Eye problems... and when to be concerned

A SUDDEN problem with your sight can be terrifying, but it’s not always something to worry about. Here we look at the most common problems – and when help is needed...

Floaters

These are a completely normal part of everyone’s vision and usually nothing to worry about, says Stephen Hannan, Optometrist and Clinical Services Director at Optical Express.

“What you’re actually seeing are shadows cast on the retina from rogue strands of collagen surrounding the vitreous jelly that holds the eye’s shape, which have pulled free and float harmlessly across the field of vision,” he explains.

While the vast majority of people have just one or two, others can have hundreds permanently drifting past. When to worry: If the occasional floater turns into a sudden cobweb of squiggles, especially with associated flashes. “It’s a sign of postvitreous detachment, where the jelly-like substance pulls away from the retina,” says Stephen.

If this happens, go to A&E straight away as it can lead to blindness. “People use the word fogginess when they could mean blurriness – a key symptom of being short-sighted and the most common cause by some way,” says Stephen. Fogginess can also be caused by dry eye syndrome, where you don’t make enough tears or the tears evaporate too quickly.

This can lead to eyes becoming inflamed, and sometimes to a deterioration of vision.

“It can be relatively easily alleviated with artificial tears from your local pharmacy,” he says. When to worry: If short-sightedness has been ruled out, and if your fogginess has appeared suddenly, your issue could be circulatory. “A blood vessel blockage at the back of the eye can cause fogginess and loss of particularly the top part of your vision – in effect a mini-stroke called a TIA, or transient ischemic attack,” Stephen says. “This should act as an early warning system to head to your GP straight away as a full-blown stroke could be on the way.”

A more persistent fogginess is more likely to be a cataract. He says: “We’d all develop cataracts if we lived long enough, but you can delay the inevitable by not smoking, eating plenty of colourful fruit and vegetables, and using proper Uv-protecting glasses in strong sunlight.”

In very rare cases, fogginess can be caused by a brain tumour pressing against the back of the eye. Stephen says: “It is extremely rare, so speak to a specialist before panicking unnecessarily.” Anyone should see coloured spots if they stare at a bright object long enough and then at a white wall, as the photosensitive cells on the retina can be temporarily ‘bleached’ and take a few seconds to adapt, explains Stephen. When to worry: Stare at a particularly bright light, such as the sun, for long enough and it can literally burn into your retina, damaging your long-term sight.

“Flashing lights that last for 15-30 minutes are often symptomatic of ocular migraines,” says Stephen. “Once the flashing lights start, you can stop a full-blown migraine by taking painkillers, drinking water, upping your blood sugar with food and lying down in a dark room.”

If the lights last for longer than 30 minutes, this could be a detached retina. “Unlike ocular migraines, these are almost always in one eye, so put a hand over one eye and see if it’s the same on both sides,” he says.

“If it affects only one eye, head straight to A&E – you may need emergency surgery to re-attach the retina and save your sight.”

Fogginess

Multicoloured lights

Tunnel vision

Hallucinations

“It’s an extremely slow change that can creep in as you gradually lose your peripheral vision,” says Stephen. When to worry: Losing your night vision can be one of the first signs of developing retinitis pigmentosa, which causes progressive loss of vision.

“Unfortunately, there’s nothing you can do about it,” says Stephen.

“Tunnel vision can also be caused by glaucoma. Caught early enough, any damage can be stopped with medicated eye drops.” Stephen says little is known about how the brain stores the information it gets from the eyes and how we use it to help us create what we see.

When people start losing their sight, their brains aren’t receiving as many pictures as they used to, and sometimes new fantasy pictures or old pictures stored in our brains are released and experienced as though they were seen. It’s a condition known as Charles Bonnet Syndrome (CBS).

When to worry: “The biggest problem with CBS is that elderly people don’t tell you they’re seeing strange things because they don’t want to appear mad,” says Stephen.

“It can lead to a vicious cycle of them feeling like they are mad, but with proper diagnosis they can know what’s causing hallucinations.”

Most people who have CBS have it as a side-effect of age-related macular degeneration.

■■ For more information, go to: opticalexpress.co.uk

Often elderly people don’t always tell you if they are seeing things... it can lead to a vicious cycle