Millions of people in the UK could benefit from sight and hearing tests, yet many fail to have these simple checks, which could help to protect two of their most precious senses

Sight and hearing are our two most valued senses and, as we get older, 55 per cent of us fear deteriorating sight the most, with 32 per cent citing hearing loss as their main concern about ageing. Yet when asked what they do to protect their sight, 13.8 million adults in the UK say they don’t have their eyes tested every two years as recommended, according to this year’s Generation Eye report published by Eye Health UK. In addition, it takes people 10 years, on average, to address their hearing loss, and almost seven million people who don’t have hearing aids would benefit from them, according to Action on Hearing Loss.

Focus on eye tests

Some 75 per cent of Britons admitted they had suffered poor eye health in the last year and 22 per cent said it had impaired their quality of life, according to the Generation Eye report.

“The most common reason for not having a test is that people don’t think they have a problem with their eyes,” says David Cartwright, chair of Eye Health UK. “Too many are simply unaware that some eye conditions, including age-related macular degeneration (AMD), glaucoma and diabetic retinopathy, may not show symptoms until vision has already been lost.”

It’s thought that over 50 per cent of sight loss could be prevented. As well as picking up early signs of eye disease and helping to correct vision problems, an optometrist can spot a number of other underlying health problems, including high blood pressure and diabetes. “Living with low vision can have a major impact on someone’s physical, social and emotional wellbeing,” adds David.

However, it’s not just the elderly who are at risk. Over 1.6 million schoolchildren in England may be living with an undiagnosed sight problem, according to new figures released by National Eye Health Week and Boots Opticians. And a new study published in the British Medical Journal found a clear link between children with visual impairment and lower literacy development. “As a child’s eyesight is usually fully developed by age eight, regular sight tests – every two years unless advised otherwise by your optometrist – are vital,” says David.

Pharmacy staff can encourage customers to get their eyes tested. David advises using opportunities to signpost people to their optometrist. “If someone walks into your pharmacy and says they’ve been experiencing headaches or have had a fall, ask when they last had a sight test,” he suggests. “Ask customers when they use pharmacy services such as smoking cessation, weight loss or diabetic screening when they last had their vision tested.”

Protecting eye health

As well as having regular sight tests, there are a number of steps people can take to protect their eye health.

Stop smoking 

“Despite there being a stronger link between AMD and smoking than lung cancer and smoking, Britain’s seven million smokers are largely unaware of the dangers. Fewer than 10 per cent realise smoking can affect their eye health,” says David. Research shows that the average age for a non-smoker to develop AMD is 74.4, five years later than a smoker. Smokers also tend to experience faster progression of AMD and poorer treatment outcomes. They are also at increased risk of cataracts, thyroid eye disease, dry eye and poor colour vision. Pharmacy staff can help by getting this message across to customers who smoke and offering them help with smoking cessation.

Nutrition

Scientific research shows that nutrition can play a role in helping to prevent the onset of eye problems. Poor nutrition is strongly linked with AMD and a diet rich in antioxidants can be helpful. “Vitamin C helps eliminate free radicals that cause eye damage. Vitamins B and E can help protect against cataracts and omega-3 oils help maintain healthy blood vessels in the eye,” says David.

Screen savers

“We each spend around nine hours a day glued to screens and devices, so it’s no surprise that 90 per cent of computer users say they regularly suffer from screen fatigue,” says David. Signs of screen fatigue include dry, sore and irritated eyes, headaches, blurred vision and impaired colour perception. “The best advice you can give is to take frequent breaks – give your eyes a rest by following the 20-20-20 rule. Look away from your screen every 20 minutes for 20 seconds and focus on objects 20 feet away,” says David. He also advises that people:

• Position the screen so light sources are not reflected on it
• Keep the screen clean
• Have enough light to be able to read the screen easily
• Make an effort to blink more to prevent dry eyes.

Common eye complaints

Customers may seek the pharmacy team’s advice about a variety of eye complaints, including the following:

Conjunctivitis

There are three different types of conjunctivitis.

Infective: Caused by a bacterial or viral infection. Eyes look pink and lids may be inflamed and there may be sticky, yellow discharge. 

Most cases resolve in one to two weeks without treatment, but lubricating eye drops can ease sore or sticky eyes. If the infection is severe or persistent, antibiotic eye drops containing chloramphenicol can be recommended.

Allergic: Caused by a reaction to pollen, dust mites or pets, eyes will be watery and itchy. 

Eye drops containing sodium cromoglicate reduce the amount of histamine released when an allergen is encountered. Antihistamine eye drops, which block the action of histamine,
are also an option.

Irritant: Caused by contact with irritants such as shampoo, chlorine or smoke. Eyes look red and feel sore, but this resolves once the irritant is removed. 

If symptoms don’t resolve without treatment, eye drops containing naphazoline can relieve redness and irritation.

Dry eye

This happens when insufficient tears are produced or tears evaporate too quickly. The eyes can be dry, gritty, sore and red. Other symptoms include eyelids sticking together on waking and temporary blurred vision. 

Artificial tears, available as drops, sprays or ointments, lubricate the eyes and maintain moisture levels. Eye ointments are best for overnight use.

Blepharitis

This causes the edges of the eyelids to become inflamed. It can be caused by a bacterial infection or a complication of rosacea or seborrhoeic dermatitis. Symptoms include itchy, sore eyelids, eyelids stuck together on waking, crusty eyelashes, a gritty feeling and photophobia. The condition can be controlled with daily eye hygiene, even when symptom-free, which includes:

• Applying a warm compress to the eyelids for 10 minutes
• Massaging closed eyelids with a cotton bud or finger to loosen any crusting
• Using a cleansing solution or a cotton bud and water to clean the eyelids.

If blepharitis doesn’t improve with daily cleansing, antibiotic drops or ointment may be necessary. Oily tear drops may also be helpful and liposomal sprays, which are applied on closed eyes, are easy to use.

Hearing loss

Some 11 million people in the UK are now affected by hearing loss, according to the charity Action on Hearing Loss, and around 6.7 million people could benefit from hearing aids. Hearing loss affects 41 per cent of those aged 50 and over, as well as 71 per cent of people aged 70 and over. And, as the population ages, the problem will undoubtedly affect more people. In fact, by 2035, an estimated 15.6 million people will be affected. 

People wait an average of 10 years before seeking help with hearing loss. Pharmacy teams are well placed to encourage customers to go for a hearing test, which can be done by their GP or at a local hearing centre. They can then be referred to an audiology clinic if necessary.

The effects of undiagnosed hearing loss can be significant, especially if it means people are unable to communicate with family and friends, as this can lead to isolation. “We would encourage people to take action as soon as possible, as hearing aids are most effective when fitted early,” says Gemma Twitchen, senior audiologist at Hearing Loss UK. “Research shows hearing loss doubles the risk of depression and increases risk of anxiety. It may also increase risk of dementia. If anyone reports sudden or unilateral hearing loss they should be advised to see their GP or visit A&E urgently.”

Helping hearing impaired customers

“We would encourage pharmacy staff to promote simple tips to their customers, especially if they complain of reduced hearing or notice ringing after a noisy night out,” says Gemma. She recommends the following tips:

• Use noise cancelling headphones
• Take regular breaks from loud noise
• Use a volume limiter on personal stereos
• Wear reusable ear plugs for clubs and gigs.

Action on Hearing Loss has this advice on how to best serve customers with hearing impairment:

• Ensure your consulting room is well lit to help those who need to lip read
• Hearing loops can help improve understanding and transmit sound more clearly
• Speak clearly and concisely, face the customer and make sure your lips and hands aren’t hidden by a computer screen or behind the counter.

Common ear conditions

A number of conditions can affect the ears, and customers may turn to the pharmacy for advice and treatment options.

Ear wax

Too much ear wax can cause blocked, painful ears and hearing loss, while too little leads to cracked, sore skin and possible infections. It often becomes a problem in the elderly. 

If excess or hardened ear wax is causing problems, recommend ear drops to soften and loosen it. Drops should be used at room temperature, two to three times daily for up to five days.

Glue ear

This childhood condition affects one in five children. The main symptom is hearing loss. It is caused by a build-up of fluid in the middle ear, and can happen after an ear infection or in children who have allergies. 

It usually clears without treatment in about three months. If hearing loss is significant or lasts more than three months, tiny tubes (grommets) can be placed in the ears
to drain fluid.

Ear infections

Otitis externa (swimmer’s ear) causes inflammation of the external ear canal. Symptoms include pain, itchiness, discharge and temporary hearing loss. It usually affects only one ear. 

A GP can prescribe one of four types of ear drops to speed up the healing process: 

• Antibiotic drops treat bacterial infection
• Corticosteroid drops reduce swelling
• Antifungal drops treat fungal infection
• Acidic drops help kill bacteria.

Otitis media affects the middle ear and is seen mainly in children under 10. Symptoms include ear pain, fever, irritability, poor appetite and impaired hearing. Most cases resolve in a few days, but can be treated with paracetamol or ibuprofen. Antibiotics are only given if symptoms are severe or persistent. Refer the patient to the pharmacist if their symptoms worsen or don’t improve or if there is a discharge from the ear.

Tinnitus

Tinnitus affects 17 per cent of 40-69 year olds and 25-30 per cent of those aged 70 and over. “If a customer complains of hearing a ringing or buzzing sound, we recommend pharmacy staff advise them to see their GP. It may be caused by a temporary condition the GP can treat, such as ear wax. Once this is ruled out, they can be referred to their local hospital for checks,” says Gemma. 

Many cases will clear up without any treatment, but for some it can cause depression, insomnia and affect daily life.

Hearing loss affects 41 per cent of those aged 50 and over, as well as 71 per cent of people aged 70 and over