A games development professional from Leamington Spa is urging UK employers to offer health initiatives for staff ahead of National Eye Health Week (23 – 29 September) after an eye test provided by her employer detected dry eye disease.

30-year-old Natasha Nathani took advantage of an annual voucher for a free eye test, provided as part of a workplace health scheme and visited the Vision Express Silverburn store. Optometrist John McClean diagnosed Natasha with dry eye as she was showing the classic symptoms – sore eyes and deteriorating vision.

Work providing corporate eye care

Natasha said: “I use three screens all day and I started noticing some irritation – dry eye disease is commonly found in people who use screens frequently. I’m so grateful that my work provided me with corporate eye care, as the condition is now under control and my sight has improved – it’s much sharper now and it’s no longer affecting my work.”

Natasha is thankful for corporate eyecare scheme

Natasha was advised to drink more water and use drops to treat the condition. Prone to migraines as a child, having at least one a month, Natasha was also prescribed VDU glasses to reduce eye strain, which can contribute to migraines. Natasha said: I’ve worn glasses since I was 11 – my glasses are a part of me. I’m glad my prescription has been updated to treat the issues I was having. I encourage everyone to have their eyes tested – you just don’t know what’s lingering behind the surface.”

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We need to increase awareness about the importance of regular eye examinations and how to access these services.

An eye examination is not just about whether you need glasses or not, it is an important health check not only for eye conditions but also for general health conditions, such as diabetes, hypertension and even brain tumours, can be detected through an eye examination.

Glaucoma and sight loss due to diabetes are on the rise

One in 16 people have diabetes (diagnosed or undiagnosed); that equates to 6% of the UK population. Diagnosis more than doubled in the last 20 years. 1,700 people have their sight seriously affected by diabetes every year in the UK. By 2025, there will be more than five million estimated people with diabetes.

Is glaucoma one of the world’s leading causes of blindness? Two per cent of the population over 40 have the condition. Often there are no warning signs and regular eye tests are important to detect early signs. Any vision loss is irreversible but early detection, careful monitoring and regular use of treatment can avoid further sight loss.

Your local optometrist is ideally placed and has the skills to monitor and manage these conditions and this is why it is so important that people are having their eyes tested regularly.

It’s often easier – and cheaper – to access a supermarket optician than your GP

We need to increase awareness among our communities about the importance of regular eye examinations and how to access these services. Just as we do now with pharmacists, we should be directing any eye-related concerns to our opticians, not GP surgeries or hospital eye clinics as a first port of call.

There has been much research to show the main reason patients don’t get their eyes examined regularly is due to cost. At ASDA we want to ensure that this is not the factor that stops our communities being able to have their eyes examined regularly. We do this by ensuring that our optical departments are affordable and we don’t penalise patients for having bad eyes by charging them more for things they need like thinner lenses or coatings on the spectacle lenses.

I think that opticians in supermarkets – where there is free parking, longer opening hours and local bus services – mean your eye health can be fitted around the other things on your to do list, making eye care even more accessible to all.

How often should I get my eyes tested?

Most children will need annual check-ups and most adults should have their eyes checked at least every two years. During your test, your optometrist will advise you whether you should be seen more frequently.

Raising the awareness of eye health and the need for our communities to have access to affordable eye care is about everyone in the optical industry pulling together, utilising skill sets of the professionals we have to ensure that we have an efficient eyecare system to avoid unnecessary sight loss.

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The UK’s ageing population and the increase of conditions such as diabetes and hypertension, are putting strain on ophthalmology centres, which are severely understaffed.

Our ageing population and the increase in conditions such as diabetes and hypertension, the demand on ophthalmology in hospitals is becoming unmanageable. This is worse in certain areas where, due to certain demographic profiles, these conditions are even more prevalent, putting a strain on the local healthcare system and vision charities.

Optometrists are well placed to support the NHS

We are constantly hearing that there are not enough GPs and doctors to support the population’s need and, due to a lack of awareness, people will still often go to their GP or A&E for eye problems.

Local optometrists can manage many minor eye conditions and will be able to appropriately diagnose and manage more serious conditions, thus freeing up overstretched GPs and hospitals. Community services (in some parts of England), supplementary examination in Scotland and WECs in Wales recognise this, utilising optometrists’ skills to support the NHS, and saving vital NHS funds.

Opticians have access to patients who are coming for their eye tests who may not be visiting another health professional, so we are also ideally positioned to support the NHS Healthy Living initiatives like smoking advice/cessation, weight management etc. Supermarkets with both pharmacy and optical departments can work together to ensure patients are getting the care from the right professional referring between the two departments. But, in order to achieve this, we must recruit more eye care professionals.

In certain areas, there is a shortage of optometrists available, but the introduction of new university departments in these areas can support this workforce shortage. However, we need to also be encouraging students to consider entering into the profession to be able to support with this increase in demand.

Supporting and incentivising eye healthcare professionals

It is imperative that optometrists are continually learning and developing their skills throughout their careers, and therefore it is so important they have access to excellent continuing education & training.

At ASDA Opticians, our optometrists have annual CET events where they can gain important interactive education and peer review/discussion. They also have access to a CET app which has over 60 different courses available at any one time, so they can tailor their training to where they want to learn more or refresh their knowledge as well as access to optical journals with further CET materials.

ASDA opticians offer more accessible working hours, being open seven days a week, with extended hours. This allows our professionals to work more flexible hours to fit around their lives.

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Glaucoma is the leading cause of irreversible blindness globally. Visual loss from glaucoma can be prevented with an early diagnosis and treatment.

The eye contains a fluid known as aqueous humour that provides nourishment to its internal structures.

This fluid is produced behind the iris (coloured portion of the eye) and then is drained out through a sieve-like structure called the trabecular meshwork at the front part of the eye.

In some eyes, abnormalities in the drainage system lead to impairment of the normal aqueous humour outflow, and intraocular pressure (IOP) increases.

This high IOP may damage the optic nerve head in the back part of the eye and impair the communication between the eye and the part of the brain responsible for the vision.

In other cases, IOP may be relatively normal, but glaucoma occurs anyway because of the inability of the eye to handle mechanical stress where the nerve fibres leave the eye, or because of poor blood supply to these same nerve fibres.

Glaucomatous optic disc

In glaucoma, the optic nerve gets damaged. A portion of the optic nerve may be assessed during an eye exam, where it can be seen as a round structure (optic disc), with the pink or reddish section representing the neural tissue, which takes the visual information to the brain.

The whitish central part represents absence of neural tissue, and it is called the ‘cup’. Some amount of cupping is normal, but excessive cupping, or an increase in the amount of cupping over time, suggests glaucoma. There are many blood vessels that emerge from the optic disc to the retina.

Glaucoma causes loss of the neural reddish tissue and there is progressive cupping of the optic disc – enlargement of the whitish central part.

How does glaucoma evolve?

The great majority of glaucoma cases evolve silently, as patients may not notice vision loss until it is significant and present in both eyes, or may assume that vision loss is correctable, as it is for other conditions such as cataract.

When the disease is at advanced stages, most patients will then perceive visual abnormalities. Glaucomatous damage to the optic nerve is irreversible, so what is lost cannot be recovered.

The asymptomatic early stages of disease and irreversible nature of the glaucoma makes it one of the main causes of blindness worldwide.

Glaucoma does not have a cure, however, this disease can be treated and the worsening of glaucomatous damage can be limited or even stopped.

Thus, an early detection associated to an appropriate treatment and follow-up can preserve your vision throughout your lifetime.

If one has glaucoma, what are the important things that can be done by the patient and his/her family members?

• Glaucoma patients must take eye drops on a daily basis and follow up lifelong with an ophthalmologist at least once/twice a year to evaluate for any worsening of disease;
• Family members – and especially siblings of glaucoma patients – must be screened annually for glaucoma;
• Any form of steroid therapy (oral, inhalational, injectable etc) can elevate IOP in glaucoma patients and should be avoided or given under strict vigilance;
• All systemic diseases like diabetes, hypertension and cardiovascular disease should be well controlled in consultation with a qualified physician and drug interactions with glaucoma medications should be checked;
• Patients who are on anti-hypertensive medicines should avoid having a very low blood pressure, as low blood pressure may be harmful for glaucoma;
• Glaucoma patients can do all physical exercise (particularly aerobic exercise), which may protect against glaucoma. Yoga is acceptable but one should avoid exercises with head down postures like shirshasana/sarvangasana (yoga positions) as these can cause an increase in Intraocular pressure;
• Meditation and relaxation exercises can help reduce IOP and also decrease the stress and anxiety in glaucoma patients.

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It’s predicted that half the people on the planet will be short-sighted (myopic) by 2050 and, most worryingly, levels of ‘high myopia’ – a prescription of -6 or more – are also on the rise. This is a concern because ‘high myopia’ can increase your risk of sight-threatening conditions such as retinal detachment, glaucoma and cataracts.

Myopia, also called short-sightedness, is a common eye condition that causes objects that are far away to appear blurred, while close objects can be seen clearly. It currently affects around one in three adults in the UK.

An ongoing study in the UK, known as the NICER study, recently demonstrated that the prevalence of myopia among school-aged children has doubled over the past 50 years and children are becoming myopic at an earlier age than in the past. Today one in five British teens is myopic.

Lower your risk of myopia

Genetic, ethnic, and environmental risk factors call all play a part in the onset of short-sightedness.

Having myopic parents can increase your risk of developing myopia, if one parent is myopic, there is a three times risk that the child will be. This risk factor can increase to between five and eight times when both parents are myopic.

However, the current epidemic is thought to be ‘acquired rather than genetic’.

Myopia among school-aged children has doubled over the past 50 years.

Intensive near work (writing, reading, and working on a computer) has been associated with myopia developing in children. Increasingly sedentary social lives of children and young people may also be contributing to the increase.

However, these risk factors can be offset by spending time outside – research shows children who spend more time outdoors are less likely to be or become myopic, even if there is a genetic risk.

Importance of the outdoors

It is known that being outdoors can reduce a child’s risk of developing myopia, yet youngsters simply aren’t outdoors enough. A recent study commissioned by the National Trust found that children spend half the time playing outside that their parents did. Today, youngsters spend just four hours a week outdoors comparedwith 8.2 hours for their parents when they were children.

Parental anxiety, demanding homework schedules and the rise of electronic entertainment are increasingly keeping children indoors. But, balancing indoor and outdoor pursuits is important – researchers have found that the lack of time children spend outdoors, rather than the increased time they spend on near work, is the more important factor in preventing and slowing myopia.

Two hours a day spent playing outdoors could be really beneficial when it comes to kids’ eye health.

Crucial sight tests

Early intervention can help slow down further increases in myopia, so regular sight tests, at school entry then once every two years unless advised otherwise by your optometrist, are important, especially for primary-aged children and teens.

Myopia control as there is no cure

There is no cure for myopia, but certain treatments are known to slow down the rate of progression in children.

Recent research has found that soft multifocal contact lenses—where the centre zone of the lens gives clear far-distance vision and the peripheral zones help with close-up focusing — are effective in reducing myopia progression in children who wear these lenses daily.

Contact lenses, inducing a change in how the eye focuses, reduce abnormal eye growth, which in turn reduces the prescription.

Other therapy options include OrthoK, atropine and spectacles.

The best myopia control will depend on a number of factors: age, prescription (level of myopia and astigmatism), eye shape, pupil size, eye sensitivity, compliance with wearing and caring for your lenses and your lifestyle.

Your dispensing optician or contact lens practitioner will guide you through the options and help you select the most appropriate solution for you or your child.

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Eye diseases don’t always cause obvious symptoms. An eye test by an optician doesn’t just check to see whether you need glasses – it’s also an important check on the health of your eyes.

Vision loss among older people is a major healthcare problem. Approximately one person in three has some form of vision-reducing eye disease by the age of 65.

Most people find that as they age, close-up vision blurs, tear ducts function less well, and eyes can get dry and inflamed. Cataracts may make your sight cloudy and hazy and cause changes to the lens in your eye. 

Poor eye health can make day-to-day life harder

Keeping our eyes healthy is important as untreated vision problems can make day-to-day life harder. Vision problems can lead to higher risk of falls, loss of confidence, which can affect going out, our confidence, our wellbeing, reading and following instructions, which could have serious consequences i.e misreading prescriptions and taking the wrong medications. 

Eye diseases don’t always cause obvious symptoms and regular eye tests (every two years or more often in some cases) are key to maintaining eye health as we age. Opticians can detect small changes at an early stage, usually before we have noticed any changes. Opticians will recognise and advise treatment and follow up for common, age-related conditions such as macular degeneration, glaucoma, cataract and diabetic eye screening. Anyone over 60 is entitled to a free eye test.

Tips to keep your eyes healthy

We can’t correct our vision without professional help, and there’s no quick-and-easy fix for eyesight problems but here are tips to keep your eyes healthy: 

• Get regular eye tests.
• Wear sunglasses to protect your eyes from the sun.
• Eat healthily, particularly plenty of fruit and vegetables, which have specific nutrients that are important for eye health.
• Stop smoking. Smoking is harmful to the eyes – research has shown that smoking increases the risk of age-related macular degeneration, glaucoma and cataracts. Cigarette smoke irritates the eyes and will worsen dry eyes.

For more information on eyesight and how to keep your eyes healthy as we age, take a look at our website: www.ageuk.org.uk

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Research shows we now spend more time looking at a screen than we do sleeping. Eye Health UK explores what increasing screen use means for our eye health.

According to the communications regulator, Ofcom, UK adults spend an average of eight hours and 41 minutes a day on digital devices, compared with the average night’s sleep of eight hours and 21 minutes.

With such high levels of screen time it’s important we’re all aware of the impact this can have on our eye health and understand some simple steps we can take to minimise the effect.

Screen fatigue

Looking at screens will not permanently damage your eyes; however, it may cause eye strain, headaches, and trigger episodes of visual stress, all symptoms of asthenopia.

These reactions to prolonged screen use are commonly known as ‘screen fatigue’ and while symptoms tend to subside after resting your eyes, screen fatigue can be uncomfortable and frustrating.

Extended screen time is also said to exacerbate existing eye conditions such as uncorrected myopia (short-sightedness).

Eye complaints

Symptoms associated with staring at a screen for long stretches without taking breaks can include:

• Tired eyes. Ocular muscles, like any others, can get tired from continued focus on close work.
• Viewing a screen for extended periods can lead to headaches and concentration difficulties.
• Blurred vision. Gazing at a fixed distance for an extended period can cause your focus to spasm or ‘lock up’. This can cause your vision to blur temporarily when you look away from the screen.
• Dry eyes. Studies consistently show that people’s blink rate drops significantly when concentrating on a digital screen. A reduced blink rate can speed up evaporation of the eyes’ tear film resulting in dry, itchy, red or even watery eyes.

Minimise the effects

There is much you can do to ease the effects of screen fatigue:

Take frequent breaks – Follow the 20-20-20 rule: look away from the screen every 20 minutes, focus on an object 20 feet away, for at least 20 seconds.

As well as being good for your eye health, frequent breaks can help your productivity and mental health – giving you time to pause, reflect and breathe.

Remember to blink. Staring at a screen can reduce your blink rate by as much as 60%. Plants placed around your home or office can help improve humidity and minimise dry eye symptoms.

A warm compress applied to the eyes may provide relief. Your optometrist or pharmacist may also recommend a spray or drops to help manage symptoms of dry and irritated eyes.

Screen positioning. Make sure the top of the screen on your desktop or laptop computer is at eye level. Having to look up at a screen opens eyes wider and dries them out quicker.

One rule of thumb when thinking about where and how to position screens is the 1 – 2 – 10 rule: mobile phones ideally at one foot (30cm), desktop devices and laptops at two feet (60 – 75cms), and roughly 10 feet for TV screens (depending on how big the screen is).

Adjusting the font size so you can comfortably read it (12pt min) may also help reduce screen fatigue.

Spotlight on lighting. To cut down on glare and eye fatigue, a study published in the Journal of Ophthalmology & Research says the level of lighting in a room when using a computer or other screen should be roughly half what it would be for other activities such as craft-work or writing on paper. Try to position computers so that light from uncovered windows, lamps and overhead light fixtures doesn’t shine directly on the screens. And, keep your screen clean – finger marks cause reflections!

DON’T FORGET: If you need glasses specifically for VDU work, your employer should cover the cost.

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Sustainability is a topic that has gained a lot of interest over the past few years, and has started conversations in many industries, one of which is fashion. 

Supermarkets across the country are becoming more environmentally conscious; reducing packaging and banning single-use carrier bags.

Optical departments within supermarkets – not to be left behind – are quickly following this positive trend.

With sustainability projects like this happening and customers, rightly, starting to raise concerns about product sourcing and its effect on the environment, supermarket opticians need to work towards more sustainable spectacle ranges.

It is important to work closely with suppliers to realise the overall vision of designing styles that are viable using their current manufacturing processes, while also remaining fashionable and delivering great quality for customers.

Traditional glasses manufacturing can be very wasteful

Frame manufacturing is currently a relatively wasteful industry, as most off-cuts and imperfect frames cannot easily be re-worked back into the production stream and find their way into landfill sites across the globe.

Over the last 10 years, however, there has been a lot of time and resource focussed on finding techniques that enable this waste stream to be viable for production.

Reviewing the manufacturing process and incorporating a recycling process – whereby the broken frames and pieces of normally discarded material could be reused and forged into a new range of lightweight and stylish frames – is the next step for a more sustainable production line.

Spectacles use a lot of protective packaging; we need to cut this down

Compared to grocery products, spectacle frames require a lot of transit packaging material that – currently – mostly ends up in landfill.

Working to minimising these materials as well as moving to materials that can be recycled via standard recycling centres is important.

An example of reducing plastic is to have a temple protecting sleeve on just one arm of the frames instead of both, as this will still prevent them from rubbing in transit and damaging the frames, but halve the plastic being used for that purpose.

An example of moving to recyclable plastic is for the dummy lenses, that are only required in transit so that frames keep their shape for when the prescription lenses are added.

With the growing concern about the impact we are having on the environment, sustainability will ultimately become the new normal and, as such, we’re passionate about working with an innovative supplier who is kick-starting this movement within the optical industry, and hopefully further empowering our customers to drive this change through their purchase choices.

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Q&A with Meena Ralhan on the importance of regular eye testing, screen time and nutrition for maintaining good eye health.

What are the signs that a child may need a sight test? Does this vary for different age groups?

All children are entitled to a free eye test on the NHS. Parents who have shortsightedness, any squint or lazy eye history in the family should have their children tested early on, i.e. before five years old.

Opticians have special methods to test children, even if they can’t read letters, and can detect any lazy eyes or squints. Noticing one eye turning in could be a sign and children sitting too close to the TV can indicate shortsightedness. Children rubbing their eyes a lot or scrunching up their faces, squinting, to see far could also indicate shortsightedness, so it’s very important to go to the opticians for the early checks.

A pair of glasses for a short time can help fix the issue while the child’s visual system is still developing, and they then may not need glasses later in life. Children under two years of age with a squint tend to knock or bump into things – or even fall over – and an optician can detect any issues with their vision early on.

If the near muscles are constantly engaged on near devices, the 20-20-20 rule must apply to give the muscles a rest.

Can too much screen time affect children’s eyes and vision?

With modern technology at its peak, children are increasingly spending a proportion of their day using screens. Their daily screen time has increased compared to 10 years ago, whether that be in school or home. Mobile phones, handheld devices and TV screens all add to daily screen time.

Children using handheld devices, such as tablets and mobile phones, should be limited to 20 minutes at a time with a five-minute break after 20 minutes – this is because screen use reduces the blink rate and can contribute to dry eyes and discomfort.

There can also be eyestrain as the focusing power of the eyes is being exerted too much for too long if breaks are not taken. The far muscles can also weaken, which increases the risk of shortsightedness.

If the near muscles are constantly engaged on near devices, the 20-20-20 rule must apply to give the muscles a rest – after 20 minutes, take a 20 second break by looking 20 feet away.

How important is nutrition and diet for eye health?

A varied and healthy balanced diet is key to the wellbeing, healthy growth and development of children. The eyes are no different and need a variety of nutrients to help maintain good eye health.

For eye diseases such as age-related macular degeneration (ARMD), dark, leafy green vegetables are known to help prevent it.

Nutrients like omega-3 fatty acids, zinc, lutein, vitamins C and E may help slow down ARMD or cataracts. Foods like salmon or oily fish, nuts and beans and citrus fruits contain the above nutrients.

Sugary, starchy and processed foods can all lead to diabetes, which does affect the eyes and can lead to sight loss.

Vision can be preserved in everyone, regardless of age, by:

• Having regular eye tests – recommended every two years and every year for certain conditions. The optometrist can detect health conditions, such as diabetes and high blood pressure and, on rare occasions, even brain tumours.
• Stopping smoking is very important as smoking has been linked to cataracts and ARMD.
• Eating a diet rich in fruit and vegetables and maintaining a healthy weight.
• Being aware of your vision in each eye separately – sometimes conditions occur in one eye first. See your opticians straight away if you notice a decrease in one eye.
• Wearing sunglasses to help prevent against cataracts and ARMD. UV light is damaging to the eyes. Look out for glasses carrying the “CE” Mark and British Standard BS EN ISO 12312-1:2013, which ensures that the sunglasses offer a safe level of UV protection.

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Eat right for good sight

Eye-friendly nutrients found in many fruit and vegetables and fatty acids derived from fish, nuts and oils can all help protect your sight. Vitamins B and E can help protect against cataracts, while omega-3 fish oils help maintain healthy blood vessels inside the eye – research has shown that eating just one portion of fish a week can reduce your risk of developing age-related macular degeneration (AMD) by up to 40%[1].

Quit smoking

Smokers have a significantly greater risk of sight loss than non-smokers. Toxic chemicals in tobacco smoke can damage the delicate surface and the internal structure of the eye. This can lead to an increased risk of many eye conditions including age-related macular degeneration (AMD), nuclear cataracts; thyroid eye disease; dry eye and poor colour vision.

Watch your weight

A body mass index (BMI) of 30+ doubles your risk of suffering age-related macular degeneration[2] and significantly increases your chances of developing cataracts.

Get fit

Aerobic exercise can help increase oxygen supplies to the optic nerve and lower any pressure that builds up in the eye. Reducing intraocular ‘eye’ pressure can help control conditions such as glaucoma and ocular hypertension.

Dietary supplements

There are lots of dietary supplements on the market that claim to be beneficial for eye health. There is no good evidence that the general population should be taking these supplements, but they may be helpful for some people who have existing AMD.

[1] Chua, B., et al., Dietary fatty acids and the 5-year incidence of age-related maculopathy. Archives of Ophthalmology, 2006. 124(7): p. 981-986. | [2] RNIB

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