Watch out for sun damage

I was pleased to read an article on the BBC website raising awareness of sun damage and the eyes yesterday. Rightly so, the importance of protecting the skin from the harmful effects of UV rays is well documented. People now take the issue seriously piling on sunscreen, ensuring everyone in the family is covered. However often the eyes are overlooked.

b- sunburn

Perhaps it’s the fact that you can’t see the burn. If you forget to wear sunglasses you don’t wake up the next morning with red, sore skin. But your eyes are also burning, you just can’t see it but the damage that is being done.

As discussed in the article, there are a number of serious conditions associated with exposure to UV rays like cataract and macular degeneration. All develop slowly over time and the effects will be felt as the body’s ability to repair diminishes. Ultimately in later years, the various conditions could cause serious vision problems and in some cases a total loss of sight.

Something that always surprises me is that parents don’t always think of sunglasses for their children. I think it’s an awareness issue. I know keeping sunglasses on a toddler is not easy but getting them used to wearing sunglasses and a hat from an early age, could help prevent them developing these serious eye conditions in years to come.

I wrote a blog back in May on selecting sunglasses. If you’re planning to buy a new pair, familiarise yourself with considerations when making your purchase.

When you think suntan lotion, think sunglasses as well.

New antibiotics make life easier

There’s been a lot of talk about increased resistance to antibiotics in the press recently with the Prime Minister himself calling for action to improve their effectiveness.

Fortunately, eyes are a special case. Drops used on the surface of the eye (termed ‘topical’ as opposed to ‘oral’ or ‘intravenous’) very rarely contribute to any resistance problems and in fact the main stay of infection treatment in eyes, chloramphenicol for bacterial conjunctivitis, has been heavily in use since 1950s and is still going strong.

One of the main issues with this drug is that it penetrates the eye pretty poorly so has to be put in quite often. A typical treatment does is every 2 hours for the first day then 4-6 times a day for 4 days. This is quite a burden if you are trying to put it in children or have trouble putting drops in yourself.

However there has now appeared a new drop called Azyter which is a drug called azithromycin. This was discovered in the 1980s and is widely used orally but is relatively new to use in the eyes. It has proven to be very effective and the dose is a much more manageable 2 times per day for only 3 days.

Because it’s much more powerful, Azyter is available only on prescription from an independent prescribing optometrist where chloramphenicol is available over the counter. Both Gillian and myself are qualified to prescribe this and Claire is undertaking the required training as we speak so you might well find us recommending this is you’ve got conjunctivitis.

Bear in mind there are many things that feel and look like bacterial conjunctivitis to the untrained eye that may require a different treatment so always come in and see us rather than your GP or just buying the drops from a pharmacy.

A smart fit for diabetics

As many of you know, one of our specialisms here is contact lenses so when stories come out about new developments, we all gather round with our morning coffee to discuss. Yesterday’s news regarding the licensing of Google’s ‘smart lens’ to Novartis lead to one of those discussions.

Googles-Smart-Contact-Lenses-Image-3
We see many patients with diabetes, managing the unique issues they face as a result of the condition. I know this story will be of particular interest to them. The smart lenses are designed to measure the level of glucose in the wearers tears so could eliminate currently invasive ways of testing glucose levels, whilst correcting vision at the same time. The licensing of this technology means the possibility of diabetics benefitting from it is now one step closer.

The lenses will probably fall under current contact lens regulation which means that they can only be fitted by a registered and qualified optometrist. As such we are likely to be fitting these ‘smart lenses’ when they eventually make it to market. That will be some years off, but we will follow the progress with great interest and the ‘smart lens’ is sure to be the basis of many more discussions around the coffee pot in the coming months and years.

Detecting Alzheimer’s through the eyes

Almost three years ago I wrote a short blog about an eye test that was being developed in a bid to spot the early signs of Alzheimer’s. So I was pleased to read over the weekend that this research is continuing with signs of success.

That said, whilst the test described may be relatively ‘simple’ in the eyes of the patient, what they are in fact describing is a process involving a very expensive and specialist piece of laser scanning technology, which is still in the developmental stages. The progress has undoubtedly been encouraging but we are still many years away from seeing it in practice.

I have already been asked if this will form part of a regular eye exam. I would suggest this is doubtful. The technology would be very expensive for a practice to purchase and a very small number of patients would fall in to the ‘at risk’ category so it is unlikely to be something you’ll ever see at your optometrists. However I hope that when it is ready, it will be easily accessible to those who would benefit from its use. It could form part of a valuable early detection system, allowing for a plan to be formed with other medical professionals to manage, and hopefully delay, the onset of Alzheimer’s disease.

It is such a devastating disease for those affected, so I do hope that research continues both in to this technology and the quest to find a drug to manage the disease.

Vision for the competitive edge

Watching the England vs. Uruguay match following the decisive goal from Luis Suarez I heard one of the commentators saying “Suarez sees things that bit quicker than anyone else.” Perhaps his competitive edge did in fact come from his eyes but over the last few days it’s become clear he can’t keep his temper under control properly.

luis_suarez_bite

Whatever the sport, football, cricket, rugby or tennis, all participators want to see the ball first. Now teams are recognising that examining vision may help their players gain the edge over the competition. Specialists such as Sport Vision work with teams and individual competitors to maximise all aspects of vision. It isn’t just about having perfect eye sight, there are many factors that contribute to clarity of vision. Aspects like depth perception and having the ability to focus accurately, would also examined by these experts.

Not every aspiring sports person has access to these services and it is worth speaking to your own optometrist about your vision in relation to your sporting performance. We have a lot of experience in the practice working with top sporting professionals experience that you we would be delighted to share.

Choosing the right contact lenses is a good place to start. Some lenses have features that are especially beneficial to sportsmen and women. For example, custom tinted lenses can be selected to reduce glare when playing under floodlights or in bright sun, and may also improve reaction times. Custom tinted lenses can be worn purely for their tint even if no vision correction is required.

In addition, a trip to your optometrist should include a test of your peripheral vision using specialised technology. You might not notice any issues with your peripheral vision on a daily basis but in sport it could mean your opponent sees the ball that vital split second before you. And even for those who consider themselves to have 20/20 vision, the competitive advantage that could be gained by making even the smallest of corrections should not be underestimated.

Blurred lines

Last week I carried out a first ever eye examination on former Scotland rugby captain Mike Blair who was recounting stories of problems he has experienced with colour deficiency prompting me to write this blog. In one particular match in Aberdeen he stepped out on to a snow-covered pitch an hour before Scotland were set to kick off, only to find the lines had been marked out in red to make them standout from the snow. However for Mike, this meant the lines were now indistinguishable. From the usual crisp, clear lines he was used to seeing, he could now only see the grass and snow. The result was the groundsmen had to busily change them before kick-off and spectators arrived to see a rare sight – a pitch with pink markings.

ishihara
This is a classic example of red/green colour deficiency which affects around 5% of men and very few women. The degree to which people are affected varies. Usually individuals can distinguish between very bright reds and greens. It is the less vibrant versions of the colours that cause the problems, and distinguishing between shades of red or green can be nigh on impossible. The condition is often referred to as ‘colour blindness’ which is an inaccurate term as those with the condition can still see colour not black and white.

The reason that more men suffer this form of colour deficiency relates to the fact that it is carried through the 23rd chromosome, commonly referred to as the sex chromosome. So both a mother and father would have to be carriers of the faulty gene for it to be passed to a daughter whereas just the mother has to be a carrier for her to pass it to her son.

Whilst it rarely causes individuals major problems, it does rule out certain professions-pilots and electricians are two that spring to mind. It is worth parents noting that the condition may go unnoticed as it is may not be routinely tested for. It is advisable to get children (really only boys) tested for colour deficiency before they start school to ensure it is spotted early. Many learning materials are not tailored to the needs of those with colour deficiency so children may struggle unnecessarily if undetected.

PS. If you can’t see the 29 on the coloured dot diagram above (called the ‘Ishihara test’ by the way), you should come and get your eyes examined!

Glaucoma – let us catch it early

We’re supporting National Glaucoma Week (9-15 June), encouraging people to take Action for Sight and book an eye exam to check for signs of the disease.

Beat-Invisible-Glaucoma
Over the years we’ve detected many cases glaucoma through simple tests before clients had any idea they had the early stages of the condition. Many are surprised that glaucoma doesn’t usually cause symptoms until it is quite advanced. It can be detected much earlier with three tests carried out as part of our comprehensive eye exam.

If there is history of glaucoma in your family then you’re probably aware of the importance of having regular eye tests. However it isn’t always genetic and early detection saves sight. Over 90% of those who have the symptoms detected early will retain sight for life and it is the main cause of preventable blindness. Signs of glaucoma, and other eye ailments can be detected in a regular eye test.

Key factors which increase the chance of glaucoma:

  • Other family members suffering from the condition.
  • People of African-Caribbean origin are four times more likely to develop glaucoma.
  • More common in older age
  • People with severe shortsightedness are known to be at increased risk
  • People with diabetes may also have an increased risk.

For more information about glaucoma please visit our website or make an appointment on 0131 225 2235.

The Eye Diet

food

Since the New Year the Sunday papers have been packed full of articles on the ‘latest’ diet.  Sugar seems to be the buzzword for 2014 and it is encouraging to see more focus on simple healthy eating than the usual range of gimmicks and fads from companies selling weird and usually not wonderful, diets.

Most people are inspired by their desire to lose some weight and look better. However few realise how beneficial a good diet can also have on eyesight. Here are some tips for a diet that will leave your eyes looking healthy.

Dark green, leafy vegetables
Eating spinach and kale for example, could help reduced your risk of macular degeneration. They contain lutein and zeaxanthin, two important nutrients that have antioxidant functions in the body and help prevent cell damage. Lutein also helps protect the retina.

Bright orange fruit and vegetables
The likes of sweet potatoes which have a rich source of beta carotene, a natural precursor to vitamin A, the vitamin most commonly associated with healthy eyes. And fruits like oranges are a great source of vitamin C which some evidence has suggested may slow the affects of macular degeneration and the formation of cataracts.

Beans
Adding zinc to your diet by eating zinc-rich foods such as beans, lentils, eggs and turkey will help the liver release vitamin A.

Oily fish
Fish such as salmon and tuna are rich in source of omega-3 which studies have found may also help protect eyes from age-related macular degeneration and dry eyes.

Wheat germ and sunflower seeds
Great sources of vitamin E which can help protect the eyes from free radical damage.

Eating a balanced diet with plenty fruit and veg of all colours will ensure your eyes receive the nutrients they require. Foods like those mentioned above will benefit you in many other ways too, so forget the fads, focus on foods packed full of nutrients and you will notice the benefits both inside and out.

Sunglasses – not just a style statement

I’ve been reluctant to start this blog. Talking about sunglasses and sunny weather will no doubt result in a May where the sun goes AWOL. Regardless, it is good to remember sunglasses aren’t just for the summer. There are benefits of wearing sunglasses even on a lovely crisp and chilly January’s day. Many fashion conscious folk don’t need encouraged to wear a pair but they shouldn’t just be seen as a style statement. They are essential to help keep our eyes healthy.

Ultraviolet (UV) light is harmful to the eyes and continued exposure to UV light can lead to long-term damage including macular degeneration and cataracts, both serious conditions affecting vision in later life. In addition, constant squinting can be very uncomfortable and lead to fine lines around the eyes. UV rays also affect the delicate skin around the eye area. This area of skin is probably the most sensitive skin on our bodies so should be treated with extra care. Jackie O had the right idea. Bigger is better when sunglasses are concerned as more of this delicate area is covered and therefore protected.

jackie-o-show-1

Few also realise that exposure to bright light can make it harder to adjust to seeing in the dark. So for example if you’re driving home in the dark after a day in the sunshine, it is especially important to wear sunglasses to ensure your eyes are able to adapt effectively.

Here are a few tips:

· Make sure the glasses you buy meet EU and British Standard and block 100% of UV light.
· Darker lenses don’t mean better protection. In fact the darkest of lenses are too dark for wearing whilst driving so watch out for that.
· A study by Which a few years back highlighted the issues that can be faced from buying cheap high street sunglasses. That said there are many low cost options out there just make sure you look for 100% UVA and UVB protection, as well as considering how dark your lenses are.
· Polarised lenses are the most effective at blocking glare.
· Always wear specialised glasses for sport, tailored to the requirements of your chosen pastime.
· Remember the little ones. The damage of UV rays can start from a very young age so make sure your children wear sunglasses too, as well as hats to cover the face, should the sunglasses get tossed aside! Wrap around glasses like www.babybanz.com are especially good to ensure they remain on, as well as protecting against peripheral glare.

So make sure you and all your family have your sunglasses close at hand for when the sun makes an appearance both at home and abroad. It will happen!

Here are some eyewear brands that we stock. All are available with prescription and non-prescription lenses. Speaking of Jackie O, there is a Ray-Ban model still available in her iconic style called Jackie Ohh – it comes in 4 colours with 2 lens colour options. http://www.ray-ban.com/uk/products/sun/RB4101

http://www.ray-ban.com/uk/

http://www.mauijim.com/shop/en/uk

http://www.williammorris.co.uk

http://www.guess.eu/en/Catalog/Browse/women/sunglasses/

http://www.silhouette.com/gb/en/home/

Lenses for the smallest of eyes

Many of my patients will know contact lenses are a passion of mine. Most of my patients have straightforward prescriptions with some requiring more specialist products. However a small number of our patients are a little more complex still.

We are fortunate to work closely with the Princess Alexandra Eye Pavilion and St John’s Hospital, taking referrals from them to provide specialist expertise in dealing with even the youngest of patients including newborns with congenital cataracts.

Babies who are born with cataracts (the clouding of the eye’s lens) are usually operated on within the first few weeks of their lives. For adults, following surgery the normal course is to be fitted with lens implants or where this isn’t possible they can wear high prescription glasses (around +15.00 or so)

Babies are different. After surgery to remove the cloudy lens they have been born with the eye is usually too small to support an implant until they are at least 2 years old. They can’t be expected to wear glasses as the prescription is as high at +35.00 and changes every few weeks as it reduces towards the usual +15.00 over the first year of life.

In fact a new study has found that wearing contact lenses for a few years before having implants fitted also gives better eventual outcomes. This is an area myself and my colleagues have a lot of experience in and it is encouraging to see further study supporting the treatment. For surgeons to get the prescription spot on for a small baby is very difficult. It is hard to judge the focusing power of the baby and the infant years are a period of rapid growth so the chance of the surgeon getting their lenses as near perfection as possible increases as the baby becomes a toddler. At this time testing is far more straightforward. The eyes have developed substantially and the child’s ability to communicate makes it easier to select the right permanent lens.

As you can imagine, it isn’t easy getting a baby to wear contact lenses, perhaps even harder a toddler, but like anything, they do get used to it and as this research reiterates, the long-term benefits are worth the short-term angst.

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5 St. Vincent Street, Edinburgh EH3 6SW
0131 225 2235