Eye condition questions

I have a sore eye/My eyes have gone red/ I can’t see as well as I normally do – Should I go to the GP or the optician?

What is dry eye syndrome?

What is blepharitis?

What is conjunctivitis?

What is Glaucoma?

What is a Cataract?

What is Age -Related Macular Degeration (AMD)?

What is a posterior vitreous detachment (PVD)?

What is a detached retina?

I have a sore eye/My eyes have gone red/ I can’t see as well as I normally do – Should I go to the GP or the optician?

Your GP is unlikely to have access to the specialised equipment and training that opticians have so your first port of call for eye care should always be your optician. We will assess your eye health and treat the problem ourselves if we can or direct you the most relevant health care professional if we can’t. We have a list of phone numbers that allow us to rapidly access the eye department at the hospital in the case of an emergency. 

Please do bear in mind though, we are not set up to offer a walk-in eye casualty service. Please phone ahead to book your appointment. We do not have an optician available at every location at all times but will always make arrangement to have you seen by an optometrist as soon as is appropriate (even if it’s at a different practice). 

If we are closed and you have an eye emergency phone NHS 24 for advice on 111

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What is dry eye syndrome?

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. This leads to the eyes drying out and becoming inflamed (red and swollen) and irritated.

The symptoms of dry eye syndrome usually affect both eyes and often include:

  • feelings of dryness, grittiness or soreness that get worse throughout the day 
  • red eyes 
  • eyelids that stick together when you wake up 
  • temporarily blurred vision, which usually improves when you blink 

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 include:

  • being in a hot or windy climate 
  • wearing contact lenses 
  • certain underlying medical conditions, such as blepharitis (inflammation of the eyelids) 
  • side effects of certain medications 
  • hormonal changes in women 

Although the condition can affect people of any age, your chances of developing dry eye syndrome increase as you get older. 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 not usually a serious condition. 

R. D. McFarlane and Nicol’s opticians have a range of treatments available to help relieve the symptoms. 

As well as medical treatments, there are some things you can do yourself to help prevent dry eye syndrome or reduce the symptoms. 

These include: 

  • keeping your eyes and eyelids clean and protecting them from dusty, smoky, windy and dry environments 
  • using your computer or laptop correctly to avoid eye strain 
  • using a humidifier to moisten the air 
  • eating a healthy diet that includes omega-3 fats 

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What is blepharitis?

Blepharitis occurs when the edge of your eyelids become inflamed. It is usually caused by an infection or a skin condition.

There are two main types of blepharitis:

  • anterior blepharitis – where the inflammation affects the skin around the base of your eyelashes 
  • posterior blepharitis – where the inflammation affects your Meibomian glands (found on the inside edge of your eyelids) 

Some people experience both types of blepharitis, as the causes are often linked.

Anterior blepharitis can be caused by either a bacterial infection or a skin condition called seborrhoeic dermatitis.

Staphylococcus bacteria are most commonly associated with blepharitis. These bacteria live harmlessly on the skin of many people but, for unknown reasons, they can cause the eyelids of some people to become inflamed.

Seborrhoeic dermatitis is a skin condition that causes skin to become oily or flaky, and it can sometimes irritate the eyelids. Seborrhoeic dermatitis often causes both anterior and posterior blepharitis at the same time. 

Posterior blepharitis occurs due to a problem with the Meibomian glands, which are found on the inside edge of your eyelids.

The Meibomian glands are responsible for producing an oily substance that makes up part of your tears. A problem in these glands can lead to excess production of this oily substance or a blockage in the glands, which can cause the eyelids to become irritated and inflamed.

R.D. McFarlane and Nicol’s Opticians have a range of treatments to help manage blepharitis. Please make an appointment and your optician can discuss them with you. 

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What is conjunctivitis?

Conjunctivitis is redness and inflammation of the thin layer of tissue that covers the front of the eye (conjunctiva). It is very common. People often refer to conjunctivitis as red eye. Other symptoms of conjunctivitis include itchiness and watering of the eyes, and sometimes a sticky coating on the eyelashes (if it's caused by an allergy). Conjunctivitis can affect one eye at first, but usually affects both eyes after a few hours.

Conjunctivitis can be caused by a bacterial infection, a virus, an allergy or an irritant. If treatment is necessary, the type of treatment will depend on the cause – your optician can advise you on the best course of action. Conjunctivitis often doesn't require treatment as the symptoms usually clear up within a couple of weeks. In some cases, antibiotic eye drops or anti-histamine eye drops can be used to help clear the condition.

It's best not to wear contact lenses until the symptoms have cleared up. Any sticky or crusty coating on the eyelids or lashes can be cleansed with cotton wool and water. 

Washing your hands regularly and avoiding sharing pillows or towels will help prevent it spreading.

See your optician immediately if you have:

  • eye pain 
  • sensitivity to light (photophobia) 
  • disturbed vision 
  • intense redness in one or both of your eyes 

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What is Glaucoma?

Glaucoma is a term that describes a group of eye conditions that affect vision where raised pressure in your eye causes damage to the the optic nerve (which connects the eye to the brain) and the nerve fibres from the retina (the light-sensitive nerve tissue that lines the back of the eye). Glaucoma often affects both eyes, usually in varying degrees. 

There are four main types of glaucoma:

  • chronic open-angle glaucoma – this is the most common type of glaucoma and develops very slowly. It is often painless with no obvious symptoms until the condition is fairly advanced. 
  • primary angle-closure glaucoma – this is rare and can occur slowly (chronic) or may develop rapidly (acute) with a sudden, painful build-up of pressure in the eye 
  • secondary glaucoma – this occurs as a result of an eye injury or another eye condition, such as uveitis (inflammation of the middle layer of the eye) 
  • developmental glaucoma (congenital glaucoma) – this is rare but can be serious. It is usually present at birth or develops shortly after birth. It is caused by an abnormality of the eye

Glaucoma can be treated with eye drops, laser treatment or surgery. However, early diagnosis is important because any damage to the eyes cannot be reversed. If left untreated, glaucoma can cause visual impairment but if it is diagnosed and treated early enough, further damage to vision can be prevented.

Anyone can develop glaucoma but you are at a higher risk if you are aged over 40 and you have a direct relation (parents, siblings or children) who has glaucoma. You are also at increased risk of developing open-angle glaucoma if you are of black-African or black-Caribbean origin. 

Attending regular optician appointments will help to ensure any signs of glaucoma can be detected early and allow treatment to begin.

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What is a Cataract?

Cataracts are cloudy patches that develop in the lens of your eye and can cause blurred or misty vision. They are very common.

The lens is the transparent structure that sits just behind your pupil (the black dot in the centre of your eye). It allows light to get to the back of your eye (retina). 

In some people, cataracts develop in the lens as they get older, stopping some of the light from reaching the back of the eye. Over time, the cataracts become worse and start affecting vision. They often develop in both eyes, although each eye may be affected differently. 

You will usually have blurred, cloudy or misty vision, or you may have small spots or patches where your vision is less clear. 

Cataracts may also affect your sight in the following ways:

  • you may find it more difficult to see in dim or very bright light 
  • the glare from bright lights may be dazzling or uncomfortable to look at 
  • colours may look faded or less clear 
  • everything may have a yellow or brown tinge 
  • you may have double vision 
  • you may see a halo (a circle of light) around bright lights, such as car headlights or street lights 
  • if you wear glasses, you may find that they become less effective over time 

Cataracts are not painful and don't make your eyes red or irritated.

Although rare types of cataracts affect babies and young children (congenital cataracts), the problem is much more common in older people. 

As well as your age, several other factors may increase your risk of developing cataracts, including:

  • a history of cataracts in your family 
  • smoking 
  • regularly drinking excessive amounts of alcohol 
  • a poor diet lacking in vitamins 
  • lifelong exposure of your eyes to sunlight 
  • taking corticosteroid medication at a high dose or for a long time 
  • previous eye surgery or injury 
  • certain health conditions, such as diabetes or long-term uveitis (inflammation of the middle layer of the eye) 

If your cataracts are mild, stronger glasses and brighter reading lights may be helpful for some time. However, cataracts get worse over time so it's likely you will eventually need surgery to remove them. There is a belief that your cataracts need to be “ripe enough” to remove – this is not exactly true. We usually recommend you have your cataracts removed when you are having difficulty seeing an every task and your optician cannot improve your sight with glasses. 

Cataract surgery involves removing the cloudy lens through a small incision (cut) in your eye and replacing it with a clear plastic one. In most cases, this will be carried out under local anaesthetic (where you are awake, but the eye is numbed) and you can usually go home the same day.

After the operation, your plastic lens will be set up for a certain level of vision, so you may need to wear glasses in order to see objects that are either far away or close to you. If you wore glasses previously, your prescription will probably change. However, your optometrist will need to wait until your vision has settled before they can give you a new prescription, this usually takes between 4 and 6 weeks.

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What is Age -Related Macular Degeration (AMD)?

Age-related macular degeneration (AMD) is a painless eye condition that generally leads to the gradual loss of central vision but can sometimes cause a rapid reduction in vision. 

In AMD, your central vision becomes increasingly blurred, leading to symptoms such as:

  • difficulty reading because the text appears blurry 
  • colours appearing less vibrant 
  • difficulty recognising people's faces 

AMD usually affects both eyes, but the speed at which it progresses can vary from eye to eye.

AMD does not affect the peripheral vision (outer vision), which means it will not cause complete blindness. 

If you notice that your vision is getting gradually worse, you should see your make an appointment to see your optician.

If your vision suddenly gets worse, images are distorted or you notice blind spots in your field of vision you should make an appointment to see your optician as soon as possible. We will then assess your vision as we can arrange for you to be seen at the rapid access macular degeration clinic at the hospital if required. 

There are two main types of AMD, called 'dry AMD' and 'wet AMD'.

Dry AMD develops when the cells of the macula become damaged as a result of a build-up of waste products called drusen. It is the most common and least serious type of AMD, accounting for around nine out of 10 cases. The loss of vision is gradual, occurring over many years. However, an estimated one in 10 people with dry AMD will then go on to develop wet AMD.

Wet AMD develops when abnormal blood vessels form underneath the macula and damage its cells. Wet AMD is more serious and without treatment, vision can deteriorate within days.

AMD is the leading cause of visual impairment in the UK, affecting up to 500,000 people to some degree. AMD tends to be more common in women than men. It is also more common in white people and people of Chinese ethnicity than people from other ethnic groups.

As would be expected by its name, age is one of the most important risk factors for AMD. The condition is most common in people over 50 and it's estimated that one in every 10 people over 65 have some degree of AMD.

However, you may be able to reduce your risk of developing AMD, or help prevent it getting worse, by:

  • stopping smoking if you smoke 
  • eating a healthy diet high with plenty of fruit and vegetables 
  • moderating your consumption of alcohol 
  • trying to achieve or maintain a healthy weight 
  • wearing UV-absorbing glasses when outside for long periods 

 

There is currently no cure for either type of AMD.

With dry AMD, treatment is mostly based on helping a person make the most of their remaining vision, such as using magnifying lenses to help make reading easier.

There is also some evidence to suggest that a diet rich in green leafy vegetables may slow the progression of dry AMD. Nutritional supplements are also available. 

Wet AMD can be treated with a type of medication called anti-VEGF medication, which aims to stop your vision getting worse by helping prevent further blood vessels developing. Early diagnosis and treatment of wet AMD is essential in reducing the risk of severe loss of vision.

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What is a posterior vitreous detachment (PVD)?

Posterior vitreous detachment (PVD) is a change in your eye which does not normally cause sight loss. It is very common and most of us will develop it at some point in our lives. Although it can cause some frustrating symptoms, it does not cause pain, harm the eye, or change the way the eye works. In the vast majority of cases, PVD will not lead to long term changes in your vision.

The eye is filled with a clear jelly-like substance called the vitreous gel. Light passes through the vitreous gel to focus on the retina. When the vitreous jelly comes away from the retina this is called a vitreous detachment.

As you get older the various structures that make up your eye change; this includes the vitreous gel. The vitreous is made up mainly of water and collagen and it has a stiff, jelly-like consistency. As you age the vitreous becomes more watery, less jelly-like and isn't able to keep its usual shape. As a result, it begins to move away from the retina at the back of the eye towards the centre of the eye.

A PVD is a natural change that occurs in the eye. Over 75% of people aged over 65 develop a PVD, and it is not uncommon for it to develop in someone's 40s or 50s. PVD is not a sign of a disease or eye health problem. For most of us a PVD happens naturally as we get older.

PVD can cause symptoms such as floaters, little flashes of light, or a cobweb effect across your vision. Some people get all three symptoms and others may only get one or two. Some people get a lot of each of these symptoms and others hardly any. Importantly, these same symptoms can be an indication of a more serious problem, such as a retinal tear or retinal detachment, which needs urgent attention.

You will not be able to tell the difference between floaters and flashes caused by PVD or retinal detachment. The only way you can tell is to have your eyes examined by an ophthalmologist or optometrist. If you suddenly experience any of the following symptoms, make sure you have your eyes examined as soon as possible - preferably on the same day or within 24 hours:

  • A sudden appearance of floaters or an increase in their size and number.
  • Flashes of light and/or a change/increase in the flashing lights you experience.
  • Blurring of vision.
  • A dark "curtain" moving up, down or across your vision, as this may mean that the retina has already partially detached.

It is important to remember that in most cases these symptoms are caused by vitreous detachment and this rarely causes any long-term problems with your vision. However, because there is a small risk that these symptoms may be a sign of a retinal tear or retinal detachment it is always best to have your eyes examined.

You may find the symptoms of your PVD only last for a few weeks, but more commonly they last around six months, with the floaters and flashes of light gradually calming down over this period. For some people the floaters caused by the PVD can last for up to a year, or longer, although this is more unusual. 

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What is a detached retina?

Retinal detachment occurs when the thin lining at the back of your eye called the retina begins to pull away from the blood vessels that supply it with oxygen and nutrients.

Without prompt treatment, it will lead to blindness in the affected eye. 

Most people will experience warning signs that indicate their retina is at risk of detaching before they lose their sight. These are:

  • the sudden appearance of floaters – dark spots that float in your field of vision 
  • sudden short flashes of light in one eye 
  • a solid black shape or “curtain” coming over the vision in your eye

Contact your optician immediately if you get any of these warning signs. 

Retinal detachment is most often the result of the retina becoming thinner and more brittle with age and pulling away from the underlying blood vessels. It can also be caused by a direct injury to the eye, but this is less common.

If your optician suspects a diagnosis of retinal detachment, it is likely you will be referred to the eye department at the hospital, usually on the same day. We have rapid access phone numbers that allow us to arrange this quickly. 

The quicker retinal detachment is treated, the less risk there is of permanently losing some or all of your vision in the affected eye. Most detached retinas can be successfully reattached with surgery. There are a number of different types of surgery available, depending on the individual.

It can take months to fully recover from surgery on your eye. During this period your vision may be reduced, which means you may not be able to do some of your usual activities, such as driving or flying.

Unfortunately, some people's eyesight does not fully return after surgery and they have permanently reduced peripheral (side) or central vision. This can happen even if the retina is reattached successfully. The risk of this is higher the longer the detachment was left untreated.

Retinal detachment is a rare condition. Only one in every 10,000 people will develop a new case of retinal detachment in any given year in the UK. As retinal detachment is associated with ageing, most cases affect older adults aged between 50 and 75. Retinal detachment caused by an injury can affect people of any age, including children.

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