharitis is a chronic condition, meaning that once it develops you'll probably have repeated episodes. There is no cure. However, there are a range of treatments that can control the symptoms. The most important one is to establish a daily eye-cleaning routine.
More severe cases of blepharitis may require the use of antibiotics. It is estimated that blepharitis is responsible for 5% of all eye problems that are reported to GPs. It is more common in older adults, but can develop at any age. Complications of blepharitis include dry eye syndrome (where the eyes do not produce enough tears, or dry out too quickly), styes (a pus-filled swelling in or on the eyelid) and conjunctivitis (inflammation of the eye).
The condition is not normally serious. Serious complications such as sight loss are rare, especially when you follow the recommended advice.
Conjunctivitis
The white part of your eye and the inner surfaces of your eyelids are covered by a transparent membrane (thin layer of cells) known as the conjunctiva. If the conjunctiva becomes inflamed, you have a condition called conjunctivitis. There are three types of conjunctivitis: irritant, allergic and infective. Each type of conjunctivitis is caused by different factors.
Infective Conjunctivitis
Infective conjunctivitis can be caused by a virus, bacteria or, in rare cases, by a sexually transmitted infection such as chlamydia or gonorrhoea. The most common symptoms include reddening and watering of the eyes. You may also notice a sticky coating on your eyelashes, particularly when you first wake in the morning, which can make your eyes feel like they're stuck together. Infective conjunctivitis is a very common condition and is responsible for 35% of all eye-related problems recorded in GP surgeries. It is most common in children and the elderly. Infective conjunctivitis rarely requires any medical treatment because the infection will normally heal by itself, usually within one or two weeks. For most people, the condition does not cause any complications. Those most at risk of developing complications from infective conjunctivitis are newborn babies, who are 28 days old or younger. An infection in the eye at a very young age can cause permanent damage. If you have infective conjunctivitis that is caused by a sexually transmitted infection (STI), your condition may last several months, rather than weeks.
Irritant Conjunctivitis
Irritant conjunctivitis occurs when an irritant such as chlorine or an eyelash gets into your eyes. This can make your eyes sore and if you rub them it can irritate them more. Avoiding the irritant and not rubbing your eyes will help. However, if your eyes are very red and painful, you should seek medical help immediately.
Allergic Conjunctivitis
Allergic conjunctivitis occurs when your eye comes into contact with an 'allergen'. An allergen is a particular substance that makes your body's immune system react abnormally, causing irritation and inflammation in the affected body part.
Cataracts
Cloudy patches in the lens of the eye that can make your vision blurry. They may eventually lead to blindness if they are left untreated. Cataracts can develop in one or both eyes and over time the size of the cataract can get bigger until the whole lens is covered.
The lens of each eye should be clear in order for your eyes to work properly. The clear lens allows light to reach the retina at the back of the eye, which enables you to see things. With a cataract, less light can reach the retina, so your vision is affected. A cataract can be present for a while before you notice you have one. However, having regular eye tests can spot cataracts in their early stages, so it's important to keep up to date with eye examinations. Ideally, you should have your sight checked by an optician every two years, although people over 60 years old may be required to have eye tests every year.
If you have a cataract, it will continue to develop. The only way to restore your vision is by having the cataract removed by surgery. Cataract surgery is one of the most common and quickest surgeries performed, and many people are able to return to their usual daily routine after 24 hours.
Macular Degeneration
Macular degeneration is a painless eye condition that causes you gradually to lose your central vision (the ability to see what is directly in front of you). You use your central vision during activities such as reading, writing and driving. Macular degeneration occurs when the part of your eye that is responsible for central vision (the macula) is unable to function as effectively as it used to. Macular degeneration doesn't affect your peripheral vision (your outer vision, sometimes known as "side vision"), so the condition won't make you completely blind.
Types of Macular Degeneration:
There are two types of macular degeneration, dry and wet. Dry macular degeneration affects your eyes gradually. Although there is no treatment for dry macular degeneration, there are ways you can learn to cope with it. Wet macular degeneration is more serious than dry macular degeneration, and can develop very quickly. It requires treatment as soon as possible.
Who is Affected by Macular Degeneration?
Macular degeneration most commonly affects people over 50 years of age. Macular degeneration in older people is referred to as age-related macular degeneration. Approximately 2% of people over 50 years of age have age-related macular degeneration. In people over 65 years of age, the number rises sharply to 80%, with about 20% of those over 85 years of age having the condition. In fact, in older people, age-related macular degeneration is the most common cause of visual impairment. Macular degeneration is more common in women than in men, although the reasons for this are not fully understood. In rare cases, young people can also be affected. This is usually caused by a genetic condition.
Diabetic Retinopathy
Diabetes is a common disease and has important implications for the short-term and long-term health of sufferers. This section will tell you more about diabetes and how it affects the eye.
Effects of Diabetes
Fluctuations in blood sugar can cause changes in the focusing of the crystalline lens within the eye and cause temporary visual blurring, particularly if diabetic control is poor. Diabetes can also cause cataracts in young people, or accelerate the development of cataracts in older people.
Diabetic retinopathy is one of the commonest causes of blindness in the UK in people between the ages of 30-65 and 12% of people who are registered blind and partially sighted each year have diabetic eye disease. At any one time up to 10% of people with diabetes will have retinopathy requiring medical follow up or treatment.
Diabetes can also affect other organs and the presence and severity of retinopathy may be an indicator of increased risk of other complications of diabetes such as ischemic heart disease, kidney disease or diabetic neuropathy (which contributes to male impotence and diabetic foot disease).
Can I Prevent the Development of Retinopathy?
Tight control of diabetes can reduce the risk of retinopathy by 60% in type I (insulin dependent) and 40% in type II (non-insulin dependent) diabetes and will also reduce the risk of other diabetic complications.
Although the majority of people with diabetes who have had diabetes for long enough will have some degree of retinopathy, eye checks will enable early diagnosis and early treatment. When people first develop diabetic retinopathy they have no symptoms, but if diagnosed at this early stage, it is a treatable condition, which is why it is important for diabetics to have regular eye tests.
When should I have my Eyes Examined?
People with diabetes need to have their eyes examined at diagnosis and yearly thereafter by their diabetic specialist, ophthalmologist or optician. Sight tests are free for people with diabetes.
Glaucoma
Glaucoma is the name given to a group of eye conditions that affect vision. Research suggests that a form of glaucoma affects about two out of every 100 people in the UK who are over 40. Because the risk of glaucoma increases as you get older, it's important to have your eyes tested regularly.
Glaucoma often affects both eyes, usually in varying degrees. One eye may develop glaucoma quicker than the other. If glaucoma is left untreated it can cause blindness. However, if it's diagnosed and treated early enough, further damage to your vision can be prevented.
There are four main types of glaucoma:
1. Open Angle Glaucoma (Chronic Glaucoma)
Open angle glaucoma is the most common type of glaucoma. It develops very slowly, so you may not realize it is happening. Open angle glaucoma occurs when the drainage tubes (trabecular meshwork) within the eye become slightly blocked, preventing eye fluid (aqueous humour) from draining properly.
When the fluid can't drain properly, pressure builds up (intraocular pressure) which can cause damage to your optic nerves and the nerve fibres from your retina. The term 'open angle' refers to the angle of space between the iris (coloured part of the eye) and the sclera (the white outer covering of the eyeball). The fact it is an open angle means there is no physical obstruction blocking the drainage: it is the tubes that have a blockage.
2. Acute Angle Closure Glaucoma (Acute Glaucoma)
Acute angle closure glaucoma refers to a narrowing of the angle between your iris and sclera. The narrowing often happens quickly, causing a sudden and painful build-up of pressure in your eye. Acute angle closure glaucoma is rare.
3. Secondary Glaucoma
A secondary glaucoma may occur as a result of an eye injury or another eye condition such as uveitis. Secondary glaucoma can be open angle or closed angle.
4. Developmental Glaucoma
Developmental glaucoma is rare, but it can be serious. It's usually present at birth, or develops shortly after birth. Developmental glaucoma is caused by an abnormality of the eyeball.
Retinal Detachment
When a retinal detachment develops, a separation occurs between the retina and the wall of the eye at the back of the eye. This is similar to wallpaper peeling off a wall. The part that is detached (peeled off) will not work properly and the picture that the brain receives becomes patchy or may be lost completely. An operation is necessary to replace the detached retina in its proper position.
What are the Symptoms?
People often describe seeing ‘something black’ or ‘a curtain’, ‘cobweb’ or ‘flashing lights’. In older people, these do not necessarily indicate a serious problem, but the sudden appearance of floaters and flashes requires a full eye examination to exclude the presence of retinal holes or tears.
What Causes a Retinal Detachment?
Nearly all retinal detachments develop because of a hole or tear in the retina. This usually occurs when the retina becomes 'thin', which can occur in short sighted people, or if the vitreous (the jelly-like substance that fills the eye) separates from the retina. Other eye or health problems such as diabetes and injuries such as a blow to the eye can occasionally be the cause of a retinal detachment. Cataract operations can also cause retinal detachment.
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