We have shared the advice from lookingafteryoureyes.org on some of the more common eye conditions we see in practice for:

Age Related Macular Degeneration

Cataracts

Dry Eye

Glaucoma

Age related Macular Degeneration Explained

What is AMD?

Age-related macular degeneration (AMD) is the leading cause of sight loss in the UK – affecting more than 600,000 people. However, most people with AMD can see well enough to get around.

The macula is an area at the back of your eye that is responsible for your central vision, most of your colour vision and making out fine detail. When the macula is damaged, it becomes harder to recognise faces, or to read or watch television. However, the edge of your vision (peripheral vision) is not normally affected.

There are two stages in AMD:

Early AMD

Early AMD is always dry AMD. This is when yellow deposits, known as drusen, build up behind the macula. Most people with early AMD have near normal vision. There is no treatment for early AMD. It is important to note that many people with early AMD do not progress to late AMD and will not develop sight loss.

Late AMD

Late AMD can ‘wet’ or ‘dry’. Around 10-15% of people with early AMD will develop wet AMD. This develops when abnormal blood vessels grow under the macula and leak blood or fluid, which leads to scarring and rapid loss of central vision. Wet AMD can develop very suddenly but it can now be treated if caught quickly. Fast referral to a hospital specialist is essential.

Late dry AMD is called geographic atrophy and is quite rare. This is where you lose vision because the retina at your macula thins but there are no leaking blood vessels. There is no treatment for geographic atrophy.

Who is affected by AMD?

The older we are the greater our risk of developing AMD. Around one in every 200 people has AMD at 60. However, by the age of 90 it affects one person in five. We are all living longer so the number of people affected is increasing. You are more at risk of developing AMD if you have a family history of the condition or already have it in one eye. 

What are the symptoms of AMD?

Here are some of the symptoms of AMD:

• Straight lines may appear distorted or bent.

• Spots or smudges may appear in your vision.
• Bright light may be more uncomfortable.
• Eyes having difficulty adapting when moving between light and dark rooms.
• Colours look faded.
• Objects may appear to change shape and size or even move, and words may disappear when you are reading.

Cataracts Explained

What are cataracts?

Cataracts are formed when the clear lens inside your eye becomes cloudy or misty. This is a gradual process that usually happens as we get older. It does not hurt. The early stages of a cataract do not necessarily affect your sight, but if your sight becomes very impaired you may be referred for surgery to replace the cataract with a clear artificial lens. This surgery is carried out under a local anaesthetic and has a very high success rate.

Who is affected by cataracts?

Cataracts mainly develop in those aged 65 or older. Younger people can develop cataracts following an injury to the eye. Some medical conditions such as diabetes, or taking some sorts of medication such as steroids, may also cause cataracts. Smokers are also more likely to develop cataracts than non-smokers and there may also be a link between UV rays (sunshine) and cataracts. A very small number of babies are born with a cataract.

What are the symptoms of cataracts?

If you have cataracts you may notice that your vision is less clear and distinct. Car headlights and streetlights can become dazzling, and you may experience difficulty moving from shade to sunlit areas. Colours may look faded or yellowed.

Many people with a cataract notice that they need to change the prescription for their glasses more often than they used to. If you are long-sighted, you may even notice that you need your glasses less than you did before you had the cataract!

Dry Eye Explained

What is dry eye?

Dry eye occurs when your eyes don’t make enough tears, or your tears evaporate too quickly. This can make your eyes feel scratchy or irritated, and in severe cases may temporarily make your vision blurry.

Who is affected by dry eye?

Dry eye is more common in women and in people aged over 65. This is because as you get older, your eyelids are not as effective at spreading your tears across your eyes when you blink. Also, the meibomian glands in your eyelids, which produce the oily part of your tears, become less effective and may become blocked. This is a condition called blepharitis.

What are the symptoms of dry eye?

Despite its name, having dry eye can actually cause your eyes to water. This is because the watery layer of your tears will dilute the oiliness of your tears, which reduces their ability to lubricate your eyes.

Symptoms of dry eye include:

• Gritty eyes
• Feeling like something is in your eyes
• Stinging or burning eyes
• Heavy eyelids
• Blurred vision
• Watery eyes (If your eyes water a lot, you may dilute the oily layer of your eyes, causing them to dry out.)

How do you treat dry eye?

Treatment of dry eye depends on what is causing it.

• If your dry eye is caused by your eyes not producing enough tears, you can use eye lubricants. These are available as drops, gels or ointment, and most are available without a prescription from your optometrist or pharmacist. Gels are thicker and stay in your eye for longer. Ointment is generally used for people whose eyes dry out at night because they do not fully close their eyes. Eye lubricants do not contain any drugs and so you can use them as often as you like. However, some contain preservatives which may make your eyes sore. If you are using them more than six times a day you should use preservative-free drops.
• If your dry eye is caused because your tears are evaporating too quickly, you can use a spray that you spray on your closed eyelids. This replenishes the oily layer of your tears and stops them evaporating as quickly. The spray is available without prescription from your optometrist or pharmacist.
• If you have blepharitis you can treat this by keeping your eyelids clean and using warm compresses on your eyelids to help unblock the glands which produce the oily part of your tears.

You can help to prevent dry eye by:

• keeping your eyes clean and avoiding using makeup, especially eyeliner
• avoiding high temperatures, central heating, draughts (for example, from air vents in cars) and air conditioning
• ensuring you blink often and look away from the screen at regular intervals, when you are using the computer to give your eyes a rest
• using a humidifier to help slow down the evaporation of your tears
• wearing glasses or sunglasses, ideally the wraparound type, on windy days
• avoiding smoky atmospheres
• having treatment to stop the tears draining away. Small plugs, called punctum plugs, can be put into the holes in your lower eyelids to stop the tears draining away. These can be easily removed if necessary.

Glaucoma Explained

What is glaucoma?

Glaucoma is a group of eye diseases in which the optic nerve, which connects the eye to the brain, is damaged by the pressure of the fluid inside your eye. It can affect one or both of your eyes and can lead to sight loss if not treated. The two most common types of glaucoma are:

• Chronic glaucoma – this develops slowly. This is the most common form of glaucoma in the UK. The most common form of chronic glaucoma is primary open angle glaucoma (POAG).
• Acute glaucoma – this causes the pressure inside your eye to increase rapidly. It may be called acute angle closure glaucoma.

Who is affected by glaucoma?

Anyone can develop chronic glaucoma. But the risk increases if you:

• are aged over 40
• are very short-sighted
• are of African or Caribbean origin
• are closely related to someone with chronic glaucoma
• have raised pressure in your eye. This is called ocular hypertension (OHT)
• are diabetic
• have high blood pressure.

People at risk of developing acute glaucoma include:

• people over the age of 40
• women
• people of East Asian or South Asian origin
• people with a family history of closed-angle glaucoma
• people who are long-sighted.

If one of your parents or children, or a brother or sister, has glaucoma, and you are over 40, the NHS will pay for your eye examination. In Scotland, all eye examinations are paid for by the NHS.

What are the symptoms of glaucoma?

Chronic glaucoma
There are no symptoms in the early stages of chronic glaucoma, so it is important to have eye examinations – especially if you are in the group of people at risk of getting this condition. In the later stages, you may have blurring around the outside of your vision.

Acute glaucoma
Acute glaucoma causes the pressure inside your eye to increase rapidly. The increased pressure can come and go, and some people get short bursts of pain or discomfort and blurred vision. This can happen when your pupils get bigger, so you may notice it at night or when you are in a dark area (like the cinema) or when you are reading. Other symptoms include an ache in the eye which may come and go, nausea and vomiting, red eyes, or seeing coloured rings around white lights, or it can be a bit like looking through a haze or mist. If you get these symptoms it is important to act quickly. If the symptoms persist, you should go to the Accident and Emergency department immediately, so that they can reduce the pressure and get rid of the pain. Even if the symptoms appear to go away, your vision may be damaged, so you should see your optometrist as soon as possible.

How do you treat glaucoma?

Chronic glaucoma
If your optometrist suspects that you have chronic glaucoma, they will refer you to an ophthalmologist (a specialist eye doctor) for a diagnosis. This may involve you having more tests. There is no cure for chronic glaucoma but it can be treated effectively, normally with eye drops which you use every day. These reduce the pressure in your eye. You will not feel that anything is happening, but you must ensure that you keep using the drops, as your sight could be much worse if you stop the treatment. It is also important that you attend your follow-up appointments.

Acute glaucoma
Acute glaucoma requires prompt treatment. The first step is to lower the eye pressure. This is done using eye drops and an intravenous injection. Once the pressure is lowered, your ophthalmologist will use a laser or surgery to bypass the blockage in your eye’s drainage system to prevent the problem coming back.

Glaucoma advice, information and support

International Glaucoma Association

RCOphth, Understanding glaucoma

RNIB.org.uk