Look out for your family

LocalEyes is Scarborough’s independent family optician

We’ve been taking care of the eyesight and eye health of Scarborough’s children, busy parents and grandparents since 1935. Here, we answer some common age related questions and let you know what to look out for and how to protect your loved ones.

Let’s start with the youngest and wonder, when should a child have their first eye test?

Of course we don’t put very young children through a standard eye test, but it is reassuring to do a screening examination where we can diagnose short or long sightedness in children as young as 1 year old. Knowing about a problem is the first step to doing something about it as uncorrected refractive error at this age can cause a “lazy eye” which may become untreatable if undiscovered.

Study and close-work

As children grow and learn, they often spend longer looking at screens than the older generation did. If close work is not balanced with outdoor, distance vision, there is an increased chance of short-sightedness developing. Researchers are concerned that this may turn into an epidemic of short sightedness due to our over-reliance on close screen viewing.

Short sightedness progresses, so if someone starts at a -2, maybe that will progress to a -8 when they are older (this is a measure of the strength of lens required to fix the short-sightedness, with 0 meaning no correction required). The science is telling us that if we can hold back short-sightedness (myopia) in the early years, in this case let’s imagine we can hold it back to a -1, then in later years they may only develop to a -4 myope.

This is a much bigger problem than just blurred vision. The retina at the back of the eye sits on the vascular choroid and it’s all contained inside the white layer of sclera (what we would think of as the ‘eyeball’). As the eye lengthens, as it does in short-sightedness, these layers have different levels of stretchiness and so stresses occur between the layers. This can lead to retinal tears and detachments and, sometimes, nerves and optical cells can get separated from their blood supply and may die off. This may lead to unusual visual distortions where, for instance, straight lines don’t appear straight (myopic macular degeneration).

Optical problems may be happening secretly if they happen to occur in peripheral vision.

The good news is there’s been a breakthrough in the treatment of short sightedness. For children suitably diagnosed, a new type of contact lens has been shown significantly to reduce the progression of short sightedness. It’s a bit like what braces do for teeth. A child so corrected would require less strong glasses and have a much lower chance of retinal tears later in life.

Bedtime active

Another problem with screens is the blue light many of them radiate. Our eyes provide feedback to our brain about what time of day it is, and the blue light from screens keeps telling our brain it’s daytime. The normal slowdown towards sleep doesn’t happen as it should if we’re staring at a screen and so when it’s finally time for lights off, it’s harder for us to drop off. This may be happening to you and your children, and we know that good sleep is essential for health.

One answer is a lens coating called BlueControl which filters out that wake-up message from your screens so you can work, study or play late and still get off to sleep. Even if you don’t need glasses for sight correction, it’s worth considering BlueControl lenses for night-time screen use to improve your sleep hygiene.

Common sight problems in older people

The most common age-related sight problem is presbyopia, where the lens in the eye becomes more rigid. That makes it harder for the muscles around it to change its shape in order to focus close up for you, and all that pushing and pulling leads to eye strain and eventually the need for glasses for comfort and focus. It’s perfectly commonplace and affects most of us around the mid forties. You know it’s happening when you want to hold your phone, menu or book at arms length. It would be unusual if it didn’t affect you.

Problems with eye lubrication are also more commonplace in older age. The moisture on the surface of the eye comprises salt water from tear ducts topped by an oil layer from glands in our eyelids which helps to prevent evaporation. If there is insufficient of either it can lead to red-eye, infections and irritable, watering eyes.

More seriously, age related macular degeneration (ARMD) is as the name suggests age related. The macula is the part of the eye that handles what you are looking at directly. It’s the hardest working part of your body and without it you can’t do really important things such as read or drive. The hard work the macula does needs to be supported by an efficient system for supplying oxygen and removing waste products. There’s also a yellow pigment layer that protects it against UV radiation. If the protective yellow pigment becomes too thin damaging free radicals, given off from the high oxygen metabolism needed for sight, can hang around leading eventually to damage to this most important part of vision. As we are living longer, this part of our eye needs more care and attention to ensure it lasts the distance.

Before loss of detailed vision, one of the earliest signs of ARMD is the presence of waxy lumps called drusen that are visible to an optician during an eye exam. These are an early warning that the macula is under stress and it allows us to give early advice to try to get things back on track. This advice, we are sorry to tell you, can include eating more kale. But we have dietary supplements if you prefer.

From the eye test which was excellent as usual, to trying on lots of glasses with lots of help from Maria, to purchasing glasses, was extremely professional in every aspect. I would have no hesitation in recommending LocalEyes to friends and family. Thank you to all concerned.

Ann L