Optometrist Eileen Hanley graduated with honours from Dublin Institute of Technology in 1988. She is a Fellow of The Association of Optometrists, and one of the team at Eye Contact Opticians, Tullamore, Co Offaly. Here she shares some of their tips and advice for eye care.
– The majority of adults are entitled to a free eye examination using PRSI entitlements, or a Medical Card.
– HSE eye screening is usually carried out during the first year of primary school. However, earlier testing is advised, particularly if there is a family history of vision or ocular issues. The critical visual development period is between ages 2-7. Early detection and management prevents longterm visual damage, and maintains binocular vision – use of both eyes allowing depth perception.
– Holding near material away, or having no interest in close work tasks, may indicate long sightedness (hyperopia). Sitting close to the TV, being unable to read number plates or recognise people on the street, and being unable to read the white board at school, are all indications of myopia (short sightedness).
– Advances in myopic control are now available which can slow progression, including a new type of daily contact lens and drug therapies.
– Using hand-held devices may increase the progression of myopia.
– Holding reading material or your phone further away as you age is a sign of presbyopia, the loss of lens elasticity causing long-sightedness in middle age.
– The absence of red-eye reflex in one eye in a photograph, when present in the other eye, needs further investigation to rule out retinoblastoma, a type of eye tumour.
– In addition to visual requirements, eye examinations can detect systemic conditions, such as diabetes, cardiovascular disease, autoimmune disorders, and tumours. Certain prescription changes may indicate a fluctuation in blood sugars or the development of cataracts. Symptoms such as doubling of vision, visual field loss, intermittent vision loss, flashes, and floaters may require further medical intervention. Every day as an optometrist is different.
Eye health
– Keeping hydrated is important for eye health, and helps prevent dry eyes.
– Hay fever, allergies, and autoimmune diseases may cause tear disruption. Women can suffer more from dry eyes when oestrogen levels drop before menstruation and during menopause. Artificial tears can help.
– Avoid heat and fans directed into the eyes ( eg car air-conditioning, ovens, and simmering pots) to prevent tears evaporating.
– Foods rich in vitamins A, C and E, and zinc and lutein, can help with macular degeneration and eye health. These include green leafy vegetables, corn, egg yolks and kiwis. Flaxseed oil helps maintain the health of your tear film.
– Always wear protective eyewear during DIY and gardening, especially strimming, to prevent eye injuries.
– Wash hands after contact with animals, in particular dogs and cats, to prevent toxocariasis. This can cause serious eye infections and even be sight threatening.
– Ultra violet rays damage skin and eye health. There are strong links between exposure to UV rays and the incidence and severity of cataracts, pterygium, macular degeneration, and eyelid cancers. Sunglasses that filter out harmful UVA and UVB rays will be labelled UV 400 CE.
– Follow prescription recommendations for all eyewear. If you don’t wear your near-correction glasses as required, especially after the age of 50, you dramatically increase the risk of affecting your distance vision.
Red eye conditions
– Red eye conditions can be caused by: irritants such as dry air or exposure to excess heat (eg the sun or welding); allergic reactions; dust; colds; trauma; and infections.
– There are three types of conjunctivitis, bacterial, viral and allergic. Bacterial conjunctivitis will always have a discharge. Viral and allergic will cause a clear, weepy, runny eye. To prevent bacterial conjunctivitis spreading, ensure hands are washed thoroughly, use separate hand towels, and clean door knobs and surfaces touched by the infected individual.
– Red eye with vision impairment is usually uveitis – inflammation – or corneal ulcers, which may be caused by shingles or the cold sore virus. Other causes of red eye include acute glaucoma, corneal abrasion, scleritis/episcleritis (inflammation of the white of eye), styes, and chalazions.
– If you have red eyes with vision impairment, pain, or light sensitivity, seek immediate medical attention. To determine the cause an examination with slit lamp magnification is essential. Every optometrist has this equipment, and they can also guide you to the best place for further treatment, if required, as not all A&E departments have an attending ophthalmologist.
Screens
The average person blinks 15-20 times per minute. This reduces to 1-2 times per minute while we are on screens. It is important to blink often when using screens. Every time you tap the enter key of your keyboard or phone, blink and look away.
– The blue light emitted from digital devices can cause eye strain, reduce the levels of contrast you perceive, and disrupt sleep by depressing secretion of the hormone melatonin. Using a blue filter on devices, or an anti-glare with blue filter coating on spectacles, will minimise these effects.
Use the 20/20/20 Rule; for every 20 minutes of screen time look at something 20 feet away for 20 seconds. This enables the eye’s lens to readjust and refocus.
Home care
– Never squeeze styes and chalazions. These, and blepharitis – inflammation of the eyelash follicles – can be treated with warm compresses, by placing a cottonwool pad moistened with cooled boiled water on the eye. Dip a cotton bud into cooled boiled water to massage the lids, rolling it along where the lash meets. Bicarbonate of soda may be dissolved in the water – quarter teaspoon to quarter pint – but never use baby shampoo. This can disrupt the eye’s tear film. Warm compressing eye-masks and wipes, available in pharmacists and opticians, are convenient alternatives.
– If you get something in your eye artificial tears may flush it out. A loose eyelash on the white of the eye can be moved towards the lower lid for removal using a cotton bud dampened with cooled boiled water.
– Blowing your nose may help move a loose eyelash to the corner of the eye for removal.