Why eye health checks are so important

National eye health week is a time to reflect on something that I think most of us take for granted. I know that I spent the first 20 years of my career dispensing advice to patients on measures they can take to improve and protect their eye health and their vision. These eye healthcare measures have now become deeply personal and all of the advice I give my patients I now have to adhere to myself.

The first event that dramatically changed my perception of my eye health was my mother being diagnosed with wet age-related macular degeneration  (ARMD) last year. Thankfully she is under the care of Mr Moin Mohamed at St Thomas’s Hospital in London. He and his team have provided the most fantastic care for her. Her eyes have responded brilliantly to the Lucentis injections which have been successful in restoring her vision.

A month or so after my mother‘s diagnosis it dawned on me that I now have a strong family history of wet macular degeneration. This puts me in an at-risk category for developing wet macular degeneration in the future. I was already doing most of the things that are important for reducing the risk of developing ARMD. I eat all the right foods and exercise five times a week. I don’t smoke and I just enjoy the occasional glass of wine at the weekend.

I have also now started to take a dietary supplement of antioxidants to try to further reduce my risk of developing ARMD in the future. This is more controversial since the evidence that these nutritional supplements are beneficial relates specifically to patients who have had ARMD diagnosed in one eye and the finding that taking the dietary supplements reduces the risk of developing ARMD in their other eye.

We don’t yet have the evidence to support dietary supplements as a measure to prevent ARMD in people who have not yet had the condition diagnosed. However, it’s logical that as long as it doesn’t cause any harm it may provide some benefit. There is some evidence that high doses of vitamin A, C, E, the minerals zinc and copper and the micronutrient lutein, when taken together, may help slow down the progression of dry ARMD, particularly if ARMD has already caused vision changes in one eye. However, there is no evidence that taking high doses of these vitamins can prevent you from developing ARMD in the first place [1].

I’ve always been someone who wears sunglasses in bright weather but I’m now especially careful to ensure that I always have my sunglasses to hand and that they are high-quality, UV-blocking CE marked sunglasses to provide my retina with a maximum protection from ultraviolet light. It never ceases to amaze me that the light we need to see is damaging to the back of our eyes!

Over the past couple of years, I have also started to experience dry eye symptoms at work. Again, this is an age-related change. In all of us, our tear film quality gradually declines with time. The meibomian glands in our eyelid margins can become blocked and inflamed, and this compromises the oil that we need to trap the moisture on the front of our eyes.

Intensive working on screens in air-conditioned offices, or in my case sitting at a surgical operating microscope in an operating theatre, places further strain on the ocular surface.

When we are undertaking tasks such as microsurgery or working on a computer, the concentrated visual attention reduces our blink rate and increases evaporation from the ocular surface.

As well as taking care to maintain good hydration and remembering to blink, I now also use an eye bag in the evenings to improve my meibomian gland function. The eye bag is a device that is placed in the microwave to warm up, and I then rest it on the surface of my closed eyes for five minutes. The heat melts the oils which have solidified at the apex of the glands and gets the glands flowing nicely. It’s a nice, relaxing way to end the day.

A comprehensive eye exam forms part of your assessment at Custom Vision Clinic. We don’t just assess your suitability for refractive surgery; we can also diagnose important conditions relating to your eye health such as glaucoma and age-related macular degeneration. They can also detect general health issues such as diabetes or high blood pressure. As you can see in the photo below, I take full advantage of having access to fantastic diagnostic equipment and ensure that I have my eyes checked regularly.

References

[1] Royal College of Ophthalmology https://www.rcophth.ac.uk/wp-content/uploads/2017/10/2017-Understanding-AMD.pdf