Sight is the sense many fear losing the most and yet eye health can often be overlooked. National Eye Health Week aims to change that
People often take their eyes for granted. According to research by the College of Optometrists, 36 per cent of people admit to waiting months before they seek help with their eyes, even if they notice their eyesight has deteriorated – and 13 per cent even wait for years before seeking help.
With the UK’s ageing population, some chronic eye conditions are on the rise. According to the Royal National Institute of Blind People (RNIB), almost two million people have a sight problem that has a serious impact on their daily lives: that’s one person in every 30. It is predicted that by 2020, the number of people in the UK with sight loss will rise to over 2.25 million. Every day, 100 people in the UK start losing their sight, which over time can affect their independence and trigger loneliness and isolation if they don’t get the right support.
Leading healthier lifestyles and early diagnosis are key to reducing the number of people experiencing unnecessary sight loss. During National Eye Health Week (NEHW), taking place this year from 19-25 September, eye care charities, organisations and healthcare professionals across the UK will join forces to promote the importance of eye health and the need for regular sight tests.
David Cartwright, chairman of Eye Health UK, the charity responsible for organising NEHW, says many chronic eye conditions can be treated successfully if they are identified early on. “Glaucoma, macular degeneration and cataracts are the most common chronic conditions in the UK,” he says. “If these remain untreated, they can cause significant eye damage. This is why having regular sight tests is so essential.”
Many people think having a sight test is only about checking whether they need to wear glasses or contact lenses. But it’s actually far more than this. An optometrist can perform a complete eye examination to check the health of the eyes and diagnose early signs of chronic eye conditions. Most eye conditions are progressive, which means they develop slowly over months or even years, and people don’t always notice the symptoms straight away. “Some eye conditions may be first identified during a routine eye examination,” says David. “A full eye examination may even spot more general health problems, such as high blood pressure and diabetes.”
In June 2016, to mark National Glaucoma Awareness Week, the Eyecare Trust issued a stark warning that as many as 300,000 people in the UK are at risk of going blind because they are living with undiagnosed glaucoma (raised pressure in the eye). This eye disease is often symptomless until vision has been lost beyond recovery and so early detection is vital. Glaucoma can usually be successfully treated with eye drops that reduce eye pressure down to within the normal range.
Most people should have a sight test once every two years, even if they haven’t noticed any problems with their vision. It should be part of their regular healthcare routine. But surveys have revealed that many people don’t have regular eye checks at all.
Certain groups need more regular checks because of their age, family history or medical history. Those over 40, with a family history of chronic eye conditions (e.g. glaucoma) and from black or minority ethnic groups may need sight tests more often. “There’s evidence that people in certain minority groups are not having eye examinations, especially those living in more deprived areas,” says David. “Yet some ethnic groups are more prone to glaucoma or other chronic eye conditions, so should be having regular examinations. The learning disabled are 10 times more likely to have a serious eye issue, but don’t always get assessed.”
One reason why some people don’t have regular eye tests is because they worry about the cost. Yet according to the Eye Care Trust, more than 30 million people in the UK are entitled to free eye examinations on the NHS. These include the over-60s, under-16s, under-19s still in full-time education and those with a family history of glaucoma. Some people may also qualify for an optical voucher, which can be used as full or partial payment towards the cost of glasses or contact lenses of their choice. If pharmacy customers are housebound, they may be entitled to an NHS-funded sight test at home, which is also known as a domiciliary sight test.
Eye health is a year-round issue. It affects people of all ages, whatever the state of their general health, and should be discussed at every opportunity. If a customer walks into the pharmacy and says they have been experiencing regular headaches or have suffered a fall, the pharmacy team can ask when they last had a sight test. The same applies to customers who ask about any eye care issue, such as hayfever, dry eyes or minor infections.
Pharmacies can play a vital role in reducing avoidable sight loss, using topical and seasonal events such as NEHW and Allergy Week to discuss eye health issues. In the summer months, the pharmacy team can remind customers that protecting their eyes from the sun is just as important as protecting their skin. According to NHS Choices, exposure to bright sunlight can cause a temporary but painful burn of the eyes, like sunburn. Looking directly at the sun can lead to permanent eye damage. “UV light from the sun can contribute to cataracts and increase the chances of developing macular degeneration earlier than usual,” says David. “Pharmacy customers should be advised to wear suitable sunglasses in sunny weather or even on bright overcast days.”
There are many ways in which pharmacies can get involved in NEHW 2016. These range from displaying posters in the window and sharing the NEHW leaflets with customers to hosting an ‘eye health awareness’ event in association with a local optometrist. Last year, over 2,500 supporters took part in NEHW 2015. There were more than 1,000 events and activities, including a 34 marathon challenge, farm shop tastings, vision screening events, coffee mornings, talks and open days.
According to the Eyecare Trust, more than a third of people say that a pharmacy would be their first port of call if they have a problem with their eyes. “Customers may ask to speak to the pharmacist if they have a red eye, pain or problems with their vision,” says David. “Sensible questioning may help to identify any underlying problems. Some symptoms can be easily explained, such as allergic conjunctivitis during the hayfever season, or red eyes associated with a cold. But if there is any degree of uncertainty, it’s vital that customers are referred to an optometrist. Red flag symptoms include loss of vision, pain, unexplained redness or discomfort, flashes or floaters, especially if these have a sudden onset.”
The pharmacy team is ideally placed to identify customers at risk of chronic eye conditions too, and refer people for advice if they have any red flag symptoms. Team members should be able to recognise the eye-related side effects of common medicines (e.g. antidepressants, heart drugs or contraceptive pills). “If pharmacists are conducting medicines use reviews, it’s essential that they discuss the topics of eye health and sight tests,” says David. “Pharmacists see a lot of older people with chronic conditions such as high blood pressure and diabetes, which can increase their risk of eye problems, and repeat prescriptions will flag this up. Talking about eye health provides more engagement with customers and adds to the overall impression of the pharmacy’s role. This can help pharmacies in the long term, when these customers come back for more advice and support.”
Many chronic eye conditions become more common with age or are related to family history. But the RNIB says that over 50 per cent of sight loss is preventable, and many people don’t realise their lifestyle could be putting their vision at risk. Smokers double their risk of developing age-related macular degeneration (AMD) – the UK’s leading cause of blindness – and tend to develop it earlier than non-smokers. Smoking also increases the risk of cataracts and can make diabetes-related sight problems worse.
A lack of regular exercise, especially in the over-60s, may increase the risk of sight loss from narrowing or hardening of the arteries, high blood pressure and diabetes. A BMI of 30 or over doubles the risk of suffering AMD and significantly increases the chances of developing cataracts.
Leading a healthier lifestyle, particularly eating a balanced diet, may help to prevent many chronic eye conditions. Antioxidants, for example, may help to prevent the retinal damage seen in AMD. Foods recommended for eye health include broad leafy greens, such as kale, brightly coloured fruit and vegetables, oily fish (e.g. salmon, tuna and mackerel), broccoli and eggs. Research has shown that eating just one portion of fish a week may reduce the risk of developing AMD by up to 40 per cent. Unfortunately, many people miss out on these essential nutrients.
Talking about the link between eyes and healthy lifestyles is a great way to introduce a range of pharmacy services, such as smoking cessation, weight loss programmes and nutrition advice. Pharmacists could use the NEHW smoking and sight loss statistics to promote their smoking cessation service and recommend suitable eye-related nutritional supplements and other products designed to improve people’s general eye health and quality of life.
This year’s National Eye Health Week takes place from 19 to 25 September. Pharmacy staff can go to the Vision Matters website to register for a free resource pack. Download a copy of the digital event handbook for more information and ideas about how pharmacies can get involved.
Leading healthier lifestyles and early diagnosis are key to reducing the number of people experiencing unnecessary sight loss
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