To mark the start of National Eye Health Week 20- 26 September, we should be looking at our lifestyle choices if we’re serious about eye health.

Ophthalmology is now the number one reason for hospital outpatient visits in England¹, whilst missed sight tests and cancelled hospital eye appointments during the pandemic will inevitably lead to a decline in the nation’s eye health.

Spending a couple of hours a day outdoors could help prevent your child becoming short-sighted.

Lifestyle counts

Regular eye tests – every two years, unless advised otherwise by your optometrist – are vital to keep eyes healthy and prevent avoidable sight loss; but what many of us don’t realise is that lifestyle can have a significant impact on eye health too.

Regardless of our genetic predisposition, diet, weight, activity levels, alcohol consumption and smoking status can all affect our chances of suffering chronic eye conditions, including the four main causes of sight loss – macular degeneration, diabetic retinopathy, glaucoma and cataracts.

Active eye care 

One recent study found being physically active can reduce the risk of visual impairment by 58% versus a sedentary lifestyle.²

Regular physical activity can lower intraocular ‘eye’ pressure (IOP) and help prevent and control conditions such as glaucoma and ocular hypertension.

Being active can also reduce the harmful overgrowth of blood vessels in the eyes which could cause and accelerate age-related macular degeneration (AMD).

Research has also shown that people who engage in regular activities such as walking and cycling cut their risk of suffering age-related cataracts by up to 10%.³

Impact of smoking on eyes 

Toxic chemicals in tobacco smoke can damage the delicate surface and internal structure of the eye. Any amount of smoking, even occasional or second-hand, can affect eye health. More than one in four (27%) cases of AMD are directly attributable to smoking.⁴

Food for thought

Spending a couple of hours a day outdoors could help prevent your child becoming short-sighted. There are many other ways that lifestyle can benefit eye health from maintaining a healthy Body Mass Index (BMI) to eating a diet rich in fruit, vegetables, fish and wholegrains.

[1] NHS Digital, Hospital Episode Statistics for England. Outpatient statistics, 2019 -20.
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047137/
[3] medicalxpress.com/news/2020-06-cataract.html
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3866712/

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Receiving a diagnosis that might lead to sight loss can be a difficult time but getting the right information about your condition and how to live with it can improve your outlook.

Whether it comes suddenly or is part of a more gradual process connected to a longer-term health issue, it can be a life-changing moment.

You may be looking for answers for yourself, a friend or family member who has received a diagnosis. 

Many different aspects of life with sight loss are likely to be in your thoughts, whether its questions about your condition itself or what support is available to help you continue to work, socialise and travel independently.

Being better informed can help put you at the centre of the decision-making process when it comes to discussing treatments or being aware of what aids may be suitable for you.

Why is information important?

Information helps give you power. Being better informed can help put you at the centre of the decision-making process when it comes to discussing treatments or being aware of what aids may be suitable for you.

There are many sources of information available, but between friends, family and internet searches, a lot of what you discover can be contradictory. It can be difficult to know which information to trust, so this National Eye Health Week, make sure you get facts from a reliable source to enable you to take an active part in your care and any treatment. 

Starting out well

RNIB have a range of eye health booklets that are co-authored by the Royal College of Ophthalmologists. If you or someone you know has been diagnosed with an eye condition, the guides, available in a range of formats, cover information that can help you take an active role in managing your eye condition.One of the processes that many people can find daunting is getting their sight loss officially registered but navigating the process does not have to be the source of worry. The full process and other day to day sources of support are explained in the booklets.

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Every day, around 300 people are diagnosed with macular disease. It’s the biggest cause of sight loss in the UK.

There are many forms of macular disease, including age-related macular degeneration (AMD), of which there are two types: dry and wet. AMD is the most common form of macular disease, but other forms affect much younger people – even children.

Living with macular disease can be lonely and isolating. But with the right support, people can cope very well. Local low vision clinics can help you find the combination of lighting, magnifiers and other tools that mean you can stay independent and continue doing the things you love. 

Telling other people how your sight loss affects you can help them understand the support you might need – even if it’s just putting things back where they belong so you can find them!

Friends, family or employers, no matter how well-meaning, don’t always understand how frightening it can be to know you’ll lose your sight. 

In the same boat

But friends, family or employers, no matter how well-meaning, don’t always understand how frightening it can be to know you’ll lose your sight. 

If you need extra support to help you understand or cope with your sight loss, you’re not alone. Our team of dedicated specialists are here for you, providing practical and emotional support to those who need it. 

Our counselling service offers free and confidential telephone sessions to help you overcome the worries and anxieties that macular disease can bring and cope with the emotional impact of living with sight loss. 

“Without the counselling service, I really don’t know how I would have got through those first couple of weeks after diagnosis. The counsellor kept me calm and positive every week and listened without judgement. I am very grateful to her and always will be.” (Katie, Macular Society member)

There are also Macular Society support groups all over the UK which are the perfect place to share experiences with other people in a similar situation. 

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Myopia is a relatively common condition among growing children, but if left uncorrected it can lead to potentially serious sight issues.

Myopia, sometimes called short-sightedness or near-sightedness, is a relatively common condition among growing children. It typically presents as blurred distance vision and if left uncorrected it can lead to potentially serious sight issues and in rare cases can even cause blindness. Other issues include the risk of retinal detachment, cataracts and an increased risk of glaucoma.

Optical expert Andy Sanders warns: “Myopia is also associated with an increased risk of retinal deterioration, where the seeing part of the eye becomes damaged because the eyeball is elongating.”

At present, myopia prevalence is currently believed to be about 25% worldwide but is forecast to reach 50% by 2050.

Myopia management

Mr Sanders, who is Professional Services Director for Hoya Lens (UK & Ireland), explains that there are several triggers for myopia, including some that still remain unclear. “One trigger we know that drives myopia is genetics,” he says. “If one parent is myopic, their child is three times more likely to become myopic and if both parents are myopic, it is six times more likely.”

While myopia is a condition that starts in childhood as their eyes grow, there are steps that can be taken to offset the impact of its progression.

Children spending more time outdoors where their eyes are focussing at longer distances may help in management of the condition. They should also take regular near work breaks, including screen breaks and ensure they have regular eye examinations.

Ultimately, glasses and or contact lenses would be required to correct the child’s vision. However, there are now treatment options available that can not only correct vision but they can help to slow down the myopia progression and reduce the associated risks.

Unique lens structure

HOYA has developed an innovative spectacle lens option, called MiYOSMART. Using cutting edge technology, that both corrects vision whilst simultaneously offering a treatment function to manage the myopia progression.

Mr Sanders says the unique lens structure – with a central area that gives full prescribed myopic correction and a honeycomb structure of ‘micro-lenslets’ in the treatment area – can slow the growth of the eyeball and provide clear vision. “All the technology is hidden as the lens looks like a standard single vision spectacle lens.

‘MiYOSMART’ is non-invasive, safe, easy to fit and effective in the management of myopia showing good acceptance and clinically proven to slow down myopia progression.”

In our view, nothing is more important than the health and well-being of your child. Now and into the future, you want to see your child thrive” he concludes.

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Daniel Hardiman-McCartney from the College of Optometrists answers common questions around poor eyesight.

What are some of the causes of poor eyesight?

Poor eyesight can be caused by a range of conditions and factors. For example, cataracts have many causes. Most people start to develop cataracts after the age of 65, but some people in their 40s and 50s can also develop them. 

Some medical conditions such as diabetes or taking medication, such as steroids, may also cause cataracts. Smokers are more likely to develop cataracts than non-smokers and there may be a link between UV rays and cataracts. A very small number of babies are born with a cataract.

Another example is short sightedness, also known as myopia. The condition usually starts during primary school years and tends to worsen until the eye has stopped growing. Myopia can also develop in very young children. Adults may also become short-sighted. You are more likely to become short-sighted if your parents are too.

What impact does poor eyesight have on life?

Poor eyesight can have an impact on every aspect of your life. Recent research conducted by the College showed that 21% of people struggle with everyday tasks due to problems with their eyesight, some of those struggles may be correctable. The same survey showed that 31% of adults in the UK noticed their vision get worse since the COVID-19 pandemic induced lockdowns. Your optometrist can help ensure you have the appropriate eyewear and check the overall health of your eye. 

Recent research conducted by the College showed that 21% of people struggle with everyday tasks due to problems with their eyesight.

What can people do if they are concerned about their sight?

It is very important that if you feel your vision has deteriorated or if you are experiencing any problems with your eyes that you should contact your local optometrist. 

We estimate around 30% of people postponed their eye care during the pandemic. At earlier stages in the pandemic, we know that many people were concerned about the safety of visiting an optometrist. Please be assured that optometrists are open and are safe to visit. 

Do you have any tips for avoiding eyestrain?

1. Practice the 20-20-20 rule. To give your eye muscles a rest every 20 minutes, look at something 20 feet away, for 20 seconds. 
2. Blink regularly.
3. Have your screen below eye level and between 40 to 75cm away.
4. Make your text size bigger to make it more comfortable to read.
5. Use lubricating drop if your eyes get dry. 

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Figures reveal that nearly 1.5 million people in the UK are affected by macular disease, the nation’s biggest cause of sight loss.

It is all too easy to take good vision for granted. As we grow older our eye health can become under increasing pressure and in particular the macula.

Layers of protection

Lutein and zeaxanthin are important nutrient that the body naturally deposits in the macula, to create a protective layer known as macular pigment. Lutein and zeaxanthin are powerful antioxidants that work like internal sunglasses, protecting the macula from the damaging effects of blue light and oxidative stress.

What is age-related macular degeneration

Age-related macular degeneration (AMD) is a progressive eye disease that affects the macula. It is responsible for central vision and allows you to see detail. It does not cause total blindness, but it makes everyday tasks such as reading, watching TV, driving or using computers more difficult. Research reveals that people as young as 37 years of age are being diagnosed with AMD.

There is no cure for AMD. While there is medical treatment for wet AMD, there is currently none for dry AMD.

The macula pigment comprises of three carotenoids, lutein, meso-zeaxanthin and zeaxanthin. The body does not produce lutein and zeaxanthin. The macular pigment can therefore become severely depleted in those with a poor diet lacking in the right foods. Hence, why it could be advantageous to use supplementations to help assist.

Treatment for AMD

Experts recommend early diagnosis to help manage the disease. There is no cure for AMD. While there is medical treatment for wet AMD, there is currently none for dry AMD. However, experts recommend taking eye health supplements.

MACU-SAVE is a supplement which contains all three macular carotenoids which are essential for macular health.

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Light therapy battles inflammation, the root cause of Dry Eye Disease. A therapy concept commonly used in dermatology has been shown to be a successful treatment for dry eye disease.

Dry eye disease can be a debilitating condition that can have an impact on lifestyle and everyday activities.

Itchy eyes, redness, a gritty burning sensation and inflammation are all common symptoms. While some sufferers turn to eye drops for relief, ophthalmologists fear that approach only offers short-term relief rather than tackling the deeper causes.

Consultant ophthalmologist Dr Samer Hamada notes the condition is on the increase, particularly with people having spent more time in front of computer screens during COVID lockdowns.

Eye surface inflammation

The disease is an ongoing eye surface inflammation where the environment, hormones, eye strain from extended screen use, or wearing contact lenses, can be factors. It may affect up to 50% of the population, though many could be asymptomatic or misdiagnosed as having an allergy.

Dr Hamada, who has a specialist interest in eye surface disease and works in the NHS and private practice, says there is an increased global interest in dry eye disease with the focus shifting towards treating the inflammation and causes, rather tackling symptoms with eye drops.

The condition occurs when the meibomian glands around each eye, which oil, water and mucus to lubricate the eye surface, become blocked or stop producing the right quality and quantity of oil. This meibomian gland dysfunction (MGD) leads to inflammation and dry eye disease.

Dry eye treatment

Intense pulsed light (IPL) technology, already used for dermatological and facial rejuvenation treatments, is being shown to be an effective dry eye treatment.

Dr Hamada, who uses the system, explains that the process sees intense light passed across the bottom eyelids and the abnormal blood vessels, which are active in the inflamed glands, to reduce inflammation and improve gland function.

This life changing durable treatment, generally given over four 10-minute sessions two weeks apart with a top-up session after 6-12 months, can also help rosacea, a common skin condition that causes visible blood vessels on the face.

Early management

Patients who find their daily life affected by the condition often turn to IPL as a last resort, but Dr Hamada suggests it should be considered much sooner.

“The treatment is life-changing and can make a big difference to a patient’s life. Early management leads to a better outcome because the longer you leave inflammation in the eye, the more damage you have” he says.

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The Royal National Institute of Blind People (RNIB) is the UK’s leading sight loss charity. Gifts in Wills make almost a third of its work possible, including practical and emotional support for blind and partially sighted people.

When Debra Roffey, 51, attended RNIB’s Living Well with Sight Loss course, she gained the tools and support to overcome her feelings of anxiety and isolation. With the right support, she built her confidence and is now able to tackle everyday challenges and live the life she wants to lead.

Anxiety and isolation

“I first experienced difficulties in my right eye when I was four years old.

I had optical atrophy. I later developed the same condition in my other eye. I used to get really nervous about going out, especially without my husband. It left me feeling isolated and limited by my anxiety. In 2015, a support worker told me about RNIB’s Living Well with Sight Loss course.

“On the course I was introduced to several low vision aids which could help me around the house, raising my confidence in doing everyday tasks.

“During the eye health and leisure sessions, I heard about new swimming sessions for visually impaired people. I used to be a lifeguard and missed swimming but feared getting back in the water.

“The support from my new friends on the course encouraged me to try swimming again and were vital in helping to improve my confidence. I began to swim regularly again, and even completed a three-mile Swimathon! It felt good to be understood.

Increasing confidence

“I was so impressed by the RNIB course that I agreed to speak at one of their events. More than 40 groups within the low vision sector were there. Before the course, I was too afraid to even speak in front of a small group of people.

The support from my new friends on the course encouraged me to try swimming again and were vital in helping to improve my confidence.

“I can’t thank RNIB enough. I can now go out by myself with confidence or spend time with friends and have a good time. I feel empowered and it’s all because of the skills I gained.”

How you can help

Many people with sight loss feel that life offers limited opportunity. A gift in your Will to RNIB could help fund courses like Living Well With Sight Loss so more people like Debra can re-build their confidence and develop the skills they need to live more independently. 

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If you have glaucoma but no one else in your family does, you may understandably wonder why, especially considering glaucoma is often genetic and can run in families.

Glaucoma is a family of diseases usually caused by high eye pressure. The increased pressure in the eye, which happens because of too much fluid in the eye, can damage the optic nerve. When diagnosing the disease, a glaucoma specialist will check the health of different parts of your eye. 

Finding a genetic link 

Genes, which are passed down from your parents, are involved in making the different parts of your eye and the components within the cells to help them function normally. Sometimes, the genes we inherit can lead to glaucoma.

Perhaps your father had cells that made more fluid than normal, but his fluid drainage worked normally. And perhaps your mother’s drainage channels were a bit narrow, but her eye made the normal amount of fluid, so again she was fine. 

But then you inherited your father’s genes for the fluid production and your mother’s genes for the drainage channels. The result is your eye is making too much fluid and it’s struggling to drain effectively, meaning you’ve developed glaucoma.

The genes were in your family all along, but no one person had enough of those genes to develop glaucoma. 

The genes were in your family all along, but no one person had enough of those genes to develop glaucoma. 

Case study

Jessica is the first person in her family with glaucoma and was diagnosed shortly after being born. She is aware that her future children are at increased risk of developing the disease. 

“I was born a typical blue-eyed baby. My eyes were a little cloudy, but this was initially ignored. After lots of tests, I was diagnosed with congenital glaucoma at around six weeks old. 

I’m now in my late-twenties and I often chat with my partner about the potential of our future children inheriting glaucoma. I remain optimistic that if my child does have glaucoma, it’s not the end of the world, because the disease has never stopped me from having a normal life. As my family and I have experienced, there is so much help available for people with glaucoma and their loved ones. So, glaucoma will never stop me from having children.

Just because you have glaucoma, doesn’t mean that glaucoma has you. You’re still able to live a happy and fulfilled life.”

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Ensuring a patient’s eyes are in a healthy condition can lead to better results from cataract surgery. 

Cataract surgery is the most common elective surgical procedure in the UK with around 400,000 operations performed every year.

For patients, correctly preparing their eyes for cataract surgery is an important step on the journey to restored vision, particularly if they suffer from dry eyes.

Eye drops, used in advance of the surgical procedure – which generally takes a few minutes and involves removing the clouded lenses and replacing them with new artificial intraocular lenses (IOLs) – can help to ensure better long-term outcomes.

Cataract surgery 

Dry eye can be mild and a slight irritation, through to debilitating and severe. Up to 75% of people undergoing cataract surgery may have it in some form. 

Mr Allon Barsam, who is an ophthalmic consultant at OCL Vision, says: “Dry eyes can cause a patient to have blurred vision. This can lead to inaccurate selection of the intraocular lenses implanted in the eyes during cataract surgery. It is important to get this right as the lenses are designed to remain in the patient’s eyes for the rest of their life.” 

Artificial tears 

Various factors cause dry eye, including exposure to air conditioning, dust, sunlight and wind, as well as problems with tear ducts. With COVID-19, there are suggestions that mask wearing, where breath is deflected up into the eyes, may also be a factor. 

“All this causes your tear film to dry up and this is why we blink,” Mr Barsam adds. “So, by using artificial tears you are preparing your tear film – essentially preparing your corneas for surgery.” 

Leaving dry eyes untreated after surgery will have a negative impact on patient’s quality of vision.

Using eye drops, which are available over-the counter and inexpensive, up to four times a day for a couple of weeks before surgery can help ensure a patient’s eyes are in optimal condition for the optical measurements used to determine the new intraocular lenses. 

In addition to creating artificial tear film from eye drops, other solutions to treat dry eyes include warm compression, vitamins and therapies to treat dysfunctional eye lid glands that secrete the oily substance, which is the tear film across your cornea every time you blink. 

Treating dry eyes after surgery is also important. “Leaving dry eyes untreated after surgery will have a negative impact on patients’ quality of vision, however, artificial tears can be used as long as needed and are a cost effective way of alleviating dry eye symptoms” concludes Mr Barsam. 

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