Eye Health
Early detection prevents serious eye damage
More than 1 million eye exams are performed by optometrists in New Zealand each year.
On average 60% of people seeking an examination will be expected to need prescription glasses or contact lenses. Eye exams may also detect diseases that affect people’s general health, for example high blood pressure or diabetes … see more >>
Many people will need eye health care such as visual training, treatment for eye disease, or referral for surgery. Any change in vision should be investigated as it could be due to a more serious sight-threatening condition … read more >>
The following is a brief overview of some of the serious and sight-threatening disorders of the eye. Any time there are symptoms it is recommended that you seek the advice of an optometrist without delay. A comprehensive eye examination will be needed to reach a diagnosis and ensure early appropriate treatment or referral occurs.
MACULAR DEGENERATION
There are two forms of macular degeneration commonly termed wet form (exudative) and dry form (nonexudative) both of which tend to occur in people aged more than 50 years.
Symptoms: Gradual loss of central vision.
Risk Factors: Age, hyperopia, family history, smoking.
Treatment: The wet form can be treated with laser photocoagulation or with intraocular injections. There is currently no treatment for the dry form. There is some evidence that a healthy diet high in green leafy vegetables and fish is helpful in retarding advancement of the disease.
DIABETIC EYE DISEASE
Symptoms: Damage to the retina as a consequence of diabetes may occur before symptoms are noticed. In later stages of diabetic eye disease reduced vision may be experienced.
Risk Factors: Poor HbA1c control; dyslipidaemia; length of time since onset of diabetes.
Treatment: Sight-threatening retinopathy and maculopathy can often be treated by laser and in some cases by intraocular injection of drugs.
CATARACTS
Symptoms: Even mild cataract can cause reduced vision and when the lens becomes more opaque vision may be severely reduced.
Risk Factors: Age; having diabetes; trauma
Treatment: Surgical removal of cataracts is a relatively simple procedure in most cases.
THE GLAUCOMAs
Primary Open Angle Glaucoma
Symptoms: Usually there are no symptoms until late stages of the disease. First awareness is usually decreased peripheral vision and in some case decreased central vision.
Risk Factors: Glaucoma in a family member; family history of blindness or visual loss from diabetes or hypertension; high myopia; age.
Treatment: This is aimed at reducing intra-ocular pressure to levels below those at which damage occurred.
Low Tension Glaucoma
Symptoms: It is possible that a person with low tension glaucoma may notice a visual field defect and this would certainly be obvious from the results of a visual fields test at the optometrist clinic.
Treatment: This is aimed at reducing intra-ocular pressure to levels below those at which damage occurred.
Angle-Recession Glaucoma
Symptoms: None are usually noticed until late stages when loss of visual field or visual acuity may be experienced.
Risk Factors: Eye trauma.
Treatment: This is aimed at reducing intra-ocular pressure to levels below those at which damage occurred.
Inflammatory Open-Angle Glaucoma
Symptoms: Pain, sensitivity to light, decreased vision.
Treatment: Normally treated with steroids, mydriatic / cycloplegic, and pressure lowering agents.
Steroid-Response Glaucoma
Increased intraocular pressure as a result of steroid use may develop within a few days or a few months after starting steroid use. Pressure normally returns to normal after steroids are discontinued. Anti-glaucoma treatment may be necessary and care should be taken to taper steroid use when discontinuing.
Pigmentary Glaucoma
Symptoms: In some cases there will be no symptoms while other people may notice blurred vision, eye pain, and coloured halos around lights after exercise.
Treatment: Treatment will depend on a number of factors in the presentation of the disease including intraocular pressure, visual field changes, and extent of the symptoms.
Acute Angle-Closure Glaucoma
Symptoms: Eye pain, blurry vision, halos around lights, frontal headache, nausea and vomiting.
This is a medical emergency and urgent medical care should be sought.
Neovascular Glaucoma
Symptoms: Some people will have no symptoms while others may have reduced vision, eye pain, redness of the affected eye, and sensitivity to light,
RETINAL DETACHMENT
Retinal Detachment is an elevation of the retina and a flap, tear, or break in the retina
Symptoms: Vision loss or visual field defect; commonly experienced as a curtain or shadow moving over the field of vision; flashes of light and/or floaters.
Treatment: Surgical repair is almost always needed.
CORNEAL INFILTRATE / ULCER
Symptoms: Red eye, painful eye – may be severe, sensitivity to light, impaired vision, discharge.
Treatment: Generally infiltrates and ulcers are treated with topical antibiotics and a cycloplegic. Admission to hospital may be necessary if the infection is sight-threatening and systemic antibiotics are needed.
HERPES VIRUS
Herpes Simples Virus
Symptoms: Most often one red eye with pain and sensitivity to light; watery eye, decreased vision, and rash on eyelid.
Treatment: Normally requires antiviral treatment. Warm soaks may make the eyelid feel more comfortable.
Herpes Zoster Virus
Symptoms: ‘Painful’ skin rash, fever, headache, red, painful eye, and blurred vision.
Treatment: Normally requires antiviral treatment. Warm compresses may make the affected skin feel more comfortable.
POSTERIOR VITREOUS DETACHMENT (PVD)
Symptoms: Flashes of light; floaters; and blurred vision.
Treatment: None indicated unless a retinal break occurs in which case laser therapy or surgery may be required.
CHOROIDAL DETACHMENT
Symptoms: Decreased vision; possibly severe pain and red eye depending on haemorrhagic involvement.
Treatment: Generally treated with cycloplegic and topical steroid medicines. In some cases surgery may be indicated.
VITREOUS HAEMORRHAGE
Symptoms: Sudden painless loss of vision or the sudden appearance of black spots and flashing lights.
Treatment: Generally bed rest is recommended together with surgery to repair any underlying cause.
IRITIS
Symptoms: Red painful eye with sensitivity to light.
Treatment: Generally treated with cycloplegic and topical steroid medicines.
ANTERIOR UVEITIS
Symptoms: Painful red eye, light sensitivity, watering eyes, and in many cases decreased vision.
Treatment: First line treatment is generally cycloplegic and topical steroid medicines.
Secondary glaucoma may result from uveitis.
SCLERITIS
Symptoms : Strong eye pain which may extend to forehead and face. Usually slow onset with gradual development of redness, watering of the eye, and decrease in vision.
Treatment: Can vary and depends on the underlying causation and co-existing conditions. Commonly treatment options will include the use of anti-inflammatory preparations.
MALIGNANT TUMOURS
Malignant tumours may develop in the conjuntiva, eyelids, or the eye itself. Malignant Melanoma of the Iris may present as a noticeable lesion within the iris while Malignant Melanoma of the Choroid may have no visible signs but may cause decreased vision or loss of field, floaters, light flashes or pain. Prevention measures include protection from the sun’s UV light and regular eye exams lead to early detection and treatment.
DRY EYE SYNDROME
Symptoms: Irritation in the eye with a burning itch or felling that something is in the eye ; often the eye will water excessively especially in wind, heat or low humidity. Usually affects both eyes.
Treatment: Artificial tear preparations and lubricating agents.
RETINTIS PIGMENTOSA
Retinitis pigmentosa may affect more than one family member; there are hereditary genetic links associated with retinitis pigmentosa.
Symptoms: Commonly difficulty with night vision and loss of peripheral vision; Difficulty with colour vision may also occur as may problems with central vision.
Treatment: There is currently no effective treatment for retinitis pigmentosa but low vision aids and rehabilitation assistance can be helpful in managing vision loss.
STARGARDTS
Symptoms: Usually presents as decreased vision in both eyes during childhood or early adolescence.
Treatment: There is currently no known treatment for but low vision aids and rehabilitation assistance can be helpful in managing vision loss. Genetic counselling may be recommended.
The major causes of blindness in the Western world are Age-related Macular Degeneration (AMD), Diabetic Eye Disease, Cataract, and the Glaucomas.
Some hard facts on eye health
- More than 70,000 New Zealanders aged 40 years and older have glaucoma. At least half do not know they have it. Untreated, glaucoma will cause loss of sight. ...read more >>
- Twenty-five thousand New Zealanders have already lost sight due to Age Related Macular Degeneration (ARMD) and a further 2,000 are developing the disease each year. ...read more >>
- Around 81,500 New Zealand adults and 13,200 children are already legally blind or have a sight impairment that cannot be corrected by glasses or contact lenses.
- Up to 20% of children may have blurry vision that can easily be corrected by glasses or contact lenses. Without correction they may struggle in the classroom, playing sports, using a computer, riding a bike, or texting their friends. ...read more >>
- Impaired vision can lead to falls, poor health, and higher levels of depression. [i]
- People with diabetes are at risk of developing diabetic eye disease which can cause blindness. ...read more>>
