Compulsory eye tests every 10 years are needed for drivers

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Drivers should have compulsory eye tests every 10 years, the Association of Optometrists has said.

One in three optometrists say they have seen patients in the last month who continue to drive with vision below the legal standard, their association said.

Motorists must read a number plate from 20m (65ft) in the practical driving test, but there is no follow-up check.

The Department for Transport said changes to eyesight should be reported by motorists to the DVLA.

“All drivers are required by law to make sure their eyesight is good enough to drive,” a spokeswoman said.

Data from the Department for Transport shows seven people were killed and 63 were seriously injured in accidents on Britain’s roads last year when “uncorrected, defective eyesight” was a contributory factor.

‘Outdated laws’

Nine out of 10 optometrists believed the existing rule – that put the onus on motorists to report themselves to the DVLA if they develop eyesight problems – is insufficient.

When drivers pass the age of 70, the emphasis changes a little. Drivers must actively make a declaration every three years that they are fit to drive. As part of that they must confirm that they meet the minimum eyesight requirement.

Brenda Gutberlet, whose 28-year-old niece Natalie Wade was killed in 2006 by a 78-year-old driver who was blind in one eye, says she wants the “outdated laws on drivers’ medical fitness” changed.

Ms Gutberlet, from Canvey Island, Essex, said her niece died just months before her wedding and that she does not want other families “to go through what we have”.

Optometrist Dr Julie Anne-Little said Britain “falls behind many other countries” because of the initial number plate test and the self-reporting of eyesight problems.

“Because sight changes can be gradual, often people won’t realise that their vision has deteriorated over time,” she said.

Ageing eyes

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Good eyesight plays a pivotal role in your wellbeing and is a significant factor in safety, retaining independence, and maintaining a good quality of life as we get older. Unfortunately, people often ignore early signs of vision problems, hoping their eyesight will miraculously clear up, which rarely happens. When you are young, it’s easy to take your eyes for granted but being aware of eye conditions is important. Early diagnosis of eye problems, followed by professional treatment, can either help preserve or improve your vision.

Optometrist or ophthalmologist – which one is right for you?

An optometrist is an eye doctor who examines eyes for both vision and eye health problems, and corrects refractive errors by prescribing glasses or contact lenses. They can also prescribe medications to treat certain eye problems and diseases.

An ophthalmologist is a medical doctor who specialises in eye and vision care. Ophthalmologists are trained to perform eye exams, diagnose and treat disease, prescribe medications and perform eye surgery. They also write prescriptions for glasses.

If your eyes are healthy and don’t require specialised medical or surgical treatment, the type of eye doctor you choose for a routine eye exam is a matter of personal preference. However, if you already have a medical eye problem — such as glaucoma, macular degeneration or cataracts — it is important to seek care from an eye doctor who is highly trained and skilled in monitoring and treating your condition. In many cases, this may mean that medical or surgical eye care by a specially trained ophthalmologist is required. In such cases, your optometrist may refer you to an ophthalmologist who is a specialist in treating your condition.

Get tested regularly
Regular eye examinations by an eye care professional are important. Most eye care experts recommend that you have a comprehensive eye exam every one to two years, depending on your age, risk factors and whether you currently wear corrective lenses. Eye and vision examinations are an important part of preventive healthcare as many eye problems have no obvious signs or symptoms.

Early diagnosis and treatment of eye and vision problems can help prevent vision loss. If you are at risk for eye problems, such as diabetes, high blood pressure or a family history of eye disease, you may need more frequent exams.

Six of the most commonly diagnosed eye conditions include:

1. Cataracts
Cataracts are caused by proteins clumping together through the aging process, which cause the lens to turn from clear to cloudy over time. A cataract starts out small and, at first, has little effect on your vision, but eventually clouds the lens and makes seeing nearly impossible. Cataracts will not go away on their own but will continually worsen. Everyone is at risk, and the only treatment option is surgery. Cataracts are the most common cause of vision loss in people over age 40, and are the leading cause of blindness in the world. In fact, there are more cases of cataracts worldwide than there are of glaucoma, macular degeneration and diabetic retinopathy combined, according to Prevent Blindness America (PBA).

2. Refractive Errors
When light passes through the cornea and the lens, it is bent – or refracted – to form the images we see. If that refraction is skewed, vision suffers. The most common reasons people wear glasses or contacts, including near-sightedness, far-sightedness and astigmatism, are caused by refractive errors.

·   Far-sightedness, also known as hyperopia, is a condition where you can easily see things far away, but your close-up vision is blurry.

·    Near-sightedness, or myopia, means you are able to see close-up objects, while faraway objects look blurry.

·    Astigmatism is a common eye condition that is caused by an error in the shape of the cornea which causes distorted, fuzzy, or blurry vision.

·    Presbyopia, a condition that causes your eye to slowly lose the ability to focus on close-up objects, is also a refractive error that is a natural part of the aging process.

3. Diabetic Retinopathy
Retinopathy is the most common diabetic eye disease. It occurs when high blood sugar levels damage blood vessels in the retina (light-sensitive layer at the back of the eye), causing swelling and scar tissue, which may lead to the retina detaching and subsequent severe, irreversible vision loss. People with diabetes should have annual eye exams including retinopathy screenings.

4. Macular degeneration
The macular is the part of the retina that allows you to see fine details. It can degenerate with age, causing everything from hazy vision to complete loss of central vision. Little can be done to improve vision once someone has age-related macular degeneration, but catching it early can slow its progress.

5. Glaucoma
Glaucoma is an eye disease that damages the optic nerve, which is the nerve responsible for sending light images from the retina to the brain. In most cases, the condition develops when too much pressure builds up inside the eye. This disease can lead to serious vision loss or blindness and rarely shows symptoms in the early stages. By the time you notice any symptoms – usually blind spots in peripheral vision – optic nerve damage is severe. This makes regular eye examinations by an eye care professional important.

6. Dry Eyes
This occurs when your eyes do not produce enough tears to keep your eyes moist. The prevalence of dry eye syndrome increases with age. Some medications and medical conditions can cause dry eyes, as can working long hours in front of a computer or in a dry environment. Symptoms may include blurred vision, contact lens discomfort, excessive tearing, eye fatigue and irritation, feeling like something is in the eye, itching, redness, and light sensitivity.

 

 

 

Manchester Royal Eye Hospital administers its first gene therapy treatment

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Manchester Royal Eye Hospital (MREH) achieves a historical milestone, as it delivers gene therapy at this hospital for the first time. MREH is participating in a gene therapy clinical trial, in collaboration with Saint Mary’s Hospital, for patients with a rare genetic eye condition, x-linked retinitis pigmentosa (XLRP).

XLRP, for which there is currently no effective treatment, is one of the most common causes of blindness in young people.

XLRP is an inherited condition that eventually leads to blindness in adult men, most often by the end of their fourth decade. It affects the retina’s ability to respond to light, a result of abnormalities in the photoreceptors in the back of the eye.

In more than two-thirds of cases, the disease is caused by a mutation to the retinitis pigmentosa GTPase regulator (RPGR) gene. Common early symptoms include difficulty seeing at night in young males and a progressive loss in the visual field and clarity of vision as they age.

The gene therapy approach being used aims to introduce functional copies of the faulty RPGR gene into the cells of the retina. The purpose of the study is to evaluate the safety and efficacy of the treatment of XLRP in patients with the RPGR mutation.  In Manchester, the study is being conducted through a collaboration between MREH, Saint Mary’s Hospital and the NIHR Manchester Clinical Research Facility, a specialist facility for early phase clinical research.

The study is sponsored by NightstaRx Limited (Nightstar), a biopharmaceutical company based in London. Manchester was one of the sites chosen to conduct the study due to MREH’s world-leading expertise in ophthalmology and Saint Mary’s Hospital’s expertise in genetics.

The surgeon leading the trial in Manchester is Professor Paulo Stanga at MREH, University of Manchester and Manchester Vision Regeneration (MVR) Lab at NIHR Manchester Clinical Research Facility.  Professor Stanga said:

“Our ambition is to be able to offer our patients appropriate treatment across the whole spectrum of this disease.  This latest study is an opportunity for us to try and stabilise disease progression for those with an early stage of a specific type of retinitis pigmentosa, known as X-linked.”

Professor Graeme Black, Consultant in Genetics and Ophthalmology, University of Manchester/Central Manchester University Hospitals NHS Foundation Trust adds:

Dave Fellows, Chief Executive Officer of Nightstar commented: “This study highlights our commitment to helping patients with the devastating consequences of inherited retinal diseases such as X-linked retinitis pigmentosa. We aim to leverage our existing relationships with ophthalmology centres of excellence, such as Manchester, to conduct multicentre clinical trials. Our goal is to be the leader in ocular gene therapy.”

Sun damage to the eyes

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Many of us know our skin needs protection from UV damage. However, our eyes are up to ten times more sensitive to UV damage than our skin and yet they are often neglected when it comes to protecting them, in fact 50% of people don’t protect themselves by wearing sunglasses.

Accumulated ultraviolet (UV) damage can cause eye diseases such as pterygium — a reddish eye growth that is mostly harmless, but can affect vision — eyelid tumours and cataracts.

Cataract is a cloudy eye growth more commonly seen in the elderly, but may also develop earlier in life or progress more rapidly in people who spend a lot of time outdoors without adequate UV protection.

If untreated, cataracts may lead to blindness. Pterygium, which presents as a benign wing-shaped lesion, usually occurs on the inner corner of the eye. But doctors are also seeing a number of double-headed pterygium cases, where the lesions appear on both the inner and outer corners of the eye, due to accumulated damage from high UV exposure.

A common early sign of UV damage to the eye is chronic or worsening eye dryness. Other symptoms include eye pain and tearing after a day out in the sun.

The danger is that early signs of UV-related eye damage are often unnoticeable and can only be detected during a comprehensive eye examination by an eye healthcare professional.

The easiest way to protect the eyes from UV damage is to choose the right eyewear and sunglasses, not all sunglasses are made equal.

Do children need sunglasses?

Up to 80% of the eye’s lifetime exposure to UV light is reached before the age of 18, which makes UV protection particularly important in childhood. Because children’s eyes have larger pupils and clearer lenses, they are more susceptible to sun damage. Plus, despite children generally spending more time outdoors than adults, 70% of them still don’t wear sunglasses in the UK.

Do Lenses with a darker tint give more protection?

Lenses with darker tints do not necessarily offer more protection. Lenses can appear colourless and yet provide 100 per cent UV protection. However, dark lenses which do not offer a sufficient level of UV protection can actually be more damaging because they cause the eye’s pupils to dilate (get bigger) and let in more harmful light.

Is Sun damage to the eyes is temporary?

Some sun damage is temporary, like some cases of snow blindness. But most damage develops over time, due to the cumulative effect of UV exposure, and eventually becomes irreversible. Clear parts of the eye, like the lenses, absorb UV light and gradually yellow, leading to cataracts. Sun damage also contributes to age-related macular degeneration.

Do I only need sunglasses when the sun is out?

Your eyes need protection from the sun all year round, even on cloudy days. Cloud cover only reduces the amount of UV light by 10%. In the evenings and mornings we also get more light from reflective surfaces like roads. Because UV is found in the invisible part of the light spectrum, we can’t see it or feel it. Plus, depletion to the ozone layer means it acts as less of a barrier, making UV protection even more important.

Can certain medical problems increase my risk for damage from UV rays?

Yes. People with cataracts (and those who have had cataract surgery), macular degeneration or retinal dystrophies should be extra careful.

Do all sunglasses offer the same UV protection?

The level of UV protection provided by sunglasses can vary. When choosing eyewear and sunglasses, consider the following:

• Ensure adequate UV protection to block harmful rays

Look for a label that says “UV400” when buying sunglasses or spectacles. This means they block light rays with wavelengths up to 400 nanometres, which protects against 100% of both UVA and UVB rays.

The shape and size matter

Your sunglasses should be well-fitted, cover your eyes and sit close to the face. For example, wraparound frames would provide better protection against harmful UV rays than round framed sunglasses that sit further away from the face. Due to differences in facial structures, the frame should also be adjusted for a comfortable fit to provide adequate coverage.

• Replace scratched sunglasses

Scratches on UV-coated lens can affect how well harmful UV rays are filtered.

Regular eye tests can save your sight

 

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Fifteen percent of Britons risk losing their eyesight by not having regular eye tests, according to new research commissioned by Optegra Eye Health Care.

The Vision of Britain report found people were leaving their eye problems too long before treatment, leaving 9.8m living in fear of losing their sight.

The study of 2,000 people also revealed 50% of first time patients needed vision correction and one in 10 required glasses or treatment, despite thinking their eyesight was fine.

Nearly a quarter of respondents shied away from eye tests in fear of having to wear glasses and one in four mistakenly believed wearing glasses would make their eyesight worse. Despite shunning regular eye exams, the report showed 82% of British adults desired 6/6 perfect vision, with 60% admitting they valued their eyesight above any other sense.

Dr Clare O’Donnell, OO and head of Optegra Eye Sciences said: ‘Without regular eye examinations, problems are being left undiagnosed and untreated which can lead to serious vision damage.

‘It is vital for everyone to have regular eye checks, even if they suspect nothing is wrong with their eye sight. By giving up just 20-30 minutes of your time once every two years, you can potentially save your vision.’

In response to the study, Optegra has produced a 20-page report containing advice on day to day eye care, from identifying vision problems in children and myth-busting. www.optegra.com/visionofbritain

Study shows new test may spot glaucoma before symptoms begin

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It might be possible to treat the main cause of permanent blindness before people notice any loss of vision, say University College London researchers, who have developed a new kind of eye exam that might spot glaucoma a decade before symptoms appear.

Glaucoma affects 60 million people around the world and most have lost a third of their vision by the time they are diagnosed.

The disease is usually caused by changes to the pressure inside the eye that kills the retina’s nerve cells.  As these cells become stressed and sickly, they start to change their chemistry and more fatty structures move to the outside of the cell.

The test uses a fluorescent dye that sticks to those cells in the retina that are about to die. Then all an optician has to do is look at the back of the eye and if the retina is illuminated in white fluorescent dots then the patient has a problem.

But it has been tested on just 16 people in safety trials and far more research is needed, the study says.

In Phase I clinical trials – the earliest form of trial designed to check new treatments are safe – the technique could spot the difference between they eyes of healthy patients and those with glaucoma.

Prof Francesca Cordeiro, from the UCL Institute of Ophthalmology, said “We are possibly talking five to 10 years before it would normally be identified.”

Current treatments to control the eye’s internal pressure can stop or slow down the progression of the disease, although they cannot reverse the damage already done.

Prof Philip Bloom, from the Western Eye Hospital in London, added: “Treatment is much more successful when it is begun in early stages of the disease, when sight loss is minimal.”

UCL’s study, published in the journal Brain, says more research is “clearly needed”.

Bethan Hughes, from the Wellcome Trust, which funded the research, said: “This innovation has the potential to transform lives for those who suffer loss of sight through glaucoma, and offers hope of a breakthrough in early diagnosis of other neurodegenerative diseases.

An eye exam would be a cheap way of monitoring the progression of diseases like dementia, Parkinson’s or multiple sclerosis than a brain scan. “Loss of sight as you age is an incredibly difficult disability, impacting quality of life and independence.”

Optometrist of the year Finalist

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Congratulations to one of our optometrists, Nick Wingate, for becoming a finalist in the Optician Awards Optometrist of the year category.

Nick joined The Outside Clinic as an Optometrist in 1998.  Due to his evident passion for patient care and desire to progress company services, he became Head of Professional Services a year later.

Under his supervision, the clinical team has grown from 6 to over 100, with more than 100,000 patients nationally, having access to The Outside Clinic services each year.

The Outside Clinic is a leading, nationwide provider of domiciliary eye care. Providing the best patient-centric/focussed care has been key to The Outside Clinic’s growth and sector reputation, a position that Nick has been instrumental in enabling and maintaining.

During the last 18 years, Nick has played a pivotal role in evolving The Outside Clinic and its processes, procedures and protocols. This has resulted in a higher standard of clinical effectiveness and support to patients and staff alike. For the patients, this means they always have a point of contact, support and guidance at The Outside Clinic. These advancements have ensured that patients receive the best service possible in their own home.

He spent time on the Optical Confederation Education Committee and the Domiciliary Eye care Committee, helping to create guidelines to improve the quality of UK Domiciliary services, with the code of conduct he helped devise now widely adopted by the NHS.

Nick’s continued commitment to excellence has meant that investment in the latest portable equipment now gives domiciliary patients a service comparable to a high-street provider.

These investments include not only portable fundus cameras but also portable slit lamps and binocular indirect ophthalmoscopes. Internally, Nick has spearheaded the design and implementation of a secure, bespoke digital record keeping system, created specifically for the domiciliary environment.

This system allows for near instant information sharing with head office, augmenting the patient and staff support network, providing field staff with the assurance of a second opinion in the event that one is required. Digital records also help minimise errors from omitted data and illegible handwriting making the probity process easier for NHS area team representatives as well as The Outside Clinic’s own record audit process.

Nick recognised early on that domiciliary eye care was an under-provisioned service, with room for growth to provide essential services to housebound and vulnerable patients who are unable to visit a traditional high street practice.

This foresight has led the way for a significant increase in sight loss prevention for patients who would not have the means for ongoing eye health care without a domiciliary provider.

Constantly forward thinking, Nick maintains the mentality of ‘what else can we do to progress patient care?’

Nick’s passion for patient care has been imperative in the The Outside Clinic’s involvement in the community services pathways. A domiciliary provision of these services has helped improve housebound patient’s choice which in turn has assisted in avoiding anxiety and reduces the need to make avoidable, often arduous journeys to hospital eye clinics.

To further enhance patient care and sight loss prevention methods, Nick has provided invaluable contributions to researching new, pioneering treatments, through partnering in various clinical research projects such as:

Noctura – The introduction of the light therapy treatment, Noctura 400 (appendix) a drug-free, non-invasive mask for DBR/macula oedema.

The Provide Project 2014 – This College of Optometry study investigated the prevalence of visual impairment using eye examination data and qualitative data on attitudes and experiences of the research optometrists, individuals with dementia and their carers.

SENSE – COG – A multinational/ Multicentred Study of Visual and Audiological effects of dementia, with the University of Manchester.

ELI Lilly XET Study – with the Avon & Wiltshire Mental Health Partnership NHS Trust. Nick is carrying out the optical testing as part of the clinical trials into Alzheimer’s medication and ocular side effects.

Nick still regularly conducts home visits as he is still passionate about patient interaction. We receive lots of patient feedback surveys and letters complimenting Nick on his level of patient care, service and the dignity and compassion he shows when visiting his patients.

These visits also allow him to ensure The Outside Clinic processes are effective and that we are doing everything possible to maximise patient care.

Over the years, Nick’s contribution to The Outside Clinic and the optical profession as a whole has been invaluable. Through continued learning, research and growth of community eye care, there is no doubt new milestones will be achieved under his supervision that will go a long way to understanding and address the future growing demands on optical care requirements for an ever- ageing population.

The Optician Awards take place on 1st April 2017 and we wish Nick the very best of luck in for the Optometrist of the year award 2017.

Shop bought spectacles are preferred to those bought online

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Study comparing over 300 pairs of spectacles found participants prefer shop bought specs over those bought online

A study commissioned by The College of Optometrists found that, when comparing spectacles bought online and those bought and fitted in optometric practices, customers preferred shop bought spectacles.

The study, published in the leading American journal Optometry and Vision Science, found that customers preferred shop-bought spectacles fitted by practice staff, ranking them higher overall than those bought online. Researchers from the University of Bradford and Cardiff University compared 154 spectacles bought online with 155 spectacles from UK optometric practices.  Participants completed a questionnaire on vision, comfort, fit, and how acceptable and safe the spectacles felt and all participants and spectacles were assessed at the University of Bradford eye clinic for clarity of vision, ocular muscle balance and fit and quality of the spectacle frames and lenses.

Mike Bowen, Director of Research for the College of Optometrists, said: “This study is important, not just because it’s the first of its kind, but also because of the rise in online purchasing. It’s important that optometrists explain to patients that someone trained in dispensing, can guide on the shape, fit and appropriateness of a certain pair of spectacles over another, which is particularly important for the elderly. As a sector, we need to prepare for the changing ways in which customers are shopping and ensure that consumers are getting a high quality service from whatever platform they choose to purchase.”

For consumers who cannot get to the high street to choose and buy spectacles, The Outside Clinic offer a free home visiting service where they will test your eyes in your own home and bring a wide selection of frames for you to choose from.

Google’s AI Reads Retinas to Prevent Blindness in Diabetics

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Google researchers have worked with doctors to develop an AI that can automatically identify diabetic retinopathy, a leading cause blindness among adults. Using deep learning—the same breed of AI that identifies faces, animals, and objects in pictures uploaded to Google’s online services—the system detects the condition by examining retinal photos. In a recent study, it succeeded at about the same rate as human opthamologists, according to a paper published today in the Journal of the American Medical Association.

But the idea behind this AI isn’t to replace doctors. Blindness is often preventable if diabetic retinopathy is caught early. The hope is that the technology can screen far more people for the condition than doctors could on their own, particularly in countries where healthcare is limited, says Peng. The project began, she says, when a Google researcher realized that doctors in his native India were struggling to screen all the locals that needed to be screened.

In many places, doctors are already using photos to diagnose the condition without seeing patients in person. “This is a well validated technology that can bring screening services to remote locations where diabetic retinal eye screening is less available,” says David McColloch, a clinical professor of medicine at the University of Washington who specializes in diabetes. That could provide a convenient on-ramp for an AI that automates the process.

World Keratoconus Day

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November 10 is the first World Keratoconus Day,  a national awareness day sponsored by the National Keratoconus Foundation. This day is dedicated to help raise awareness about keratoconus (KC), as well as educate and advocate for those living with KC.

We aim to do this by:

  • Encouraging people around the world to share their KC stories
  • Educating patients, friends and family about keratoconus
  • Collaborating with fellow KC organizations

Keratoconus, often abbreviated to “KC”, is a non-inflammatory eye condition in which the normally round dome-shaped cornea progressively thins causing a cone-like bulge to develop. This results in significant visual impairment.