Ask the doctor - eye health

Read expert medical advice with doctors' questions and answers from Prima, SHE and Good Housekeeping

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Eyeing up cheap specs
I need some new reading glasses and wonder whether the cheap ones I've seen on sale in pharmacies are safe. Are they proper glasses?

A recent survey on behalf of Foster Grant suggests that many people have put off buying new glasses because they are concerned about the cost, despite admitting to eyestrain, blurred vision, headaches, or having to move the page further away from their face when reading. It's natural to become increasingly long-sighted from middle age on, and
you should use reading glasses if you need them, to prevent eyestrain. The reading glasses on sale in pharmacies and supermarkets are proper glasses with strengths ranging from +1 to +3.5, and they are safe and effective to use. It's still important to have your eyes checked regularly, but if you are told you just need reading glasses, you don't have to pay a lot of money for glasses sold at the opticians. You can
ask the optometrist to write down your prescription for you and then
shop around to find a cheaper pair, either online or in pharmacies.

Dr Sarah Brewer, Prima (Sept 09) 

 

Why does ageing alter our eyesight?

Can you explain why people become more long-sighted as they grow older?

When light passes through the pupil, it is focused onto the retina by the lens. To do this, it becomes fatter or thinner. At rest, the lens takes up a shape that is thin and fl at for distant vision. To focus on close objects, the lens becomes fatter and thicker. As we get older, however, the lens becomes less fl exible and loses its ability to focus light from near objects onto the retina. Known as presbyopia, this results in the onset of long vision, usually noticed around the age of 45. By 65, little focusing ability remains, so small print has to be read at arm's length. Regular eye checks become increasingly important, as other eye diseases such as cataracts, glaucoma and macular degeneration are more common, too, and can result in loss of vision if not diagnosed and treated.

Dr Sarah Brewer, Prima (Aug 09)

 

Do I need to be tested for glaucoma?

My mother has just been diagnosed with glaucoma, even though she felt fine and had no symptoms. Does this mean I should have my eyes checked, too?

Actually, you should have your eyes checked regardless of your mother's diagnosis! Glaucoma causes raised pressure inside your eyeball, and can damage your eyesight permanently. The good news is that it can usually be treated easily and effectively with regular eye drops. On the down side, it often doesn't cause symptoms in the early stages, and can only be picked up by your optician. Yet recent research shows more than half of us haven't been to our optician for the past 5-10 years, and one in five would only see an optician if they had a problem. Yet the Royal National Institute for the Blind recommends that everyone should have their eyes checked every two years - more often if they have problems. You're at increased risk of glaucoma if you're short sighted, over 40, have diabetes or, as in your case, have a family member with glaucoma. So don't delay - a routine eye check could save your sight.

Dr Sarah Jarvis, Good Housekeeping

Allaboutyou adds: see our guide to keeping your eyes healthy

 

 

How can I protect my eyes?

 

I have diabetes, and have my eyes checked at least once a year. At the moment they're fine, but I know diabetes can severely damage the eyes. How can I protect myself?

Your eyes are indeed at greater risk if you have diabetes, so well done for getting regular eye checks. You should have proper photographs taken of your retina (the back of your eyes) - talk to your GP if this isn't happening. If these checks do show up damage, you may be referred for laser treatment, which can cut by half the risk of your eyesight being affected. Meanwhile, though, keeping your blood sugar and your blood pressure under tight control is important as that will hugely reduce the risk of damage. If you have any evidence of damage to your eyes or kidneys (another possible complication of diabetes), your blood pressure should be below 130/80 mmHg. If it's higher than that when your doctor checks it, she may recommend tablets to bring it down. A drug called Candesartan, which comes from the blood-pressure lowering family the ARBs, can also help to protect your eyes. 

Dr Sarah Jarvis, Good Housekeeping

 

 

My eye is painful

Why do I keep getting a stye on my right lower eyelid?

 

A stye is a small abscess that develops in the follicle of an eyelash root. Usually, discomfort and soreness is felt in the area for 24 hours, followed by a painful, red swelling. This fills with pus to form a visible head. Treatment includes applying warm compresses, and plucking out the affected lash so pus can drain away. Your doctor may prescribe antibiotic eye drops or ointment, too. Increase your intake of fruit and vegetables, and boost your general immunity with echinacea, probiotics and a multivitamin and mineral supplement. Ask your doctor to check your blood-glucose levels, as recurrent infections can be a sign of undiagnosed diabetes.
Dr Sarah Brewer, Prima

 

My eyelids look puffy

I've started taking the corticosteroid drug prednisolone for a disease called sarcoidosis. My eyelids now look puffy, especially on waking. Will this get better?

 

Sarcoidosis is a disease that causes tissues throughout the body to become inflamed.
It mainly affects young adults, and usually targets the lungs, skin, eyes, liver and lymph nodes. Symptoms improve within six months to two years in more than two-thirds of people when the disease is limited to the lymph nodes in the chest, and in around half of those whose lungs are affected. Symptoms vary and can include fatigue, fever, weight loss, aches and pains, and sore eyes.
In nine out of ten cases, recovery comes within two years and no treatment is needed. If symptoms are more severe, as in your case, corticosteroid drugs help. Do
tell your GP that your eyes are swelling, so they can try to find the cause. Steroids can result in certain side effects with eyes, but as sarcoidosis itself can affect the eyes, it's important to find out exactly what's going on. You can also contact the sarcoidosis charity SILA at www.sila.org.uk or 020 7237 5912.
Dr Sarah Brewer, Prima

 

I'm experiencing problems with my left eye - redness, watering and blurred vision, and it's painful to look at bright light. Should I get it checked out?
Yes. It sounds like iritis, a common condition that causes inflammation of the iris - the coloured part of the eye - and makes eyes more sensitive to light. Like yours, most cases occur suddenly and usually only in one eye. Iritis is usually of unknown cause but can be the result of an infection or eye injury. More rarely, it's caused by an autoimmune disease, where your immune system starts to attack the body's own tissues. Left untreated, it can create serious problems and may even lead to permanent vision loss. Treatments aim to relieve the discomfort and discover the underlying cause - cycloplegic eye drops dilate the pupil and steroid drops tackle the inflammation. To avoid complications, it's important to treat the condition as quickly as possible, so make an appointment to see your doctor now. For more information, visit The Iritis Organisation at www.iritis.org
Dr Louise Selby, SHE

Milky line on the iris

I’ve noticed I have a milky line around my iris and, as suggested, I’ve had my cholesterol checked. I’m relieved to say it’s normal but I hate the way my eyes look and wonder if there’s anything I can do to get rid of the line?

The bad news, I'm afraid, is that this line - an arcus senilis - can't be treated and is unlikely to go away on its own. The good news is that as long as your cholesterol is normal, it isn't going to cause you any problems in the future. I'm afraid it's something you're going to have to live with, although it's worth remembering it may be something only you will ever notice.
Dr Sarah Jarvis, Good Housekeeping

Regular eye tests

I’ve never had any problems with my eyesight and I really resent the amount of money it costs to get my eyes checked. I’m only 39, so do I seriously need to worry about seeing an optician regularly?

Yes, it really is essential, even if you do have perfect eyesight. Your optician will also be checking for potential problems you may not notice, such as raised pressure inside your eyes, which can lead to glaucoma (a potentially eyesight-threatening condition). If your check was perfect last time, a test two years later should be enough - but ask your optician's advice.
Dr Sarah Jarvis, Good Housekeeping
 

Glaucoma signs

My mum has glaucoma, and the last time I saw my optician I was told I needn’t go back for another two years. Are there any signs I should watch for in the meantime?

Because of your family history, it's great that you're having regular eye check-ups as they can certainly detect early signs of conditions such as chronic glaucoma. However, other common eye conditions cause symptoms, which can alert you to the need for urgent action. Conjunctivitis, for instance, causes redness and soreness of the eye, but doesn't affect your vision or cause pain. It's annoying but not a medical emergency. But if the red eye is accompanied by acute pain and/or reduced vision you must get urgent medical help. Flashing lights can be an early warning sign for detached retina, which can cause blindness if not treated. Problems with focusing, losing your peripheral vision, or an increase in the size of the normal blind spot at the centre of your visual field can all be warning signs of glaucoma. If you have any symptoms and you're not sure if they're serious, phone your GP or optician for advice.
Dr Sarah Jarvis, Good Housekeeping

Lump on eyelid

I’ve got a lump on my eyelid that my GP says is a meibomian cyst. It’s not painful, but I think it looks unsightly, and I’d like it removed. However, my doctor says I don’t need to have it cut off. Should I insist?

 
Meibomian cysts are common and are caused when one of the tiny glands in your eyelid gets blocked. The good news is this cyst won't do you any long-term harm, or damage your eyesight, and it may disappear by itself over the course of a few months. If it doesn't - and it's something that obviously bothers you - talk to your GP again about referring you to an eye specialist to have it cut out under local anaesthetic.
Dr Sarah Jarvis, Good Housekeeping
 

Cataract operation

My optician told me I have cataracts, and sent me to the hospital. However, the eye doctor there said they don’t need to be removed yet. Won’t waiting cause long-term damage to my eyesight?

No, I'm delighted to say that delaying surgery won't affect your eyesight in the long term at all. For about 90% of people, cataract surgery will restore their eyesight almost to normal. If your cataract is at an early stage and isn't affecting your eyesight a great deal, the doctor is right to say that there's not much to be gained by having the procedure at this stage. Cataract surgery these days is a very simple operation that's almost always done in a day under local anaesthetic, and complications are rare.
Dr Sarah Jarvis, Good Housekeeping
 

Glaucoma check

My mother has had glaucoma for some time and is almost blind now. I've been told that it runs in the family and am worried I will suffer the same fate. Should I get tested? Is there anything I can do to prevent it happening to me?

Glaucoma is an eye condition where the nerve at the back of the eye (the optic nerve) is damaged. It is usually caused by an increase in eye pressure. You absolutely must get tested, and the good news is that eye tests are free for those with a family history of the condition who are aged over 40. If it were left up to me, I would recommend checks from the age of 30. Go and have it looked at as soon as you can, and certainly before you notice any symptoms. By the time you start to feel a change, there may already be a lot of damage to the eye. As the condition progresses, vision is lost gradually from the sides. It is not until the end stages that your central vision starts to go and you begin to notice a problem.
 
If you are diagnosed with glaucoma, damage to the eye can be prevented by the regular use of eye drops such as latanoprost, which increases the flow of fluid out of the eye, or timolol, a beta blocker, which reduces the amount of fluid produced in the eye.
Once these treatment options are deemed necessary you will be on them for life. They are prescription-only and an ophthalmologist (eye specialist) would need to prescribe them.
For more support and information, visit www.glaucoma-association.com or contact the Royal National Institute for Blind People.
Dr Louise Selby, SHE
 

Is laser eye surgery a risk?

Do you advise laser surgery for correcting short sight?

I had it done myself several years ago and am pleased with the results. Modern laser eye treatment (Lasik) produces virtually no discomfort and, as well as correcting short-sight, can correct long-sight and astigmatism, too. Local anaesthetic drops numb the front of the eye and the surgeon cuts a small flap in your cornea. This is folded back while a laser reshapes the front of your eyeball according to your prescription. The flap of corneal tissue is then replaced, antibiotic drops inserted, and a temporary contact lens fitted. When treating short-sight, more than 90 per cent of people achieve 20/20 unaided vision. The risk of side effects is low but your surgeon will explain these fully if you decide to go ahead.
Dr Sarah Brewer, Prima

 

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The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk