Autumn 2013

Welcome to our latest newsletter. In this edition an article titled Drive and Survive is on our sight and driving. For more information about cataracts, a very common condition of our eye, then read When Cataracts Attack. Many people suffer with watering, itchy and swollen eyes, Cry Me A River is all about these symptoms. Finally if winter sports is your hobby, then read A Sporting Chance, which has advice on eyecare and winter sports.

Drive and Survive

As the seasons change driving becomes significantly more challenging. Issues like glare and low ambient light come to the fore and getting behind the wheel demands additional diligence and awareness.

One of the biggest challenges of driving is avoiding glare. Staring into the full-beam headlights of an oncoming vehicle can cause retinal burn, while sunsets frequently occupy that irritating zone just below the sun visors. One essential tool for any motorist is a pair of tinted prescription sunglasses, and anti-reflection coatings on conventional glasses are also highly advisable. When choosing frames be careful with thick arms as these could potentially obstruct vision at side-turnings. Keep a spare (or older) pair of prescription glasses in the car at all times in case an everyday pair break or go missing.

Our eyesight levels deteriorate imperceptibly slowly, so regular eye tests are essential. Vision needs to be pin-sharp for night driving, since darkness makes it harder to identify road signs, lane markings or potential hazards. Low light also diminishes our colour recognition, depth perception and peripheral vision levels, and our night vision worsens with age. Sight tests are particularly critical for motorists over the age of 40 to determine whether theyíre capable of identifying objects beyond the headlamp arcs.

Keeping the windscreen clear is important for good visibility, and detritus outside the wiper blade zones can obscure peripheral vision, so donít assume plentiful screenwash and fresh blades are sufficient. Dust and dirt builds up inside the screen as well, forcing our eyes to work harder and increasing the risk of headaches, so try to clean the inside of each window regularly. On a similar vein, donít be tempted to drive off before the demister has cleared any moisture from inside the windscreen ó the human eye doesnít function sufficiently well in low light to compensate for these additional handicaps. If demisting the car causes any eye-related irritation opticians can advise on ways to counteract this discomfort.

When Cataracts Attack

Although their name can cause alarm, and their presence can be distressing, cataracts are one of the less serious eye-related conditions. Despite being the most common cause of impaired vision throughout the world, cataracts can easily be dealt with, and effective treatments are available to avoid any risk of sight damage or blindness being caused by leaving them unattended.

Situated behind the coloured part of your eye, the lens is a clear piece of tissue that lets light pass through. Cataracts are hazy patches in this lens, obstructing daylight in a similar manner to clouds blocking sunshine. Eventually, the lens will become so misty that although light still filters through, patients are unable to focus on details. Cataracts can be present in new-born babies, and are more common among diabetics, but they are usually associated with the older generations, while men and women are equally at risk.

Cataracts often develop in both eyes, but at different speeds, and it can take years for a person to notice the deterioration in their vision. As with so many other medical issues, the key to successful treatment lies in identifying possible symptoms as early as possible. Your optician will be able to spot the presence of cataracts during a routine eye test, using a device called an ophthalmoscope, which directs a bright light through the lens of each eye to highlight any resultant cloudiness. Early-warning signs also include difficulties seeing things in dim or bright conditions, discomfort when facing towards powerful light sources, a washingout of colours, and problems focusing on written words or a TV picture. Other symptoms can involve halos around light sources and double vision, although these are relatively uncommon.

Experts are uncertain about the exact causes of cataracts, but there are some things everyone can do to minimise their personal susceptibility. A healthy diet is a key factor in helping to prevent cataracts from developing, as is not smoking. Perhaps surprisingly, wearing a wide-brimmed or peaked cap can also make a difference, because it means the eyes donít have to filter out harsh sunlight that contains potentially harmful UV rays.

If you do develop cataracts, medical treatment typically involves a small operation as an outpatient, under local anaesthetic. With liquid drops helping to dilate the pupil, a surgeon breaks down the lens into tiny pieces using ultrasound, before these fragments are sucked out through a small incision in the cornea. A bespoke artificial lens is then inserted, made from plastic or silicone, and designed to remain in place permanently. It is normally possible to go home once the surgery is over and recuperation should involve little more than avoiding strenuous activities for a few days afterwards.

Cry Me a River

Although we only usually shed tears in extreme circumstances (perhaps in response to chemical irritation, or a really sad movie), our eyes are constantly being lubricated by tears. These droplets of moisture normally reach our eyes and drain away virtually unnoticed, but a number of conditions can make our eyes water uncontrollably, and it is important to understand any possible causes and treatments.

A leading cause of watering eyes is blepharitis, which typically manifests itself in swollen, dry and itchy eyelids. This is usually caused by a bacterial infection or an existing skin complaint, taking the form of either anterior (outside) or posterior (inside) blepharitis. These variants respectively affect the front of the eyelid around the eyelashes, or glands within the lids themselves.

While blepharitis sufferers are prone to recurrent attacks, this isnít a severe condition, although it necessitates avoiding contact lenses and make-up as treatment proceeds. This can involve the use of topical or oral antibiotics, alongside basic steps like a warm compress, or rubbing the eyelid edges with a cotton bud or a wipe containing a mild cleaning agent. Your optometrist can advise on suitable products.

Our eyes can also overflow if our tear ducts get blocked, or if something is stimulating excessive tear production, such as a reaction to hayfever, or overcompensation in response to Dry Eye Syndrome.

Young babies and the over-60s are more prone to watery eyes, while any physical irritation on the surface (such as an ingrowing eyelash, ingrained dirt or an inflammation like conjunctivitis) can lead to excessive tearing.

Good hygiene is vitally important preventing certain issues from developing in the first place, and always begin your diagnosis or treatment with an appointment at your opticianís practice, where they can recognise symptoms, identify problems and recommend appropriate actions.

A Sporting Chance

Winter sports are hugely popular nowadays, but by their very nature, they place unique demands upon our eyes. To ensure effective protection against issues such as snow glare, it is important to understand the specific issues generated by being outdoors for long periods in cold conditions.

Even on a cloudy day, harmful ultraviolet rays can still reach our eyes, and these UV levels increase in high altitudes or closer to the equator. It is easy to be dazzled by sunshine as it reflects off snowy surfaces or even bodies of water so effective eyewear is just as crucial in winter as it is in summer in order to protect our corneas, lenses and retinas.

Sunglasses are the default choice for eye protection, but advances in lens technology are helping conventional vision correction products to bridge the gap. Spectacle lenses can now be photo-chromic (also known as transitional), adjusting their tints according to light levels, while some contact lenses come with UV protection integrated into them. Low-technology solutions like brimmed hats can also be useful for reducing the amount of ultraviolet light that reaches our eyes.

Avoid cosmetic or decorative sunglasses in favour of ones with approved UV resistance. CE or BS EN marks confirm suitable levels of sun protection, as do UV 400 labels or the promise of 100 per cent UV protection. Polarising lenses reduce reflective glare, such as sunlight on water or snowy ground, as this can be a particular issue for skiers or snowboarders. Anti-reflective coatings also help to eliminate glare, while scratch-resistant veneers and shatterproof lenses are other optional extras that can help to preserve sunglasses, which tend to lead a harder life than spectacles.

Certain types of lenses are now being manufactured specifically for their sporting credentials. Polycarbonate lenses are very light and impact-resistant, which makes them ideal for wearing during outdoor activities, and anti-mist coatings on spectacles can be useful when moving between warm and cold environments, to prevent fogging. Some lenses are calibrated to deliver better views of (and through) water and these are highly recommended for sailing enthusiasts.

Imperfect eyesight can affect every element of sporting performance, from peripheral awareness and timing through to balance and endurance levels. Regardless of whether a particular winter sport involves the land, air or sea, your optician will be able to offer advice on suitable products and solutions to maximise your performance, and minimise any risk of UV damage. On that subject, a final tip is to pick close-fitting spectacle or sunglasses frames that fully cover the eyes, rather than frames you can peer over or around - the effectiveness of eyewear protection is diminished if light can still directly reach your eyes.