Eye problems often develop slowly and have no symptoms, but regular eye examinations can spot early signs. Next month’s National Eye Health Week will aim to encourage us all to have regular eye tests

The facts about the UK’s eye health are worryingly stark. One hundred people in the UK start to lose their sight every day, but half of all cases could be prevented with regular sight tests and early treatment, according to the Association of Optometrists. Yet some 20 million of us fail to have regular sight tests, and up to a million children in the UK are thought to have an undetected vision problem.

NHS England forecasts a significant increase in the number of people with eye problems in the coming decades, with agerelated macular degeneration (AMD) cases set to grow by 19.6 per cent by 2030, cataracts by 14.5 per cent and glaucoma by 5.2 per cent. What’s more, partial sight and blindness in adults is estimated to cost the UK economy around £22 billion a year, which is why NHS England’s ‘Call to action’ campaign aims to improve eye health and provide better eye health services.

National Eye Health Week

Pharmacy teams are in a great position to encourage customers to have regular sight tests and eye health examinations, and get any eye symptoms checked early. The fifth National Eye Health Week takes place from 22-28 September this year, when eye care charities, organisations and health professionals will join forces to promote the importance of eye health and the need for regular sight tests for all.

“With more than a third of people saying their pharmacist would be their first port of call if they have an eye complaint, pharmacy can play a vital role in reducing avoidable sight loss and improving eye health,” says David Cartwright, chair of National Eye Health Week. “Talking to your customers about eye health is also a great way to introduce a wide range of pharmacy services, so I’d encourage all pharmacies to get involved in the week.” Each day of National Eye Health Week will have a different focus, including women’s eye health, sight after 60, sports vision, smoking and nutrition. To register for a free pack, and for full details, visit: Vision Matters

Why sight tests matter

Everyone should have their eyes examined at least every two years, but many people don’t. “There are still far too many people who go for years – even decades – without having an eye examination,” says Dr Susan Blakeney, clinical advisor to the College of Optometrists. “Sometimes this is because they think they only need a test if they wear glasses or notice any change in their vision.” At the Association of Optometrists, Karen Sparrow, head of professional development, says: “People still believe that if they have an eye examination they’ll be told they need glasses and this will be expensive. In fact, our first priority is eye health – they can take their prescription for glasses, if they need one, wherever they like.”

Helen May, eye health advisor and optometrist at the Royal National Institute for the Blind, believes that lack of knowledge about eye health is an important factor. “A large proportion of people only have an eye test when they have symptoms, but unfortunately there are several eye conditions which are asymptomatic and are only detected in routine eye examinations,” she says. “Optometrists are also able to detect changes in the eyes caused by many systemic conditions, such as hypertension, high cholesterol and diabetes.”

As well as checking a person’s vision, an eye test can pick up early signs of sight problems including glaucoma, AMD and cataracts, and spot the signs of health conditions such as diabetes, high blood pressure, high cholesterol and even multiple sclerosis (MS). Everyone should have an eye test at least every two years, while those with diabetes, glaucoma or a family history of it should be tested annually. Remind customers that it’s free for many people, including under 16s and over 60s.

Pharmacy teams are in a good position to remind customers of the importance of regular eye tests. “During their interactions with patients,” says Dr Blakeney, “we would encourage them to remind people about the importance of looking after their eyes in the same way they look after other aspects of their health, and to stress the importance of regular eye tests.”

Helen agrees, adding: “It is important that pharmacy staff ensure everyone who wants eye drops or advice about their eyes has had a recent eye examination and is advised appropriately. If there are changes in the customer’s vision, a persistent red eye or any concern, it is important to refer them to an optometrist for further investigations.”

Common eye conditions

Here are some of the most common eye conditions you’ll come across in the pharmacy:

AMD

This affects the macula, a part of the retina, and causes loss of central vision. It’s most common in people over the age of 65, and smoking increases the risk. It’s also thought that sun exposure is a risk factor. First signs are usually problems reading small print, blurred central vision and straight lines looking distorted or wavy. An optometrist can check the eyes and measure changes in vision, referring to an ophthalmologist if necessary.

A number of treatments are available for wet AMD (which accounts for 10-15 per cent of cases), and they work by stopping the growth of new blood vessels. There is no treatment for dry AMD, the most common type, although some research has found that high doses of antioxidant vitamins may slow the disease’s progression.

Cataracts

Cataracts occur when the lens in the eye becomes less transparent, which makes vision blurred and misty. The most common cause is age, but the condition can also develop as a result of diabetes, steroid medication, trauma and other eye conditions. Other factors include smoking, sunlight exposure and poor diet. As well as making vision cloudy and unclear, cataracts can mean that sufferers need more light to read smaller print. They may also notice changes in their colour vision. An optometrist can diagnose cataracts and offer a referral if necessary. They can be treated successfully with surgery.

Glaucoma

Glaucoma is a condition caused by optic nerve damage, which can be the result of raised eye pressure or a weakness in the optic nerve. It’s more common in people over 65 and also in those of African origin.There is a family history link, and people with diabetes are more at risk too. Those with a family history are entitled to a free annual eye test from the age of 40. There are often no signs in the early stages of glaucoma, but peripheral vision gradually becomes affected. Regular eye examinations can pick up the condition. Treatment includes eye drops to reduce eye pressure, laser treatment and surgery.

Dry eye

Dry eye usually only causes mild discomfort, but in severe cases, it can damage the front of the eye. It’s common in older people, as tear fluid production decreases and the eyelids become less effective at spreading this fluid over the eyes. Contact lenses, central heating, air conditioning, staring at a computer screen for too long and some medications can also cause dry eye. 

OTC artificial tear drops, gels and ointments can help.

Conjunctivitis

A customer coming in with red, watery eyes most likely has conjunctivitis. It could be infective conjunctivitis – with a burning sensation, gritty feeling and sticky coating on lashes – or allergic, which will cause itchy eyes too. The type of conjunctivitis needs to be established before it can be treated – if in doubt, refer to the pharmacist.

Chloramphenicol is an antibiotic available as drops or ointment OTC to treat infective conjunctivitis. Another option is propamidine isethionate drops. For allergic conjunctivitis, antihistamine drops work well.

Medical conditions that affect eye health

Diabetes

Diabetes affects the blood vessels in the eyes, and if they become blocked or leak, the retina can be affected, causing diabetic retinopathy. Some 40 per cent of people with type 1 diabetes and 20 per cent with type 2 diabetes are affected. The condition may be mild, with no change to the person’s vision, or it can progress and cause sight loss. Diabetes can affect the macula, causing central vision loss. It can also lead to the development of cataracts.

Annual retinal screening is an essential means of picking up early signs of eye problems in people with diabetes. Controlling blood sugar, blood pressure and cholesterol levels can reduce the risk of complications.

High blood pressure

Hypertension can damage the blood vessels in the retina and cause a condition called hypertensive retinopathy. There are usually no early signs, but it can be picked up in an eye examination and treated by controlling blood pressure and maintaining optimal weight.

Multiple sclerosis (MS)

An early sign of MS can be optic neuritis – inflammation of the optic nerve, which can cause blurred vision and sight loss. Apart from blurred vision, signs include a change in colour perception and a blind spot in central vision. It can be picked up during an eye examination.

More information

• College of Optometrists and Look after your eyes
• RNIB / 0303 123 9999
• National Eye Health Week 
• Association of Optometrists