If you notice any changes in your vision, or have any concerns, you should see your doctor, ophthalmologist or optometrist immediately. You should have regular eye checks every two years to ensure the health of your eyes, even if you have not noticed any symptoms or changes.
The following provides information about common eye conditions that is general in nature. This information is not a substitute for speaking to your doctor.
Glaucoma is the name given to a group of eye diseases that occur when too much pressure develops inside one or both eye balls. It is a leading cause of vision damage and blindness in people over 40 years of age, but it can affect people of any age. If glaucoma is detected early, treatment can prevent vision loss in most cases.
It is estimated that one in eleven Australians will develop glaucoma. Half of those with glaucoma are undiagnosed.
Symptoms of Glaucoma
Symptoms of early glaucoma in adults are often vague and variable, making it hard to detect. As glaucoma disease advances, symptoms such as blurred vision or a gradual loss of peripheral (side) vision can occur. At this stage of the disease, treatment can control further damage, but vision that is already lost cannot be restored. That is why it is crucial to have regular eye checks every two years. When you have your eyes checked, ask to have your optic disc assessed and have your eye pressure measured. A major risk factor for glaucoma is a family history of the disease. If you have a parent with glaucoma, your risk of glaucoma is three to five times the average risk. If you have a sibling with glaucoma, your risk is seven to nine times the average risk.
The incidence of glaucoma also increases with age. Only one in 200 40-year-olds have glaucoma, but one in 12 people over the age of 80 will have glaucoma. Other risk factors for glaucoma include previous eye injuries, exposure to steroid medications, short-sightedness, diabetes, history of migraines, and high blood pressure. Fortunately, glaucoma in infants is rare. However, when it does occur in infants it can be devastating, especially if not detected early. Signs of glaucoma in babies include large, watery eyes, and sensitivity to light. Any baby with these symptoms should to be examined urgently by an ophthalmologist.
If you have glaucoma, it is important to have regular appointments with your ophthalmologist and use your medications faithfully. If for some reason you are unable to do so, discuss this with your ophthalmologist. Ensure your technique of instilling eye drops is effective, and ask for help if necessary. Tell your ophthalmologist about any problems or side affects you might be experiencing, and tell your family to have their eyes tested regularly.
The Eye Surgeons' Foundation has provided significant funding towards the Australian and New Zealand Registry of Advanced Glaucoma (ANZRAG). This project continues to look at ways to identify people at high risk of developing glaucoma so that they can be diagnosed early and treated before they start losing vision. To help find out what puts people in a high-risk category for glaucoma, the project is establishing the world’s largest registry of advanced glaucoma cases. In 2014, the project team identified two new genes linked to glaucoma gaining a better understanding of glaucoma and its management. You can find out more about this project here.
Macular degeneration is the physical disturbance of the centre of the retina called the macular. The macular, which is about the size of the capital letter ‘O’ in this sentence, is the part of the retina that is capable of our most acute and detailed vision. We use the macular for reading, driving, recognising faces, watching television, and for doing finely detailed work.
Macular degeneration is the leading cause of blindness in people over the age of 55. However, even with the loss of central vision, colour vision and peripheral vision may remain clear. Vision loss usually occurs gradually and can affect each eye differently.
Macular degeneration appears to be hereditary in some families but not in others. Since macular degeneration affects most patients later in life, it is difficult to study successive generations in a family. Recent studies of twins indicate that both genetic and non-genetic factors play important roles in age-related macular degeneration. Research to determine the genes associated with hereditary macular degeneration will help lead to early detection, early intervention, and possible cures.
Symptoms of Macular Degeneration
1. Difficulty reading or doing other activities that require fine vision
2. Distortion - where straight lines appear wavy or bent
3. Problems with distinguishing faces
4. Dark patches or empty spaces appearing in the centre of your vision
If you experience decreased night vision, sensitivity to glare, the need for increased light, or poor colour sensitivity, this may also indicate something is wrong. If you have any of the symptoms listed above, you should immediately seek help from a medical eye specialist (ophthalmologist).
Is Early Detection Important?
Early detection is crucial. People destined to develop macular degeneration can sometimes be treated before symptoms appear, and this may reduce the severity of the disease and therefore reduce the degree of vision loss. Better treatments for macular degeneration are continually being researched, and these include medications, surgical techniques, and better low-vision aids.
Can Nutrition Help Treat Macular Degeneration?
Some scientists have suggested an association between macular degeneration and high saturated fat, low carotenoid pigments, and other substances in the diet. There is evidence that eating fresh fruits and dark green, leafy vegetables (such as spinach and collard greens) may delay or reduce the severity of age-related macular degeneration. Taking anti-oxidants like Vitamins C and E may also have positive results. Selenium and Lutein are also sometimes recommended, but you should always consult your physician to determine appropriate dosage. There is continued research in the areas of nutrition and supplements, and their effect on macular degeneration.
Macular Degeneration Research
The Eye Surgeons' Foundation has been supporting the Fight Retinal Blindness! Project to investigate the safety, effectiveness and possible adverse outcomes of new treatments for macular degeneration (such as injections into the eye). The risks and benefits of these new treatments will be tracked in participating ophthalmic practices. You can find out more about this project here.
In 2016, The Eye Surgeons' Foundation, via the Ophthalmic Institute of Australia, will provide funding to hopefully provide a new class of therapeutics for diseases such as Age-Related Macular Degeneration.
Cataract is the eye condition responsible for the largest single direct health cost in Australia. In 2004 it was estimated that almost 1.5 million Australians aged 55 or over had cataracts.
A cataract is a cloudy area in the lens of the eye. The lens is mostly water and protein, with the protein arranged to let light pass through and focus on the retina. Sometimes the protein clumps together and clouds a small area of the lens. This is a cataract. Over time, the cataract may grow larger and cloud more of the lens, making it hard to see. Left untreated, cataracts can cause blindness.
The most common causes of cataract
1. Age-related cataract - most cataracts are related to ageing, and most often occur over the age of 60.
2. Congenital cataract - some babies are born with cataracts or develop them in childhood. If these cataracts affect vision, they may need to be removed.
3. Secondary cataract - cataracts can also be linked to a number of other health issues, such as diabetes or the use of steroids.
4. Traumatic cataract - cataracts may develop after an eye injury.
Exposure to bright sunlight can increase the risk of developing cataracts, and new studies suggest nutrition may play a greater role in preventing cataracts than previously thought. Antioxidants (vitamins A, C and E), the use of polyunsaturated fat, and consuming higher amounts of protein may protect against the development of cataracts.
Symptoms of Cataract
Because cataracts develop slowly, it is rare to notice a sudden change in vision. Many people with cataracts are unaware their vision is deteriorating, and may continue to drive with vision below the legal limit. Common symptoms of cataract are:
1. Sensitivity to glare and bright lights (especially when driving)
2. Clouded or blurred vision (near or distance vision)
3. Halos around lights (especially at night)
4. Washed-out colours
5. Double vision or multiple images in one eye
6. Frequent spectacle prescription changes
The Eye Surgeons' Foundation supports sustainable international development projects across Myanmar, Timor Leste, India, Bangladesh and Cambodia aimed at providing cost-effective removal of cataract from disadvantaged patients in these countries.
In young people, the major cause of vision loss due to retinal disease is diabetic retinopathy.
Diseases of the retina can lead to partial or total loss of vision. For young people, retinal disease can be caused by the presence of other diseases such as diabetes. For older people, the most common retinal diseases are associated with conditions such as macular degeneration.
Symptoms of Retinal Disease
Diabetes can cause progressive damage to the eye’s retina, and in the early stages of diabetic retinopathy, there are usually no symptoms. The good news is that 90 percent of blindness due to diabetic retinopathy is preventable if it’s diagnosed early.
An extensive eye examination should be done as soon as diabetes is diagnosed, and at least every two years after that. If diabetic retinopathy is diagnosed, eye examinations may need to be done yearly. Timely, specialised laser treatment of the eye - specifically for diabetic retinopathy - is beneficial for people with this condition.
In older people, the retinal disease that most often causes vision loss is macular degeneration. Macular degeneration affects the central vision used for reading and fine visual tasks. Symptoms include distorted vision, where straight objects appear bent. Other symptoms include blind spots or dark patches in the central vision.
Changes in vision in one eye may go unnoticed if the other eye has good vision, therefore it is important for people with macular degeneration to have their eyes tested separately to detect these changes. There are new, highly effective treatments for neovascular (wet) macular degeneration. Early detection and treatment is essential to prevent permanent damage to vision.
Retinal detachment is an uncommon but significant cause of visual loss. Retinal detachment can often be prevented by treating retinal tears before they lead to detachment. Warning symptoms include the sudden onset of spots or lines that appear to ‘float’ in the vision and may look like insects. Other symptoms include flashes of light, which can appear as ‘lightning streaks’ to the side of the vision. If this occurs, seek an eye examination immediately. Laser treatment of retinal tears can often prevent further complications.
Other conditions such as retinal vascular disease may affect the macula and cause loss of vision. A retinal examination by an ophthalmologist can determine the exact nature of the retinal condition.
Trachoma affects almost 10 percent of the world’s population. It usually occurs in undeveloped countries where people live in overcrowded conditions and have poor hygiene and limited access to water. For decades, there have been significant efforts to eradicate trachoma around the world, but despite these efforts, trachoma still exists.
Australia is the only developed country that still has trachoma. Whilst trachoma disappeared from mainstream Australia 100 years ago, it still occurs far too frequently in remote indigenous communities.
Trachoma, an ancient Greek word for ‘rough eye’, is an infectious eye disease caused by the bacteria Chlamydia trachomatis. This bacteria can be spread easily on an infected person’s hands or clothing, or may be carried by flies that have come in contact with discharge from the eyes or nose of an infected person. Because trachoma is transmitted through close personal contact, it tends to occur in clusters, often infecting entire families and communities.
Trachoma is often referred to as ‘a quiet disease’, because those infected by trachoma do not instantly go blind. The disease manifests gradually. While children are most susceptible to infection, they may not notice its effects until adulthood, when scarring from repeated infections causes the eyelashes to turn inward and scratch the cornea.
In some communities, the disease is so common that blindness from trachoma is simply accepted as a fact of life. Yet trachoma is treatable, and the suffering and vision loss this disease causes is avoidable.
The trachoma bacteria has an incubation period of five to 12 days. People with trachoma initially experience symptoms similar to conjunctivitis, such as a stinging pain in the eye, photophobia (sensitivity to light), and swelling of the eyelids. If the disease is not treated, the inside of the eye thickens and gradually scars. The lachrymal glands, which normally form tears, become scarred too. Eyelids turn inwards, making them rub against the cornea, and this causes ulcers on the eye. In the advanced stages of trachoma, the scarring is so bad it causes blindness. This usually happens around 40 to 50 years of age.
The Eye Surgeons' Foundation, along with a number of aligned health organisations in Australia, funded the Central Australian Eye Health Program. This program addressed the backlog of more than 1,000 people in Central Australia waiting for eye surgery. Some of those waiting for eye surgery had cataracts and trachoma.
Rare Eye Diseases
Because of the rare incidence of some eye diseases, there is often little known about the conditions, their causes and treatment.
The Eye Surgeons' Foundation contributed significantly to a vital research project called The Australian and New Zealand Ophthalmic (Rare Diseases) Surveillance Unit where researchers continue to collect information at a national level about cases of rare eye diseases. This information creates a critically important resource for the management of these diseases, about many of which little is currently known.
Some examples of rare eye diseases include:
- acanthamoeba keratitis (amoebic eye infection)
- retinopathy of prematurity (vision loss in premature babies)
- ophthalmic trauma (injury causing the eye to fill with blood)
- rare complications of surgery such as endophthalmitis (infection)
- sympathetic ophthalmia (inflammation in the un-operated eye)
You can find out more about The Australian and New Zealand Ophthalmic (Rare Diseases) Surveillance Unit here.