Eye care advice

Last week I attended the ‘Glaucoma Wet Lab’. Officially for doctors, these are hands on practical events where you are offered the chance to practice surgical techniques on pigs eyes. Whilst I perform a huge range of tests and administer numerous treatments on a daily basis, I have never had the experience of eye surgery, so this was a fantastic experience for an eye enthusiast such as myself. During the training, which was sponsored by health care company, Allergan, we used proper operating microscopes, amazing instruments which are worth about £500K each, as well as high grade surgical instruments. I, alongside a number of doctors, performed a ‘trabeculectomy’ which is a technique to reduce the pressure in the eye used when glaucoma drops alone aren’t working. It essentially involves making a new drainage channel in the eye to relieve the pressure. You can watch it here if you like, it’s a less gruesome animation of the technique. There were lectures from the consultants, who assisted each of us with the surgery. I performed pretty admirably with scalpel in hand but the sutures were lot trickier to secure than I’d imagined. Still much to learn but great fun and a fantastic insight. I now have an incredibly detailed understanding of this operation, allowing me to better manage patients who have had it done, with a clearer understanding of the potential complications. Although I’ll never perform this surgery on a human, it is far better to train yourself beyond your current level of knowledge and expertise than simply repeat what you already know. This has given me new insight into this area, and in fact greater confidence about minor surgical procedures like removing foreign bodies. We are an incredibly passionate team of eye care professionals at Cameron Optometry and never miss an opportunity to further our training. Some opticians go into work every day, do their job, and go home. Our team are complete eye enthusiasts, we live and breath eyes. Eyes are our passion. We aren’t ashamed to admit, we are a team of eye geeks!

We’re supporting National Glaucoma Week (6-12 June) and encouraging people to book an eye exam to check for signs of the disease. An estimated 600,000 people in the UK have glaucoma, with potentially another 300,000 having undiagnosed glaucoma (source: www.glaucoma-association.com). Beat invisible glaucoma Over the years we’ve detected many cases glaucoma through simple tests before patients 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 more common in older age people with severe short-sightedness are known to be at increased risk people of African-Caribbean origin are four times more likely to develop glaucoma people with diabetes may also have an increased risk. For more information about glaucoma please browse our website or make an appointment on 0131 225 2235.

Children are encouraged to enjoy books from a young age, and learning to read is a huge part of their early years at school. Therefore, for parents, seeing your child struggling to read can be worrying. However if your child is having difficulty reading it may be a sign of visual stress. What is visual stress? Visual stress causes an individual to have difficulty when reading. They may experience light sensitivity, headaches or other ‘stresses’ which are brought on by looking at text at close distance. Reading can become very tiring and uncomfortable for children with visual stress. What are the symptoms? Someone with visual stress may experience symptoms such as moving text, blurred text, patterns, lights or blobs of colour appearing on the page or sore head or eyes, when they read. What signs might parents notice if their child has visual stress? Your child may be struggling to concentrate on homework or visual tasks for any length of time. They might fidget while doing work, or move the task nearer or further away. Your child might miss words or lines when reading, frequently re-reading the same line or rubbing their eyes. Visual stress and dyslexia Visual stress is not the same as dyslexia, however people with dyslexia may well experience visual stress. By treating visual stress, some of the difficulties caused by dyslexia may be alleviated. How can visual stress be treated? Some cases of visual stress can be treated easily by changing the colour of background that they read on. A simple colour overlay can make a huge difference, as it is often the glare from a white background that causes many of the symptoms. Tinted reading glasses can also be worn. What do I do if my child has the signs of visual stress? Make an appointment with your optometrist, ensure they have experience in diagnosing visual stress. They will be able to identify it quickly and be able to assist in treating the symptoms, referring them to an expert if required. For further information on dyslexia and the eyes please visit the British Dyslexia Association.

With one in ten faking results because they want to wear glasses! A recent survey has found that over half (54%) of Britons have lied to their optometrist. When it comes to your eyes, examinations are there to help identify issues, many of which can be rectified if identified early enough. And although we’re quite sure none of our patients fall into this category, it is worth reiterating the importance of being open and honest when you visit your optometrist. Nearly half (44%) said they wanted to impress their optician or optometrist, as if poor eyesight is something to be ashamed of. The most worrying statistic was the fifth of respondents who said that they lied about existing eye pain, which can obviously be an indicator of a serious issue affecting your eye health. And serious message aside, we were amused to see that the research by health group Optegra, also found that one in ten faked their results because they wanted prescription glasses! We get this a lot with children, however were surprised that adults were at it too… Make sure you don’t waste an eye examination by trying to fiddle the results or not disclosing information relating to your eyes or general health. And for all you out there who want a shiny new pair of designer glasses but don’t need them…we can easily provide you with glasses with no prescription and promise not to let your secret out 😉

The first thing to say is, retinoblastoma, a form of eye cancer in children, is very rare. However, because it is rare, there is little awareness of the symptoms or even its existence. It is a fast growing cancer so early detection is essential. Most common in children under the age of six, the survival rate is high but it is essential that parents and carers know what to look out for. Change in iris colour, usually in just one eye. A squint or lazy eye – a common issue in young children and one that is usually not a sign of retinoblastoma, but something that you must get checked by an optometrist. A red, sore or swollen eye – a common symptom of conjunctivitis and other eye infections but again something that needs to be examined by an expert. Unlike with eye infections, the red, swollen eye will not be accompanied any discharge. A white eye or glow in one or both eyes or no ‘red eye’ in photos. If you take a photo of your child and one eye is red in the picture but the other isn’t this could be a sign that needs investigated further. Deterioration in eyesight – something that you should always have explored by your optometrist. Again, like many of these symptoms, more often than not this should not be a cause for serious concern but should always be examined. About half of retinoblastoma cases are a result of a faulty gene which results in the condition affecting both eyes. The cause of non-genetic cases is unknown and in these cases only one eye will be affected. Early treatment is very effective and relatively non-invasive. If left untreated, the concern is that the cancer could spread to other parts of the body. Any signs of retinoblastoma will be picked up in a routine eye examination. Yet another reason it is essential that you should take your child to see an optometrist at least every two years. And trust your instincts. If you notice any changes in your child’s vision or eyes, book in with your optometrist for a thorough eye examination. At Cameron Optometry we ensure children receive a comprehensive eye examination using market-leading technology, to give you complete peace of mind. Eye examinations for children in full-time education are free. If you want more information on retinoblastoma, the Childhood Eye Cancer Trust CHECT, has a wealth of useful information on its site and provides invaluable support to those affected by the disease.

We are often asked about whether there is anything you can do to reduce the chance of becoming short-sighted. So we've compiled some advice on steps you can take, which is especially important for parents to be aware of as their children’s eyes develop. In the UK, one in three people will end up myopic, the medical term for short-sighted, where objects in the distance appear blurred. Mild to moderate myopia can be corrected with glasses or contact lenses, however high levels of myopia can be far more problematic. As the degree of myopia increases, the lenses in your glasses get thicker, but more worryingly, the risk of developing additional eye conditions such as retinal detachment, glaucoma, cataract and macular degeneration increases. Having family members who are short-sighted is a strong risk factor for developing it yourself. While we can’t do anything about our genetics there are steps you can take to reduce the chance of becoming short-sighted (myopic). Increase the amount of time spent outside each day. Research shows this is the single most beneficial step you can take to reduce the chance of developing myopia. The brightness of natural light and/or the far-off focus is thought to be the reason this is so effective. At least two hours a day is a good target. Take regular breaks from close work. Look away from close tasks, such as working on a computer or reading, for a minute or so to change focus, or vary tasks every 30-60 minutes to alter the focusing demands on your vision. Limit additional close work (over and above school or work) to two hours per day. This includes reading, hand held computer games, drawing, homework, computer work, phones and tablets. Keep your prescription up to date. Research shows that wearing the correct prescription slows the development of myopia, whereas wearing a prescription weaker than you require, speeds it up. Take vitamin D. There is some evidence that taking a vitamin D supplement can slow establishment of myopia. Start early. The earlier in life these steps are taken, the best chance they have of making a difference.   Visit our Myopia Management page for further information on the treatment of myopia.

We’ve been shortlisted for another award! As some of you may be aware Ian Cameron currently holds the title of UK Contact Lens Practitioner of the Year With that success behind us, along with the UK Practice of the Year award we won a couple of years ago, we are delighted to let you know that we’re finalists again! This time, we are up for UK Technology Practice of the Year at the annual Optician Awards. We’re delighted and honoured that a team of optical industry experts have short-listed us for this award. We place a real emphasis on the use of market-leading technology and hopefully you have experienced its use first hand in the practice. We invest heavily in technology, ensuring that we provide patients with the most thorough eye care available in the country. It doesn’t end with the installation of the impressive looking equipment. Our highly trained staff are able to expertly analyse the findings, giving great reassurance to patients. It is not just our shiny scanners that have seen us shortlisted for this award. It’s our use of other forms of technology. For example, we are delighted to share scans online with patients, whether it’s sharing it with other health professionals, or simply because your child wants to show their friends the inside of their eyeball! Behind the scenes, we ensure the practice runs smoothly for the benefit of our patients, utilising technology to ensure ease of access and communication with patients. And soon, we’ll be one of the few optometrists (or opticians) to offer online booking on our new website. OK, a bit of trumpet blowing there, but we’re pretty chuffed and we want patients to feel 100% confident that by coming to Cameron Optometry they are receiving the highest level of eye care available. Now to get the glad rags ready for the awards night in April.

This coming Wednesday (4 November 2015), the Nystagmus Network is encouraging people to hold events to raise awareness of the condition that affects around one in 1,000 people in Scotland. ‘Wobbly Wednesday’ events will raise funds, but more importantly awareness and understanding, of a condition that is characterised by an involuntary movement of the eyes, which often results in seriously reduced vision. We have many patients with nystagmus and are especially pleased to help raise awareness of the condition. A Wobbly Wednesday walkabout to a wobbly jelly afternoon tea, there are lots of easy ways to support this event. The condition, which ranges in severity, can result in those with nystagmus being unable to drive or use a computer. Contact lenses and glasses can result in improved vision however will not reduce the uncontrolled to and fro eye movement. Nystagmus and contact lenses For a condition that affects an estimated 60,000 people across the UK, it always surprises us how low awareness levels are and those who are diagnosed with nystagmus can feel isolated and unsure of the best options available to them. In our experience those with the condition usually do better with contact lenses. Soft lenses have the flexibility to move with the eye so they are always looking through the lens. This is especially true if their ‘null point’ (the angle at which the eyes move least) is off to the side, which it is in most cases. You might notice people with nystagmus turn their head to one side a lot – this is where their eyes move least and the vision is most stable and therefore best. There is also some argument that wearing rigid gas permeable (RGP) lenses provide physical feedback to the brain that the eyes are moving and may reduce the level of the ‘wobble’ – a benefit of them being rigid and less comfortable than soft lenses. This is an example of where a ‘one size fits all’ approach doesn’t work. The majority of our patients find soft lenses to be the best solution, however a handful have found RGPs to be more effective in controlling their condition. Nystagmus is often a symptom of other conditions such as albinism, aniridia or achromatopsia so the complete picture must always be considered before working with the patient to agree the most appropriate way to manage it. For further information on how you can support Wobbly Wednesday and to access a range of resources visit www.nystagmusnet.org. Or to donate to the charity text WWNN15 £10 to 70070.

Gillian shares her motivations for competing for this invaluable charity Running is a wonderful sport. It requires little more than a pair of trainers and some get up and go. The World Athletic Championships will start later this month and when everyone lines up at the start line, what will inspire me, is the idea that no matter where they are from, or how wealthy they are, they are all on an equal playing field. Sadly this equality is not present in all areas of life, in particular when it comes to health care. Thankfully charities like Vision Aid Overseas are helping to address the issue of inequality in eye care. I have been involved with the charity since I qualified as an optometrist and have been able to see first hand, the results of the great work they do. The charity is dedicated to transforming access to eye care in developing countries. They utilise optometry volunteers from the UK to provide eye examinations in health centres and rural settings. Latterly they have also been heavily involved in training local people in VAO health centres with the aim of eventually seeing the countries reach self-sufficiency. The need for the charity is great with around 670 million people, 10% of the world's population, disadvantaged by poor vision due to a lack of spectacles. That means 670 million people with healthy eyes, do not see, simply because they don’t have spectacles. If you wear spectacles you will appreciate just how challenging your day would be without them. Imagine the educational, occupational and social disadvantage that people with similar prescriptions face. I have undertaken a number of sporting challenges before, ranging from endurance events such as Tough Mudder to the London Marathon. In November I will take on a new challenge: The Ethiopian Great Run, running at altitude in the highest city in Africa. A challenge I am taking on to raise essential funds for those in need of basic eye care. I have quite a substantial sponsorship target to reach and I would be thrilled with any donations people can afford to give. Thank you! You can donate to Gillian by visiting her Just Giving page: https://www.justgiving.com/Gillian-Bruce1

Pioneering work recognised at Optician Awards We are delighted to announce that managing director, Ian Cameron, has been named UK Contact Lens Practitioner of the Year at this year’s Optician Awards. Recognising the specialist work he performs on a daily basis, the award is an acknowledgement of his work supporting those with complex eye conditions. A thrilled Ian said, “It is a great honour to receive this award, especially as the judging panel is made up of highly regarded optical industry experts. I am hugely passionate about the work I do and am always eager to help those with specialist eye conditions who had thought that they couldn’t wear contact lenses. Lenses have life-changing potential for some people, from babies who have had cataracts removed, to those who have complex conditions like keratoconus, it’s my job to find the right approach to ensure they can enjoy all the benefits that contact lenses can bring. “We are soon to launch a specialist myopia (short-sightedness) clinic for children in a bid to stop their vision deteriorating throughout their childhood, through the use of specialist contact lenses. This is an approach that has shown great results but parents, and even some optical professionals, are unaware of the potential benefits of contact lenses in halting the progression of myopia.” The award will sit alongside our Association of Optometrists (AOP) UK Practice of the Year award and Donald Cameron’s AOP Lifetime Achievement Award which he collected last year. You only get one pair of eyes, so you really should give them the best possible care. That is what everyone at Cameron Optometry aims to do every time a patient walks in to the practice. It has been an incredible few years for the practice and we are confident the success will continue in the coming years with our fantastic team here.

As part of Royal Blind Week at the end of last month, the charity challenged people to take some time out to experience what it is like to be blind, whether for an hour or a whole day. Those who took the challenge shared their experiences, talking of how difficult daily mundane jobs became and what they missed seeing, people’s expressions, scenery etc. But what did they see? Most probably they were wearing thick blindfolds so saw complete darkness and I think many would assume this is what a person who is blind would see. However this is rarely the case. This was highlighted in a recent BBC article , ‘What people see instead of darkness’. One individual, who lost his sight in childhood, says the world is an array of luminous colours and light, seeing swirls of light, spinning circles of colour as you might see in a kaleidoscope. The article was a follow up to an article by a journalist who lost his sight in his youth and he says one of the things he misses most since losing his sight is darkness. Even although he has had the cord cut between his eyes and his brain, his world still has colour and lots of it, moving, swirling, changing colours. Some who have been blind since birth describe seeing nothing, no colours, not even darkness. Like what you see out of the back of your head or as another person said it as “like trying to see out of one’s foot”, you literally don’t see a thing. If you are fortunate enough to have your sight, make sure you look after it.

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. 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!

As you may have noticed at your eye appointments over the last couple of years, in addition to taking a retinal photograph of your eyes we offer a scan of the deeper retinal layers, using our Optical Coherence Tomographer (OCT) scanner. Being one of the first practices or hospitals to have this equipment in Edinburgh we have been learning more and more of the value of these scans as our experience grows and research continues. The most recent neurological research suggests that OCT measurement of the retinal thickness may offer a fast and effective way to monitor progression of Multiple Sclerosis (MS) The research suggests that patients with relapsing MS had rates of retinal thinning up to 42% quicker than those without replases. Perhaps as more therapies are developed to slow MS progression testing retinal thickness will be a useful tool in monitoring how effective these treatments are. As ever, the eye provides a window to the health of the rest of the body. While we use the OCT more commonly to detect and monitor early signs of eye disease, particularly glaucoma and all types of macular degeneration , we also see the value in having these scans done in your healthy eye to establish baseline data that could be invaluable in the future.

Results of a 2 year study into the long term effects of Corneal Cross Linking (CXL) in people with progressive keratoconus have shown encouraging results. Corneal cross linking has been gaining a reputation as an important treatment for stabilising progressive keratoconus, but as a relatively new treatment, long term results on its effects are scare. This study measured various aspects of vision and shape in 40 eyes over 2 years in patients under 18 with progressive keratconus. Visual acuity both with and without correction in contact lenses of glasses but a significant amount and the prescription or power of the eyes reduced a noticeable amount making correction of the vision easier. Measures of the shape of the cornea also improved over the study with the shape becoming more regular and a reduction of aberrations which are various types of ‘optical interference' that cause haloes, glare and shadowing in keratoconus.