Age-related macular degeneration (AMD) is the leading cause of sight loss amongst the elderly population in the UK – affecting more than 600,000 people. However, most people with AMD can see well enough to get around.
The macula is an area at the back of your eye that is responsible for your central vision, most of your colour vision and making out fine detail. When the macula is damaged, it becomes harder to recognise faces, or to read or watch television. However, the edge of your vision (peripheral vision) is not normally affected.
AMD can be described as being dry or wet. Dry AMD, is the most common type of AMD and occurs with age. It is the gradual degeneration of the retinal cells at the back of the eye leading to deposits on the retina called drusen. Dry AMD usually progresses slowly and people may not notice any change for many years. Most people with dry AMD have near normal vision. Currently, there is no treatment for dry AMD. However, there are some steps that you can take that may help reduce the risk of the condition from getting worse.
Wet AMD is much less common and develops when abnormal blood vessels grown into the retina and leak. Wet AMD can cause sudden and rapid loss of central vision.
Here are some of the symptoms of AMD:
Here are the things you can do to reduce your risk of developing AMD:
Most people’s eyes are round like a football and light focusses on one area of the retina (the thin layer of tissue that lines the back of the eye). If you have astigmatism your eye is shaped a bit like a rugby ball. This means that the light focusses on more than one area of the retina so your vision is distorted (you may find it difficult to tell ‘N’ from ‘H’, for instance) or blurry.
Astigmatism can cause blurred vision, headaches and eyestrain (you may notice this after concentrating for a long time – on a computer, for example). Astigmatism normally occurs alongside short sight or long sight.
Astigmatism is a type of refractive error, and is corrected with glasses, or contact lenses to enable you to see clearly. If your astigmatism changes, or you are having it corrected for the first time, you may find your glasses feel strange at first, whilst your brain gets used to seeing things with the astigmatism corrected.
Cataracts are formed when the clear lens inside your eye becomes cloudy or misty. This is a gradual process that usually happens as we get older. It does not hurt. The early stages of a cataract do not necessarily affect your sight, but if your sight becomes very impaired you may be referred for surgery to replace the cataract with a clear artificial lens. This surgery is normally carried out under a local anaesthetic and has a very high success rate.
Cataracts mainly develop in those aged 65 or older. Younger people can develop cataracts following an injury to the eye. Some medical conditions such as diabetes, or taking some sorts of medication such as steroids, may also cause cataracts. Smokers are also more likely to develop cataracts than non-smokers and there may also be a link between UV rays (sunshine) and cataracts. A very small number of babies are born with a cataract.
If you have cataracts, you may notice that your vision is less clear and distinct. Car headlights and streetlights can become dazzling, and you may experience difficulty moving from shade to sunlit areas. Colours may look faded or yellowed.
Many people with a cataract notice that they need to change the prescription for their glasses more often than they used to.
Cataracts often simply mean that your prescription for glasses needs changing. If the cataract is still affecting your day-to-day life, and your optometrist cannot improve this enough by changing your glasses, you can ask them to refer you to an ophthalmologist (eye specialist) for surgery. This involves removing the cloudy lens (the cataract) and replacing it with a clear plastic one. If you have cataracts in both eyes, surgery will normally be carried out on one eye at a time.
If you have diabetic retinopathy, the small blood vessels in your retina leak blood and fluid into the retina – the light-sensitive layer of cells at the back of your eye. Although this does not affect your vision in the early stages, if it is left untreated it may lead to sight loss.
Diabetic retinopathy affects people with type 1 or type 2 diabetes, especially if you:
You can reduce your chances of developing diabetic retinopathy by keeping your blood sugar, blood pressure and cholesterol levels under control.
The early stages of diabetic retinopathy do not usually have any particular symptoms, so if you are diabetic, it is important that you are regularly checked for diabetic retinopathy.
If the condition progresses, you may experience the following symptoms:
You will usually be treated for diabetic retinopathy in hospital. The main treatments are:
Dry eye occurs when your eyes don’t make enough tears, or your tears evaporate too quickly. This can make your eyes feel scratchy or irritated, and in severe cases may temporarily make your vision blurry.
Despite its name, having dry eye can actually cause your eyes to water. This is because the watery layer of your tears will dilute the oiliness of your tears, which reduces their ability to lubricate your eyes.
Symptoms of dry eye include:
Treatment of dry eye depends on what is causing it.
You can help to prevent dry eye by:
Glaucoma is a group of eye diseases in which the optic nerve, which connects the eye to the brain, is damaged by the pressure of the fluid inside your eye. It can affect one or both of your eyes and can lead to sight loss if not treated.
The two most common types of glaucoma are:
Anyone can develop chronic glaucoma. But the risk increases if you:
People at risk of developing acute glaucoma include:
Chronic Glaucoma: There are no symptoms in the early stages of chronic glaucoma, so it is important to have eye examinations – especially if you are in the group of people at risk of getting this condition. In the later stages, you may have blurring around the outside of your vision.
Acute Glaucoma: Acute glaucoma causes the pressure inside your eye to increase rapidly. The increased pressure can come and go, and some people get short bursts of pain or discomfort and blurred vision. This can happen when your pupils get bigger, so you may notice it at night or when you are in a dark area (like the cinema) or when you are reading. Other symptoms include an ache in the eye which may come and go, nausea and vomiting, red eyes, or seeing coloured rings around white lights, or it can be a bit like looking through a haze or mist.
Chronic Glaucoma: If your optometrist suspects that you have chronic glaucoma, they will refer you to an ophthalmologist (a specialist eye doctor) for a diagnosis. This may involve you having more tests. There is no cure for chronic glaucoma but it can be treated effectively, normally with eye drops which you use every day. These reduce the pressure in your eye. You will not feel that anything is happening, but you must ensure that you keep using the drops, as your sight could be much worse if you stop the treatment. It is also important that you attend your follow-up appointments.
Acute Glaucoma: Acute glaucoma requires prompt treatment. The first step is to lower the eye pressure. This is done using eye drops and an intravenous injection. Once the pressure is lowered, your ophthalmologist will use a laser or surgery to bypass the blockage in your eye’s drainage system to prevent the problem coming back.
Ocular hypertension is when the pressure of fluid in the eye is higher than normal. People with ocular hypertension are at a greater risk of developing a condition called glaucoma.
Eye pressure slowly rises with increasing age, so ocular hypertension is mainly found in people aged over 40. However, it can occur at any age.
Most people with ocular hypertension do not experience any symptoms. However, your optometrist can pick it up during your eye examination and will continue to monitor you to make sure you do not develop glaucoma which can cause damage to your optic nerve.
As OHT does not cause any damage to your vision, it does not need any treatment. However, you should be regularly monitored to make sure you do not develop glaucoma. If the pressure inside your eye is very high, even if it is not causing any damage to your sight, your optometrist or ophthalmologist may recommend eye drops or surgery to lower the pressure as a preventative measure.
Presbyopia is the inability to focus on things that are at normal reading distance, such as text on your mobile phone and print on packaging. It is a natural part of ageing and happens as your lens loses elasticity.
Presbyopia occurs as we get older – and will happen to everybody – even those who have never previously had a problem with their eyesight. It usually starts to become noticeable in your late 30s or early 40s.
People with presbyopia have difficulty focusing on things that are close, such as menus, phone screens and books – especially in dim lighting. As this progresses, you will also find that things that are further away from you, such as computer screens, also become blurry. You may also notice that it takes longer to change your focus between looking at something close and looking at something far away (or vice versa).
Presbyopia is usually managed with glasses or contact lenses. You can either wear single vision reading glasses or – if you find it inconvenient to swap between reading and distance glasses if you need them – you can use bifocal or varifocal lenses in your glasses.
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