ON THE COVER Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
Eye problems become more common with age, but there are steps you can take to cut your chance of sight-threatening problems, and there have never been more effective treatments to preserve sight. With age – usually from your 40s – your lens becomes less efficient at focussing, leading to the inevitable middle-age glasses. Perhaps the bestknown lens problem is cataract, where the usually clear lens of the eye becomes cloudy, as if looking through frosted glass, and the gradual loss of vision can’t be corrected with spectacles. You may also notice spots on your vision, haloes around bright lights, and problems seeing in well-lit environments. About 1 in 3 over 65s of both sexes have cataracts, which can affect one or both eyes. Fortunately, a simple day-case procedure under local anaesthetic allows your eye surgeon to replace the lens, usually with great success.
Your eyeball is full of nourishing fluid called aqueous humour. This is constantly topped up, and the excess drained away through a meshwork at the front of the eye. If you have glaucoma, the pressure inside your eyes is raised because of a mismatch between the amounts of fluid produced and removed. Left untreated, this pressure build-up can damage your optic nerve and lead to gradual loss of vision. By the time you get symptoms, you can have significant permanent problems. Worse still, sometimes the fluid outflow gets completely blocked, leading to the severely painful red eye of acute glaucoma. Without emergency
AN ACUTELY PAINFUL RATHER THAN SORE RED EYE, ESPECIALLY IF YOUR EYESIGHT IS ALSO AFFECTED, IS A MEDICAL EMERGENCY. GO STRAIGHT TO A&E!
treatment, this can lead to permanent vision loss.
Fortunately, with early diagnosis and regular long term eye drops, damage can almost always be avoided – but it needs to be diagnosed. Glaucoma is common, affecting 1 in 50 over 40s and 1 in 10 over 75s. Your risk is higher still if it runs in your family, you are very short sighted or have diabetes. Everyone should have regular eye checks every 2 years at least. But if glaucoma runs in your family, you’re entitled to free NHS eye checks every year to rule this out.
Another eye problem related to ageing is Age Related Macular Degeneration or ARMD. Your macula is a small area of your retina with the highest proportion of light-detecting cells for seeing fine detail. With age this area can become less efficient, making ARMD the commonest reason for severe sight loss in over 50s. However, it doesn’t cause complete blindness.
There are two main kinds of ARMD. About 9 in 10 people have the “dry” variety, which can’t be treated but tends to progress much more slowly. The “wet” kind can cause more rapid vision loss, but can be treated with injections into the eye under local anaesthetic.
It’s essential to protect your eyes, even if you don’t have symptoms. It’s never too early to get into the habit of wearing sunglasses with good UV protection whenever you’re in bright light. And an eye check with your optician at least every 2 years can pick up treatable problems you may not know you have.
Smoking increases your risk of ARMD, as well as cataract, so it’s just one more reason not to do it. Keeping your blood pressure under control (with tablets from your GP if needed) and keeping your weight within normal limits will also both reduce your risk of eye problems. Next week: Are you drinking too much?
IF YOU HAVE DIABETES, ANNUAL EYE SCREENING TO PICK UP EARLY TREATABLE SIGNS OF EYE DAMAGE IS ESSENTIAL SO TELL YOUR GP IF YOU HAVEN’T BEEN INVITED