|
By
Dr David Delvin
HAVE YOU GOT PROBLEMS WITH YOUR EYES
Do
you have eye problems? Unfortunately
people of retirement age do tend to run into difficulties with their
eyes. I find that often
they are bewildered about their condition, because no-one has
explained it clearly to them. So
today, I want to tell you about some of the really common eye
disorders, which might affect you or your partner.
The
topics I am going to cover are:
¨
The structure of the
eye
¨
The ageing eye
¨
Cataracts
¨
Retinal detachment
¨
Glaucoma
¨
Conjunctivitis
¨
Diabetic eye problems
¨
Blepharitis
¨
‘Eye strain’
¨
Common questions and
answers about the eye
So
I hope this month’s article will help you!
Click
here to go back to the top of the page.
One
reason why people get bewildered about eye problems is this - very
few members of the public understand the structure of the eye and
what it does. Well, the
first thing to understand about it is that it is a delicate organ.
You only have one pair of eyes to last you a lifetime. So you need to take care of them!
The
eye is shaped like a globe, in fact you can imagine it as being like
a ping-pong ball but rather smaller; it is slightly less than an
inch (that is 2.5cms) across. It
works like a camera, in that light comes in at the front and is then
focused by a lens so that it produces an image on a screen at the
back.
So
when you look at (say) a beautiful rose, the rays of light from the
flower enter your eye through the pupil, which is just a round hole.
They then hit your lens, which is a bit like a tiny spectacle
lens. The job of the
lens is to focus the image of the rose onto your retina, which is a
curved screen at the back of your eyeball and your retina sends
details of this image to your brain.
So you see the rose.
Your
eye lies in the socket formed by the bones of your skull.
So it is reasonably well protected from injury expect at the
front. Fortunately the
exposed front part of your eye gets some protection from your
eyelids. Whenever
anything makes a movement towards your eye, your eyelid
automatically comes down in a blink.
But clearly, you need to try and avoid any blows to the eye.
It also needs protection from harmful fluids – therefore
never put anything in your eye unless you are sure it is OK to do
so. Your eyes also need
some protection from strong sunlight (see below).
You
could say that the eyes were originally ‘designed’ to last about
40 years or so. But
people live much longer than that these days!
Unfortunately, after the age of 40 our eyes do tend to
deteriorate quite a bit. Admittedly
many people do retain sharp vision till they are 80 or 90.
However, a lot of us do tend to encounter the following
problems:-
¨
Presbyopia
– this means the typical ‘long-sightedness’ of middle age, in
which people find it more and more difficult to read small print.
To begin with they cope by holding the reading material
further and further away from them.
But eventually they need to get reading glasses.
¨
‘Fuzziness’
of the lens – this may proceed to the stage where the
person has a cataract (see below).
¨
Raised
pressure – as the system of ‘fluid drainage’ in the
eye gets a bit older and less efficient, the pressure inside the eye can rise.
That may continue until Glaucoma (see below) develops.
Regular testing of eye pressure is extremely important when
you reach retirement years.
¨
Ageing
of the retina – unfortunately, the ‘screen’ at the
back of the eye (the retina) does tend to deteriorate with age. Therefore,
few people of 80 will have the ‘eagle eye’ that they
possessed when they were 20! However,
there are exceptions to the rule…
From
all this, I think you can see easily that it is vitally important to
take advantage of the eye tests which local opticians provide.
Anybody aged 60 and over can have a free eye test every two
years under the NHS. Even
if you are under 60, the cost of an eye test is not very great.
So it is well worth having one every couple of years.
Please note that optometrists vary a bit in what they charge
for a test, so it is worth shopping around a little.
Click
here to go back to the top of the page.
People dread the
word ‘cataract' - don’t they?
It is understandable they feel this way, because cataracts
are among the commonest causes of blindness.
However, most cases of cataract can be cured these days!
But
what is a cataract? It
is a gradual clouding of the lens of the eye.
Everything that you look at is viewed through that lens.
So if it clouds up your vision gets cloudy too.
Why do so many people get cataracts?
Mainly it is a question of ‘wear and tear’ – in other
words, the lens starts wearing out after all those years of use.
Experts say that if we lived long enough, all of us would get
cataracts one day. A
few cases are due to injury to the eye, but not many.
I must go out on a limb here and say that I think that a lot
of cases are due to excessive exposure to sunlight.
After all, cataracts are commonest in countries like India,
where the sun pours down relentlessly.
However, I must admit that eye experts regard the ‘sunlight
theory’ as unproven! Nonetheless,
my feeling is that on very bright days, it is a good idea to protect
your eyes with a decent pair of sunglasses even in Britain!
Symptoms
– The main symptoms of
a cataract are:-
¨
Blurring of your
vision;
¨
Poor vision in bright
light;
¨
Problems with glare;
¨
Difficulty in seeing
things close up;
¨
Difficulty with
distinguishing colours.
Treatment
of cataract –
There are no medicines or pills, which will make cataracts better,
so don’t be fooled by those con-artists who try and sell false
‘cures’ for the condition.
Fortunately, there is a highly successful surgical treatment
– cataract extraction.
The type of operation used today gives wonderful results and
it doesn’t cause all that much pain.
What the surgeon does is to remove the cloudy interior of the
lens and replace it with an artificial lens.
Result – vastly improved vision as a rule.
Detachment
of the retina (the ‘screen’ at the back of the eye) is quite
common especially in those who are shortsighted.
It may follow a blow to the eye or just occur on its own. What happens is that the retina comes away from the eyeball
like wallpaper peeling off a wall.
The result is the person sees a dark curtain speaking across
this field of vision. This
alarming experience may be preceded by a sudden flash of light or by
a strange sensation of seeing ‘black rain’.
A
person who seems to have a retinal detachment must be seen by an eye
surgeon right away. The
treatment is surgery usually with a laser to try to reattach the
retina to the eyeball.
Glaucoma
is potentially very serious, since it commonly causes blindness.
Your best defence against it is to have regular eye tests.
These are especially vital if you have a close relative who
has glaucoma since the disorder often runs in families.
There is more
than one type of glaucoma. But
in all cases, the problem is that the pressure in the eye is too
high. This build-up
damages the nerve fibres that connect the retina to the brain.
Everyone should be aware that in many cases, glaucoma
produces absolutely no symptoms in the early stages.
That is why regular visits to the optician’s are so
important.
The
initial treatment is usually with special pressure lowering eye
drops, but frequently surgery is necessary in order to relieve the
tension inside the eye.
In contrast this
is, thank heavens, generally a pretty trivial illness.
It is an inflammation of the membrane, which covers the
‘white’ of the eye. Frequently, it is caused by germs. Symptoms include redness of the eye, a yellowy discharge
(which a lot of people still call ‘sleep) and a tendency for the
lids to stick together. Treatment
with antibiotic eye-drops is usually very successful.
Vast numbers of
‘retirees’ now have diabetes.
Sadly, one of the nasty things about diabetes that it often
attacks the eye. The
main problems which is causes are:
¨
Diabetic
retinopathy (common) – this means a serious disruption
of the retina by the effect of the disease and is less likely to
happen if you can keep your diabetes under very strict control.
Treatment is a highly specialised business and may involve
surgery or laser therapy.
¨
Diabetic
cataract (rare) -
Cataract is as a rule easily treated by surgery.
This
means ‘inflammation of the eyelid’.
It is commonly caused by infection or allergy.
Treatment with appropriate eye drops is usually successful.
Anybody over the
age of 50 is likely to have been brought up with the idea that
reading too much will cause something called ‘eye strain’ and so
may cause deterioration of vision!
This just isn’t true.
However, peering at small print particularly in a poor light
is very likely to give you headaches!
Q
My wife is always rubbing her eyes.
Could this harm them?
A
Most people seem
to have this natural human instinct to rub the eyes with the
knuckles particularly on waking up!
I must say that I’ve never seen anyone come to harm from
this. But as I said
above, the eye is a really delicate structure.
So please urge your wife to take it easy and not to
‘drive’ her knuckles in to the eyeball.
Q
Does a little bit
of yellow stuff in the corner of the eye matter?
A
A tiny bit
doesn’t matter. But if there is a lot of it, you should get some eye drops
such as Brolene from your chemists.
If those do not do the trick, consult your doctor.
Q
As I have got
older, I have tended to see things like bits of gossamer drifting
across my eyesight. The
optician examined me and he says they are just harmless
‘floaters’.
A
No, sir.
Huge numbers of us have these ‘floaters’ – I have had
one all of my life! They
are caused by small imperfections inside the eyeball.
As the optician has examined you, you have nothing to worry
about, I assure you.
Q
Can cataract
surgery ever go wrong?
A
Yes, any type of
surgery can sometimes go wrong.
But if you are in hands of a good eye surgeon, the chances of
running into any serious trouble are low.
Q
I am 68 and have
been diagnosed as having something called ‘macular degeneration’
but nobody has told me what it is.
A
Macular
degeneration is now common in the UK, mainly because the population
is living longer. It is
a ‘wearing out’ of the central area of the retina (which is the
screen at the back of the eyeball).
It is probable that if we lived to 110, all of us would get
macular degeneration. However,
a few cases are hereditary.
Chief symptom is loss of vision, mainly in the central area
of whatever you are looking at.
People who seem to be developing macular degeneration need to
have a special test called ‘fluorescence angiography’, in order
to find out the extent of the problem.
Laser therapy may be helpful and eye surgeons are trying to
develop other techniques.
Q Is
an eye transplant possible?
A Not
yet sorry.
Click
here to go back to the top of the page.
Q
I am retiring next
month. I thought I would have one of those MOT medical check ups and
I was very surprised to find that the report said that I had ‘some
arthritis’ in my knees. Does
this mean I am going to be crippled?
A
Not at all, sir.
Very few people realise that by the age of 60, most men and
women have a small amount of arthritis somewhere in their bodies. But it is not generally the kind of arthritis that would put
you in a wheelchair.
Q
I am 69 – do you think that I am too old to take up ocean racing?
A
No, indeed, but
this is a very strenuous form of sailing. So you should definitely
have a very full medical check up before you start to consider
crossing the Atlantic.
Q
I am 51 and have
recently discovered that two of my relatives died of cancer!
Does this mean that I am highly likely to get it?
A
No sir, like most
people you haven’t realised just how common cancer is.
Because we are all living longer, it is now the most frequent
cause of death just above heart disease.
So having a mere two people in your family who it is really
nothing out of the ordinary. NB
To stand the best chance of avoiding it, DON’T SMOKE!
Click
here to go back to the top of the page.
|
