What your eye examination will show
If you need to get glasses for the first time
If you need to change your current glasses
What is happening with your general health
It is vital that you have regular eye examinations, even if you have perfect sight.
By looking at the health of your eyes, our optometrists can pick up early signs of many conditions before you’re aware of any symptoms.
Some conditions that can affect the eyes are:
Cataracts are caused by a clouding of the natural lens within the eye which gradually happens over a number of years. It is much more common the older we get, and it doesn’t hurt.
The only way to get rid of a cataract is to have an operation and when you and your optometrist feel it has reached a stage where the cataract is interfering with your vision, a referral can be made to an eye hospital to have this carried out.
Cataract surgery is usually performed under a local anaesthetic and has very high success rates.Why do cataracts occur?
Cataracts occur for many reasons – usually it is related to age, although exposure to UV light and smoking are significant factors in developing cataracts at a younger age.
Genetics and family history also play a significant role, as does being diabetic and taking certain medications such as steroids.
Occasionally babies will be born with a cataract. There is no scientific evidence to suggest any eye drop or supplement will prevent the development of cataracts, and your main defense is to have a healthy diet, stop smoking and wear CE marked sunglasses on bright days (even in Forfar!!).What are the symptoms of cataracts?
Initially you will notice a change in how clearly you see, or you may have frequent changes in your spectacle prescription.
Some people who were long sighted previously will notice that they are able to read clearly without wearing their reading glasses, whilst others will notice that their distance vision isn’t as good.
Most people start to notice glare from oncoming headlights when in a car at night or on sunny days, and you may start to notice problems adapting when changing from a bright to dim environment (or vice versa).
Gone are the days where you have to wait until a cataract is ‘ripe’ before having it removed – assessment is now based on how having a cataract is affecting your quality of life. This may involve your ability to perform daily tasks, drive or hobbies.What’s involved in cataract surgery?
Usually your optometrist will refer you to an ophthalmologist who will go over the risks of surgery and asses your needs.
Approximately 1% of cataract surgeries will not go as planned, and it is important that anyone undertaking this type of treatment understands this risk. Surgery is usually performed under local anaesthetic but your ophthalmologist will make sure that you are unable to feel anything during this time.
The surgery takes about 20 minutes from start to finish, and for 4-6 weeks afterwards you will need to use eye drops 4 times per day. During this time, there are some do’s and don’ts regarding heavy lifting and bending but you will be given advice on this in writing by the hospital performing the operation.
After this time you will be advised to visit your optometrist to check that your spectacles are suitable for use as there is often a change in spectacle prescription after your have had cataract surgery.
Sources: NHS Choices | College of OptometristsAge-related macular degeneration (AMD) is a painless eye condition that causes you to lose central vision, often in both eyes.
Central vision is what you see when you focus straight ahead. In AMD, this vision becomes increasingly blurred, which means:
+ Reading becomes difficult
+ Colours appear less vibrant
+ People's faces are difficult to recognise
This sight loss usually happens gradually over time, although it can sometimes be rapid. AMD doesn’t affect your peripheral vision (side vision), which means it will never cause complete blindness.
When to seek medical advice
Visit your optometrist if your vision is getting gradually worse. If your vision suddenly gets worse, images are distorted or you notice blind spots in your field of vision, seek medical advice immediately and book an emergency appointment with an optometrist.
If AMD is suspected, you may be offered an OCT examination by your optometrist as this can give vital information about the nature of macular degeneration present, and if referral to an ophthalmologist (eye specialist) for further tests and any necessary treatment is indicated.
Sometimes our optometrists will recommend multivitamin supplements to help provide nutritional support for your eyes if they think you are at risk of macular degeneration. Examples of these are Ocuvite Lutein or Macushield. As an example of the benefit this can offer, these supplements can give you as much lutein in one capsule as you would manage to get from consuming 13 portions of broccoli or 44 red peppers! (They are not however intended as an alternative to a balanced diet).
Why it happens
Macular degeneration develops when the part of the eye responsible for central vision (the macula) is unable to function as effectively as it used to. There are two main types – dry AMD and wet AMD.
Dry AMD
Dry AMD develops when the cells of the macula become damaged by a build-up of deposits called drusen. It’s the most common and least serious type of AMD, accounting for around 9 out of 10 cases.Vision loss is gradual, occurring over many years.
There is no treatment for Dry AMD although having a diet which is rich in leafy green vegetables and oily fish can help. The main factor identified in developing AMD is smoking, and this is another reason to kick that habit! An estimated 1 in 10 people with dry AMD will go on to develop wet AMD.Wet AMD
Wet AMD – sometimes called neovascular AMD – develops when abnormal blood vessels form underneath the macula and damage its cells and underlying structures.
Wet AMD is much more serious than dry AMD, and without treatment, vision can deteriorate within days leaving irreversible damage. This is why it is important that if you notice any sudden distortion or change in your vision, you must make an appointment with your optometrist as soon as you can.
More information is available at www.macularsociety.org (@MacularSociety) or by calling the Macular Disease Society on 0300 3030 111.
Sources: NHS Choices | Macular Society
Glaucoma describes a group of conditions that is associated with damage to the optic nerve and development of visual field (peripheral vision) abnormalities.
It may be related to increased pressure in the eye and can be an acute (sudden) condition or chronic (something that happens over a period of time). It is much more common to have chronic glaucoma and this is usually painless and not associated with any symptoms until much later in the disease process.
This is why having a regular eye examination is very important as your optometrist will look for early signs of this disease every time you have an eye test performed.
If you have a close family history of glaucoma (such as parent, sibling or child) and you are aged 40 years or older, it is advisable that you have your eyes tests once per year to screen for glaucoma. This examination is provided free of charge in Scotland and will only take about 30 minutes of your time.
Other risk factors for developing glaucoma include being very short or long-sighted, being African or Caribbean descent or having raised pressure inside the eye (also known as Ocular Hypertension).
How is glaucoma detected?
There are three main tests for glaucoma.
+ Assessment of the back of the eyes – this involves using special instruments to look at the optic nerve. This may be done directly via an ophthalmoscope or a slit lamp, or by using specialist photography. By looking at the appearance of the optic nerve over time, changes in its structure can be detected, which may indicate the presence of glaucoma.
+ Intraocular Pressure measurement – this measures the flow of fluid inside the eye. It does not hurt but this test can sometimes make you jump! This may be verified by measuring your ‘Central Corneal Thickness’ (aka CCT) if there is a suspicion of glaucoma being present.
+ Assessment of your visual field – this involves evaluating your peripheral vision. This basically involves checking how far round you can see whilst looking straight ahead.
What is the treatment for glaucoma?
Usually glaucoma is treated by using daily eyedrops for the rest of your life. It is not something that will go away, and in more serious cases that do not respond to eyedrops, sometimes surgery is needed to control the pressure within the eye.
The decision to start medications for glaucoma should only undertaken by a doctor who is a specialist in this condition, and therefore if your optometrist is suspicious of this, they will arrange an appointment for you to see someone with this knowledge.
Driving and Glaucoma
If you have glaucoma in both eyes, the law states that you must inform the DVLA of this. Most people are able to continue to drive but it may mean that you are required to attend additional appointments at the request of the DVLA to asses your visual field for driving.
More information can be found at www.dvla.gov.uk/driverhealth.
For more information, look up glaucoma on the NHS Choices website www.nhs.uk, or phone SightLine, an information, support and advice service provided by the International Glaucoma Association on 01233 648170, or visit www.glaucoma-association.com.
Sources: NHS Choices | College of Optometrists
Dry eye syndrome, or dry eye disease, is a common condition that occurs when the eyes do not make enough tears or the tears evaporate too quickly or the tears do not spread properly across the surface of the eye. This leads to the eyes drying out and becoming inflamed (red and swollen) and irritated.
Dry eye syndrome is also known as keratoconjunctivitis sicca, or simply ‘dry eyes’.Symptoms of dry eye syndrome
The symptoms of dry eyes syndrome usually affect both eyes and often include:
+ Feelings of dryness, grittiness or soreness that get worse throughout the day
+ 'Hot’ eyes
+ Red eyes
+ Eyelids that stick together when you wake up
+ Temporarily blurred vision, which usually improves when you blink
You should make an appointment with your optometrist if you experience persistent symptoms of dry eye syndrome. They will examine you to check if the problem is caused by an underlying condition and arrange further tests.
Although dry eyes can be very bothersome, it is rarely associated with a serious eye condition but if left untreated can lead to complications.What causes dry eye syndrome?
Dry eye syndrome can occur when the complex tear production process is disrupted in some way.
There are many different reasons why this can happen, although a single identifiable cause is not often found.
Common causes includes:
+ Being in a hot or windy climate
+ Using a computer for long periods of time
+ Air conditioning
+ Wearing contact lenses
+ Certain underlying medical conditions, such as blepharitis (inflammation of the eyelids)
+ Side effects of certain medications
+ Having a poor diet
+ Not drinking enough water or drinking too much alcohol or caffeine
+ Hormonal changes, such as during the menopause
Although the condition can affect people of any age, your chances of developing dry eye syndrome increases as you get older and it’s estimated that up to one in every three people over the age of 65 experiences problems with dry eyes.
Dry eye syndrome is also more common in women than men.
How dry eye syndrome is treated
Dry eye syndrome is not usually a serious condition. Treatments are available to help relieve the symptoms, which include eye drops to lubricate the eyes, medications to reduce any inflammation, and (if necessary) procedures to prevent tears from draining away so easily.
At Angus Optix, because our optometrists are trained in dealing with dry eye symptoms, they may be able to offer a solution which your GP has previously failed to find.
If dry eye syndrome is caused by an underlying condition, treating this condition will usually help relieve the symptoms.
Sources: NHS Choices | College of Optometrists
Blepharitis is a condition where the edges of the eyelids become inflamed (red and swollen). It is a common condition, accounting for an estimated 1 in 20 eye problems reported to GPs.
Blepharitis can develop at any age, but is more common in people over 40. It is a chronic condition that may flare up from time to time throughout your life. Signs of blepharitis can include:
+ Itchy and sore eyelids
+ Eyelids that stick together and are difficult to open, particularly when you wake up
+ Eyelashes that become crusty or greasy
+ Dry eyesWhen to get advice
See your optometrist if you are unable to control the symptoms of blepharitis with simple cleaning measures alone. Your optometrist can usually diagnose blepharitis based on your symptoms and an examination of your eyes.
Usually blepharitis is treatable with a few simple steps every day to control symptoms.What causes blepharitis?
Blepharitis can be caused by an reaction to Staphylococcus bacteria which is present naturally on the eyelids or as a complication of a skin condition, such as:
+ Seborrhoeic dermatitis – a condition that causes the skin to become oily or flaky
+ Rosacea – a condition that causes the face to appear red and blotchy
Blepharitis is not contagious.How blepharitis is treated
Blepharitis is usually a long-term condition. Most people experience repeated episodes, separated by periods without symptoms.
Blepharitis cannot be cured completely, but a daily eyelid-cleaning routine that involves applying a warm compress, gently massaging your eyelids and wiping away any crusts can help control the symptoms. Our optometrists are trained to give advice on the management of blepharitis and will be able to advise on any over the counter remedies that will help symptoms clear up quicker (such as heat pads for the eyes, cleansing agents and tear supplements).
More severe cases may require antibiotics that are either applied to the eye or eyelid directly, or taken as tablets. Again this is something that our optometrists are able to deal with, which means you can avoid a trip to your doctors or a hospital to manage this condition.
If they feel it is appropriate, your optometrist may recommend a procedure called ‘Blephex’ which involves a micro-cleansing of the eye lids to remove debris which has collected at the base of the eyelashes.
This give you a ‘clean slate’ to start your blepharitis treatment from and speeds up the time it takes to resolve.
Please enquire on 01307 462461 for more details about this procedure, or look at www.blephexlids.co.uk.Complications
Blepharitis is not usually serious, although it can lead to a number of further problems.For example, many people with blepharitis also develop dry eye syndrome which can cause your eyes to feel dry, gritty and sore.
Serious, sight-threatening problems are rare, particularly if any complications that develop are identified and treated quickly. In severe cases, blepharitis can cause eyelashes to become white or fall out all together.
Sources: NHS Choices | College of Optometrists
Choosing your glasses
Once your eye test has been completed, your results will be handed over to our dispensing optician or a clinical assistant to help you choose the right glasses and take any measurements associated with this.
We have a wide range of frames and lenses to choose from, suiting many different styles and budgets.
It is important that you choose a pair of glasses that you feel happy with, and we will make any minor alterations to the frames to ensure they fit properly and a comfortable to wear.
Why are eye tests important?
Regular eye tests are important because your eyes don’t usually hurt when something is wrong.
A sight test is a vital health check for your eyes that can pick up early signs of eye conditions before you’re aware of any symptoms – many of which can be treated if found early enough.