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Macula Degeneration

Macula degeneration (AMD) is a condition that affects the central part of the vision. The part we use to look at things directly. It can occur gradually (dry type) or suddenly (wet type).

Key facts:

  • Mainly affects people over 60, but can occur sooner.
  • Most common cause of sight loss in the developed world
  • 600,000 people affected in the UK
  • Half of these are registered as sight impaired

Risk factors:

  • Age – Over 60s at greater risk
  • Smoking – Can occur at an earlier age due to smoking
  • Genetics – family history increases the risk
  • Diet – poor diet can cause deficiencies in the vitamins, mineral and antioxidants needed to main a healthy macula
  • Blood pressure – high blood pressure increase the risk
  • Sunlight – light from the blue end of the visual spectrum can increase oxidative damage, leading to macula degeneration.
  • Gender – women have a greater risk of developing the condition

Risk factor often occur in combination and it is not possible to pin the condition down to one reason or another.

What can i do:

  • Having regular eye checks will help pick up the condition sooner, and may even be before you experience any symptoms.
  • Look at your lifestyle, take regular exercise, quit smoking, have a diet rich in green leafy vegetables.
  • Assessing your lifestyle with your Optometrist can identify areas that may place you at higher risk.
  • Taking macula antioxidants if you have risk factors may help to maintain macula health.
  • Using good quality sunglasses will help protect your eyes form harmful UV light.

Treatment:

Wet macula degeneration can be treated with a drug that limits the growth of new and leaky blood vessels.

Dry macula degeneration does not have any know treatment however antioxidants are thought to play a part in maintaning macula health and may delay the onset or progression of the condition.

If you will need to be referred, we are able to refer you for wet macula degeneneration by direct fast referral to the following treatment centres.

Central Middlesex Hospital;
Charing Cross NHS Trust;
Chelsea and Westminster NHS Foundation Trust;
Ealing Hospital NHS Trust;
Hillingdon Hospitals’ NHS Foundation Trust;
Imperial College Healthcare NHS Trust;
Moorfields’ Eye Hospital NHS Foundation Trust.
A copy of the referral is sent to your GP. You are then contacted by phone within 2 weeks with an appointment.
For those with dry macula degeneration we can provide macula supplements. Our Optometrists recommend Macushield for maintaining macula health as it contains all three macula pigments found at the macula.

Meso-Zeaxanthin is only found in one place in the body, the centre of the macula, in the back of the eye. The Meso-Zeaxanthin in MacuShield is extracted from marigolds. These marigolds are grown specifically for the production of of this ingredient. Other sources of Zeaxanthin are certain types of sea food in limited quantities.

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Cataracts

A cataract is cause by a change in the structure of the natural lens

Key facts:

  • Start developing in people as they get older
  • Can occur at birth, due to drugs or trauma (less common)
  • Age related cataract are very common
  • Stops the light from reaching the back of the eye and affects vision
  • They develop over many years
  • Requires surgery to remove and replace the affected lens.

Risk factors:

  • Age – Over 60s at greater risk.
  • Smoking – Can occur at an earlier age due to smoking.
  • Genetics – family history increases the risk.
  • Diet – poor diet can cause deficiencies in the vitamins, mineral and antioxidants needed to main a healthy lens.
  • Medication – taking certain medication like corticosteroids at high dose or for a long time.
  • Sunlight – prolonged light exposure from the blue end of the visual spectrum can increase oxidative damage, leading to cataracts earlier.
  • Alcohol – drinking excessive amounts of alcohol.
  • Diabetes – cataracts start earlier in diabetics and may affect monitoring of diabetic retinopathy

Risk factor often occur in combination and it is not possible to pin the condition down to one reason or another.

What can i do:

  • Having regular eye checks will help pick up the condition sooner, and may even be before you experience any symptoms.
  • Look at your lifestyle, take regular exercise, quit smoking, have a diet rich in green leafy vegetables.
  • Assessing your lifestyle with your Optometrist can identify areas that may place you at higher risk.
  • Using good quality sunglasses will help protect your eyes form harmful UV light.

Treatment:

Treatment for cataracts is done surgically by removing the affected lenses and replacing it with a ocular implant. The surgery is quick, taking under 20 minutes, one eye is done at a time, vision is restored almost immediately.

You can be referred via the NHS, which takes a few months. A referral is sent via your GP to the hospital eye service where an eye surgeon (Ophthalmologist) will assess you and discuss the treatment plan.

You can also be referred privately through you health insurance provider or to a private eye hospital.

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Diabetes

Diabetes is a disease of the small blood vessels found all over the body.

Key facts:

  • Two main types; type 1 and type 2
  • Untreated diabetes can damage your organs
  • Symptoms include: feeling thirsty, peeing more than usual, feeling tired regularly.
  • 1 in 16 people have diabetes in the UK, and this is rising.
  • Can cause serious long-term health problems.

Risk factors:

  • Age – Over 60s at greater risk
  • Smoking – Can occur at an earlier age due to smoking
  • Genetics – family history increases the risk
  • Diet – Being over-weight. Eat a health balanced diet and maintain a healthy weight
  • Blood pressure – high blood pressure increases the risk
  • Exercise – Not enough exercise increases you risk. Take regular exercise
  • Ethnicity – Asian backgrounds are at higher risk

Risk factors often occur in combination and it is not possible to pin the condition down to one reason or another.

What can i do:

  • Having regular eye checks will help pick up the condition sooner, and may even be before you experience any symptoms.
  • Look at your lifestyle, take regular exercise, quit smoking, have a diet rich in green leafy vegetables.
  • Assessing your lifestyle with your Optometrist can identify areas that may place you at higher risk.
  • Taking macula antioxidants if you have risk factors may help to maintain macula health.
  • Using good quality sunglasses will help protect your eyes form harmful UV light.

Treatment:

If you are diagnosed with diabetes you will be put on the national diabetic eye screening service to maintain a record of the health of your eyes. You should still attend for your annual sight test at Oldfields Opticians even if you are under the eye screening service. Your prescription is at risk of changes if your diabetes control is variable. This will allow us to pick up changes related to your diabetes sooner.

If signs of diabetes are found in your eye, depending on the severity, you may need to have treatment with laser.

There is a new therapy now available for Diabetic Retinopathy. You can find out more about it by clicking here.

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Glaucoma

Glaucoma is a family of diseases, which causes retinal nerve death. There is no accepted definition of Glaucoma due to the different aspect of the disease. Factors which cause or contribute to Glaucoma are varied.

One factor that has a very strong link to the progression of Glaucoma is Interocular Pressure (IOP). An increase in IOP is thought to cause damage to the retinal nerves at the Optic nerve head, leading to Glaucoma, this is called Primary Open Angle Glaucoma (POAG). However, IOPs within the normal range can also be found in those that develop Glaucoma. This is then called Normal Tension Glaucoma (NTG). It is thought that those with this type of Glaucoma are sensitive to even IOPs in the normal range or there are other factors at play, which are not fully understood.

For both Primary Open Angle Glaucoma and Normal Tension Glaucoma treatment regimes involve lowering the IOP with the use of Glaucoma drops. These drops lower the IOP by either reducing the production of aqueous or increasing the drainage of aqueous.

Another type of Glaucoma is called Angle Closure Glaucoma and occurs as a result of poor drainage of aqueous from the eye. Angle Closure Glaucoma can cause symptoms of flashes, pain, and blurred vision. Treatment for this type of Glaucoma is by surgery to increase drainage out of the eyes.

Glaucoma is more prevalent in those who have a family history of Glaucoma. So, for one who has a parent with Glaucoma then there chance of getting it are ½ and those who have a sibling who has Glaucoma, their chances of getting it are ¼.

Glaucoma can also be caused secondary to drugs. This is called Drug induced Glaucoma. Drugs such as steroids can lead to drug induced Glaucoma with prolonged use.

The good news is that Glaucoma, if detected early is a controllable disease. With regular sight tests, especially for those with a family history of Glaucoma the disease can be detected early.

The detection of Glaucoma is done routinely if you are over 30 years of age and when we give you a sight test at home.

How do you test for glaucoma?

The three main tests for glaucoma are; An assessment of the optic disc at the back of the eye, a pressure check & a fields assessment to map your peripheral vision.

The pressure check done at most Opticians involves the use of an instrument that blows air on the eyes surface (the puff test). At Oldfields Opticians we use ‘NO PUFF’ technology to test your pressure.

These are screening tests. We also provide the ‘Gold Standard’ in pressure checking, used in hospitals. Goldmann Applanation Tonometry – this is done using a perkins instrument, which is also portable. This means we can also provide the service at home visits. This service is provided for an additional fee.

How often should I have am eye examination if I have a family member with glaucoma?

If you have a patent or sibling with glaucoma, you should have an examination every year from the age of 40. The NHS will fund your examination once you are over 40.

What happens if my eye pressure will be high?

If your pressures as measure with our ‘No Puff’ technology instrument are found to be high. You will be offered the Applanation Tonometry for a small fee. If the pressures are still high, we will need to refer you to the local; Ophthalmology service located at Grand Union Village health centre.