Saving your sight

As you grow older, it’s more important than ever to have your eyes regularly checked by a professional.

Optometrists can detect a number of conditions that in the early stages have no obvious symptoms, but which left unchecked, can lead to blindness.

The New Zealand Association of Optometrists (NZAO) says everyone, especially older people, should have a regular eye examination. Age Concern New Zealand says this should be state-funded (see below).

"Once sight has been lost, it’s generally gone forever.”

Around 81,500 New Zealand adults and 13,200 children are legally blind or have a sight impairment that cannot be corrected by glasses or contact lenses.

“The number of people affected by eye conditions is increasing with our ageing population and one of the saddest facts is that if people were diagnosed early by their optometrist the degree of vision lost could be reduced,” NZAO national director Dr Lesley Frederikson says. 

Macular degeneration

Age-related macular degeneration (ARMD) is one of the most common causes of low vision and visual impairment in older people.

This occurs when the centre part of the retina becomes damaged. This part is the macula – the part of the eye that helps people to see fine details.

“When it is damaged, the vision in the centre of your eye blurs or darkens. Jobs like reading, sewing or driving sooner or later can become very difficult and even impossible. The first symptom is loss of ability to see objects clearly.

“Straight lines appear to be wavy or distorted. Other signs include a dark area blocking the vision in the centre of your eyes or grey and white spots appear in the centre of your vision. Sometimes there is a loss of clear and correct colour vision and print appears washed out when reading.

There are steps you can take to prevent ARMD

• Avoid smoking

• Eat fish and green leafy vegetables

• Take dietary supplements and anti-oxidants if your doctor advises you to do so

• And, especially if there is a family history, have a regular eye examination with you optometrist.

For most ARMD there is no treatment currently available, aside from special vision aids.

Glaucoma

This can result in too much pressure from eye fluid in the eye and it's another cause of low vision, particularly in older people. This high pressure can damage the optic nerve and if the pressure persists, glaucoma will worsen your sight.

People at risk –

• Have a parent, brother or sister with glaucoma

• Are over 60 years old

• Have medical conditions: high blood pressure, diabetes, thyroid disease, or a history of migraine.

• Take steroids over a prolonged period

• Have a history of eye injury or injuries that have involved sudden blood loss

• Are myopic (short sighted) or hyperopic (long sighted).

Usually there are no symptoms except vision loss, in advanced cases, which is why it is so important people visit their optometrist for a regular check up – at least every two years.

In a few cases, glaucoma will develop rapidly with blurred vision, loss of side vision, seeing coloured halos around lights, redness of the eye, nausea or vomiting and pain in the eye,” Dr Frederikson says. This is serious and should be treated as a medical emergency.

While glaucoma can’t be prevented, it can be detected before vision loss occurs. If detected and treated early the disease can be controlled.

Diabetes

Reduced vision is one of the most distressing and difficult complications of diabetes. More than 200,000 people in New Zealand have diabetes.

Diabetes may cause damage to the eye’s light sensitive lining, the retina, and produce changes called diabetic retinopathy where the walls of the blood vessels are weakened. These tiny blood vessels at the back of the eye begin to bulge and leak, oozing blood into the eye. Cellular changes can also cause fats and fluids to leak into surrounding tissue, damaging the eye.

“As the disease progresses, you will notice rapid changes in vision. With regular examinations any threats to your sight can be detected and treated promptly, minimising the risk of permanent loss of vision.”

Low vision affects

Research shows people with low vision are negatively affected in terms of independent living, quality of life, self-ranking of health, depression, falls and fractures. They are also likely to have increased need for community and/or family support and earlier institutionalised care.

Safety issues include being able to read names and directions on medicines, reading important demands for payment such as electricity bills to avoid disconnection, reading safety instructions, and checking oven settings and temperature to avoid stove fires.

However, optometrists can prescribe low-vision aids such as magnifiers. 

Comment

We are calling for a free annual eye examination for people over 65. See our Briefing to the Minister of Health, section 3, for more information. [PDF file 0.02 MB] 

Inability to afford eye care can be debilitating, and can result in an older person becoming housebound or having to make a premature move into residential care. A state-funded annual eye examination for every senior New Zealander could go some way to preventing this kind of escalation.

Age Concern New Zealand believes that it is inexcusable that older people can be unable to access care because of low incomes.

Resources

> VISIT Diabetes New Zealand

> VISIT Glaucoma New Zealand

> VISIT New Zealand Association of Optometrists

> VISIT Retina New Zealand

> VISIT Royal New Zealand Foundation of the Blind

> VISIT the Save Our Sight campaign website