Keep An Eye

Apr 02 2024.

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Getting your eyes tested regularly is vital even if your vision seems to be fine. Such tests allow a specialist doctor to monitor your eyes for vision problems and signs of disease. We had a chat with Dr Amila De Alwis, Consultant Eye Surgeon, President, College of Ophthalmologists of Sri Lanka regarding issues pertaining to the eyes. 

Q WHY ARE THE EYES IMPORTANT? About 80 per cent of our information from what is around us or from our environment, be it to work, in school or to be safe in a workplace comes from our eyes.

Q HOW OFTEN MUST CHILDREN CHECK THEIR EYES AND WHAT ARE SOME OF THE KIDS' DISEASES IN THE EYES? Children’s eyes are different to adult eyes as they are in the process of developing vision and they need clear vision to ensure that their visual development is complete. So it’s very important that their eyes are checked regularly – at birth, six months, three years, five years and every two years when they are in school and if they detect something wrong, whether it is a focusing issue or a squint,  they can treat them early and get the vision back on track. If we don’t diagnose and treat some of these issues early there are cases we cannot get the vision improved or back on track. Very premature children need to get their eyes checked regularly. The other areas are to check for glasses, squints and some bad allergies.

Children’s eyes can also develop eye pressure or glaucoma,  and in a small percentage, there is also a condition called retinoblastoma. This is present in about 20 or 25 children a year in  Sri Lanka where you get a tumour in the eyes or the centre of your eye is white. Or it could be a childhood cataract. In such cases, the eyes must be checked immediately. 

Other warning signs that a child could be having issues with the eyes are that they are having a squint or having trouble seeing things at a distance with one eye or both eyes together. If they get frequent headaches or if they are rubbing their eyes a lot etc they should see a doctor.  

Q WHAT ARE SOME OF THE COMMON CAUSES OF LOSS OF VISION? Adult-wise the most common cause of reversible or preventable blindness is cataracts, where the lens in the eyes becomes less transparent and cloudy. This is most commonly seen around the age group of 60-65 or 70 years age group onwards or occasionally seen at a younger age. As mentioned sometimes earlier during childhood as well. It’s a very common cause of blindness and decreased vision. It’s a very straightforward operation where the cloudy cataract is replaced with an artificial lens and where the eyesight improves and this is something that we recommend should be done. In adults, glaucoma or where the pressure is higher than the eye can tolerate causes irreversible damage to the optic nerve, the nerve that takes our vision from the eye to the brain. If not detected and treated, it will lead to total blindness. 

Generally, we want to test for glaucoma at a young age. So at around the age of 40 when you go to get your eyes checked it is good to get that screened as well. If it is diagnosed, with a consultation, a clinical examination and possibly a few other tests, a simple method of using eye drops may be given.  If still not controlled, they may use a surgical option to bring the pressure down where the glaucoma does not progress. This is something we need to increase awareness among the public, that there is a condition and that they need to get it checked. Because with the most common types of glaucoma, you don’t realise that there is something wrong and that there is a gradual reduction in the peripheral vision unless it's screened and looked for.  

Q WHAT ARE SOME OF THE HEALTH ISSUES THAT AFFECT THE EYES? Another huge problem we are encountering is that with an increase in the prevalence of diabetes-related diabetic eye changes or what you call diabetic retinopathy is becoming very common. We recommend that the doctors treating diabetes should also advise their patients to get their eyes checked at the time of diagnosis of diabetes in most cases, and then every year after that to look for these diabetic changes. Just like in glaucoma where if it is not diagnosed early it can lead to irreversible loss of vision.  

Q WHAT ARE SOME OF THE MOST VULNERABLE GROUPS LOSING  THEIR EYESIGHT? The vulnerable groups can be broadly categorized into three groups – the younger child who is also likely to have problems but is unable to express themselves, and it is very important that we check them regularly up to the teenage years, as if their problems are not corrected long-lasting problems can persist. The second group is the working group where it is important to get your eyes checked for glaucoma, diabetic changes and focusing issues. Finally the senior group, especially after the age of 60 there must be regular checks to look for diabetic change, glaucoma and also the need for glasses and cataracts.

Q WHAT TESTS IF ANY CAN BE DONE  FOR THE EYES? The first thing is to get a regular eye check-up done, where vision and eye-sight are checked and then depending on what the doctor sees he will advise on the tests – basically a vision check and a check of the eyes, a focusing check and getting your eye pressure checked. If the doctor sees any changes such as a direct possibility of diabetes, glaucoma or any other focusing issues, there are other tests that could be done to help confirm the diagnosis and then later on see how effective the treatment is.

Q HOW IMPORTANT IS IT TO KNOW YOUR ‘ FAMILY’S HISTORY’ ON  EYE HEALTH? When considering family history,  children whose parents have been wearing glasses or if there is a family history of glasses in certain families, this is a reason to get the eyes checked. Also in glaucoma, there is a strong family history so generally we would recommend that if someone in the family has it, then the others too must get their eyes checked. Cataract is more of an age-related illness. If children have it, then it could be connected to it being there in the family.  

Q DO SCREENS POSE A PROBLEM FOR KIDS AND ADULTS? When it comes to screens there is a condition called  Myopia where you can see things that are nearby but not see things that are far away and it is becoming more prevalent in countries such as Singapore, Taiwan and Korea where by the time they are 18 years, many children are Myopic.

Q WHAT ABOUT FOOD HABITS? We advise greens, vegetables, fruits etc as they all contain essential vitamins and minerals needed for the development of the eyes. Avoid junk food and those that have high levels of sugar, processed food etc to keep your eyes healthy.

By Kshalini Nonis

Advise to children
Avoid being near screens for long periods and take a break of about one and a half minutes every half hour. Spend time outdoors Research has shown that more time outdoors-  like an hour or two daily- helps keep the chances of you developing myopia progressing under better control.
Screen time for adults
For adults too screens are a huge issue. Although the vision may not get weak, if you are staring at the screen the whole day, your eyes will get dry as you are not blinking enough and you also get tired etc and you end up with a headache. Therefore for this too every half hour or so we advise them to look really far for about a minute and a half, or even keep their eyes closed. Eyes need that break.  Outdoor time and having adequate amounts of water to prevent dehydration is important.


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