How to keep your eyes looking and feeling healthy

Our sight naturally changes over the years, but many conditions can be halted or reversed if spotted early enough. Our GP, Dr Melanie Wynne-Jones, tells you what to look out for

Retinal detachment

This condition affects more than 7,000 people a year, usually in later life, although occasionally after trauma.

The retinal lining tears and lifts, triggering light flashes, ‘floaters’ (dark spots, flecks or cobweb effects) and/or blurred vision – it may feel like a dark curtain coming down. It’s more common in short-sighted people, after cataract surgery or posterior vitreous detachment (the vitreous peels away from the retina as we get older), or after a detachment in the other eye. If this happens, you need to see an eye specialist as soon as possible. Treatment may include pneumatic retinopexy/ vitrectomy (injecting a gas bubble to hold the retina in place until it heals and/or removing the vitreous) or an external band that exerts pressure, combined with laser/ freezing treatment. Around 85% can be successfully reattached. Recovery takes several weeks and vision may continue improving for months, although it isn’t always as good as before.

Blocked circulation

This is more common in older people. The retinal artery can be blocked by blood clots (from the heart or neck carotid artery), hardening or inflammation of the arteries (with pain in the temple), blood conditions and drugs, such as the oral contraceptive pill. This produces sudden painless sight loss, sometimes with early warning symptoms. Immediate drugs or surgery may rescue your sight, and you’ll need treatment for the underlying cause. Retinal vein

blockage is more common if you smoke, have raised eyeball pressure, blood pressure or cholesterol levels, or diabetes/ blood-clotting problems. Vision loss is painless and may improve with injections, laser therapy and treatment for underlying conditions. A stroke affecting the visual cortex also causes you to lose one ‘side’ of your vision and possibly a drooping mouth or movement/ speech difficulties too; call 999.

Optic nerve damage

Optic neuritis produces inflammation that can be painful, affect colour vision and cause blurring/fading. It can develop over a few days or weeks at any age and has many causes, including infections, immune system disorders, inflammation, drugs and multiple sclerosis. You’ll need blood tests, scans and the correct treatment. Occasionally, tumours or brain swelling can squash the optic nerve.

Foreign body, corneal ulcer, uveitis and acute glaucoma

These conditions all produce sudden stabbing eye pain, headache, reduced vision, redness, watering and eyelid spasm. Foreign bodies should be quickly removed using local anaesthetic; ulcers can be caused by trauma, bacteria and viruses. Uveitis (deeper inflammation) may be due to infection, immune disorders and acute glaucoma (sudden rise in eyeball pressure caused by blocked fluid drainage). You’ll need instant treatment, such as antibiotics, steroids or pressure-lowering drops or tablets to prevent sight loss.

Chronic/simple (primary) open angle glaucoma

Nerve fibre damage and rising eyeball pressure produce gradual peripheral sight loss (‘tunnel vision’). It can start in midlife and affects around one in 10 people over the age of 70, although half don’t realise they have it. It can run in families and is linked to short-sightedness, raised blood pressure, diabetes and African-Caribbean origin.

It’s detected and monitored by measuring eyeball pressure and visual fields (whether you can detect flashing lights on a screen), and treated with pressure-lowering drops or laser/surgery to improve drainage. You’ll need lifelong checks and treatment.

Age-related macular degeneration

This is the UK’s most common cause of sight loss, with 70,000 new cases a year; it affects one in 12 elderly people. Risk factors include age, smoking, family history, obesity, diet (high fat/starch, low fruit/veg), sunlight exposure, lightcoloured eyes, being Caucasian (white) and having AMD in the other eye. It affects central vision, so objects in front of you lose sharpness, brightness or colour, making it hard to read or drive. You may get glare/ flashes, struggle in dim lighting or have visual hallucinations; you’ll keep your side vision as it is less sensitive.

‘Dry’ AMD (90% of cases) is currently incurable, but can be slowed with a healthier lifestyle (see box, above), while vision can be improved with better lighting, magnification and other aids. In ‘wet’ AMD, new blood vessels grow and can leak/bleed, destroying sight. This can be treated with anti-VEGF inhibitor injections or laser/surgical treatment.

Cataracts

Our transparent eye lenses gradually discolour and develop specks (deposits/ cataracts) that reduce and distort incoming light. Half of us have cataracts by the time we’re 65; we may struggle to see, especially in poor light, and develop glare (worse at night), ‘haloes’ or double vision. Cataracts can run in families, be linked to diet, lifestyle, toxins, sunlight exposure, diabetes, previous eye inflammation, trauma or steroid treatment.

They can be removed and replaced with an artificial lens using local anaesthetic; 95% of operations restore excellent vision in otherwise healthy eyes, but you may need glasses.

Dry eye syndrome

This develops if we don’t produce enough tears (caused by age, hormone changes, some medicines or immune disorders such as Sjögren’s syndrome), or if they evaporate too quickly. Eyes feel dry, gritty, sticky, look red and may even water. Avoid dry, hot, windy or smoky atmospheres or try a humidifier. Wraparound glasses, avoiding eye make-up and eating omega-3s (oily fish, nuts and seeds) may help, too.

Apply a warm compress (a flannel soaked in cooled boiled water) for 10 minutes twice a day and gently massage to stimulate natural oils. You can get lubricating eye drops from a pharmacy or on prescription; if it’s severe your GP may refer you for stronger treatment or surgery to improve tear flow.