Glaucoma:
Open angle glaucoma is a chronic condition in which the pressure inside the eye builds up very slowly causing permanent damage to the optic nerve which results in loss of peripheral vision or tunnel vision and eventual blindness if left untreated. There is no pain involved!  A sufferer can often read the bottom line of the eye test chart without any difficulty until the condition is very advanced, making diagnosis difficult but essential! Pinder’s are able to screen for glaucoma with special instrumentation, including screeners, perimeters and digital cameras.

 

Zeiss FDT screener

Closed angle glaucoma is very different, involving pain, redness, nausea and blurred vision. This is due to the pressure inside the eye rising to very high levels over a short period of time requiring urgent medical attention. Although no warning is apparent, some eye-types are more predisposed to this acute attack of glaucoma and if recognised, preventative treatment can sometimes be instigated.

Early diagnosis of the disease enables early treatment, often just with drops such as Timoptol or Xalatan, to lower the pressure in the eyes and prevent any further loss of the field of vision. Those with a family history of glaucoma are at much higher risk (especially when over 40 years of age), as are those of Afro-Caribbean origin and diabetics, and therefore certain close relatives of glaucoma sufferers are entitled to a free NHS eye examination. Contact your nearest practice to find out if you are eligible.

Zeiss Humphrey perimeter

Cataracts
In the normal eye, light enters and is focussed by the lens onto the retina. The light's pathway through to the back of the eye is perfectly clear.

A cataract is not a disease, but an age-related clouding of the lens in the eye, preventing light from being focussed properly on the retina. If the affected areas are small or if only the periphery of the lens is affected, there may be no marked effect on vision apart from a mild yellow tinge and no treatment will be needed. However, if the central area of the lens becomes opaque, then visual loss becomes much more noticeable.

Cataracts are painless and generally slow to develop. If vision is impaired the standard treatment is keyhole surgical removal of the lens and replacement with a clear soft plastic one, performed under local anaesthetic with instant restoration of vision. Some surgeons even recommend multifocal Intra-Ocular Implants to allow a degree of reading without spectacles!

Pinder’s are proud to be part of the North Notts. Cataract Scheme designed to speed-up the referral process for cataracts and will be pleased to give details.

Most patients are in and out of the hospital of their choice within a few hours, amazed at the improvement in their vision!

Diabetes
Diabetes mellitus is known to affect 2.4% of the population (and there is probably a similar  number of undiagnosed diabetics )and accounts for at least 10% of the NHS budget. It is a condition in which the amount of sugar in the blood is too high, because the body cannot use it properly.

Symptoms of untreated diabetes include increased thirst, passing large amounts of urine, tiredness, weight loss and blurred vision. Treatment varies, and may be a combination of diet control (to prevent large intakes of sugar) and taking tablets (so called Type 2 diabetics). Insulin injections are used in a minority of cases (so called Type 1 diabetics).

Unfortunately, diabetes is the major cause of blindness in the working age population. Pinder’s optometrists are proud to be a major contributor to the Diabetic Retinopathy Monitoring Scheme established in north Nottinghamshire for the benefit of local diabetics. We work more closely with general practitioners and diabetologists to help reduce preventable vision loss due to diabetes by providing a comprehensive free annual eye examination with dilatation. The vast majority of patients also take advantage of our advanced digital imaging system in which we can take digital photographs of the back of the eyes for a more thorough examination (as recommended in the National Institute for Clinical Excellence guidelines) allowing more accurate monitoring of the progression of the disease and enabling timely intervention of sight saving treatment.

Diabetes is a rapidly growing health concern worldwide, especially in western civilised regions where obesity is a major contributory factor. There is an optometrist accredited for diabetic eye screening at each branch of Pinder’s Eyecare. If you have any concerns please contact your local branch of Pinder’s….we want to help! (www.diabetes.org.uk), (www.medweb.bham.ac.uk)

 

Diabetic retinopathy with haemorrhages and exudates

Age Related Macular Degeneration (ARMD):
Age related macular degeneration is a painless condition caused by the degeneration of the central portion of the retina (macula), resulting in the loss of central vision.

www.rnib.org.uk

The macula is responsible for the detailed vision directly in front of you, used for tasks like reading and recognizing faces. This is the most common cause of blindness in people over 60 years of age and affects 33% of those over 75 years old.

Macular degeneration is often split into two forms, dry and wet!  ‘Dry’ or atrophic macular degeneration results in a slow gradual deterioration in vision as the retinal cells stop working due to atrophy of the Retinal Pigment Epithelium (RPE) and the formation of drusen (clumps of waste material).

Dry’ form of ARMD with drusen.

The ‘Wet’ or  exudative  form of macular degeneration is caused by the growth and leakage of new vessels below the retina (Choroidal Neo-vascularisation or CNV) which break through Bruch’s membrane and the RPE to elevate the retina and destroy it with scar tissue.

There is no recognised treatment for the dry form of degeneration, but the Wet form may be ameniable to laser or photodynamic therapy (PDT) to help seal the leaking blood vessels if caught early enough. PDT is a very expensive treatment due to the enormous cost of the verteporfin drug used, but it is now available on the NHS in specific hospitals. If you suspect that you are suffering such a condition check for any central kinks or distortions in the vision of each eye (look at the grid below) and notify your optometrist immediately.

Amsler grid

Because of the prevalence and severity of this condition, and the long-term implications on all aspects of life it is important that everyone over 50 years of age has regular eye examinations whether there are symptoms or not. www.maculardisease.org

Tablets for better vision?

At least 12.5 million people in the UK aged over 60 have early signs of Age-related Macular Degeneration (AMD) of which 600,000are registrable blind or partially sighted, and as we are an ageing population this trend is set to increase dramatically.

AMD causes loss of central vision with difficulty in reading, writing and driving and often results in loss of independence and frustration. Once AMD develops, there is no cure for it, so prevention is the best course of action. Much of the damage to the cells of the macula is oxidative and accumulative, due to excess uv or blue light exposure and smoking. Other risk factors that promote AMD include poor lifestyle, poor nutrition, lack of exercise, cardiovascular disease and a positive family history of AMD.

So what can we do to reduce these risk factors?

Improvement of lifestyle is important as is cessation of smoking and a good dietary intake of carotenoids (e.g. lutein and zeaxanthin) and other antioxidants such as vitamins A,C and E from green leafy vegetables and fruit to prevent the oxidative damage to the macular cells. Lutein filters blue light (harmful radiation) and is a strong antioxidant to protect the cells of the macula from oxidative stress, along with the only other macular carotenoid antioxidant, zeaxanthin.

Our bodies are less efficient at absorbing these nutrients as we age and in our modern, high speed world, some experts have advocated the use of convenient dietary supplements such as ICAPS  and  OCUVITE which contain all these elements. Ask your optometrist whether you would benefit from these supplements…..before it’s too late!