eye health advice
The Malta Association of Optometrists recommends a routine eye examination at least every 2 years, or sooner if recommended by an optometrist or doctor.
For example, the following groups are advised to have eye examinations at more regular intervals:
- Children under 16 years of age.
- Adults over 70 years of age.
- Those with diabetes or other systemic health conditions.
- Those with a family history of glaucoma, or other eye significant eye conditions.
And of course, if you are experiencing symptoms within less than your regular interval, whether relating to your vision or how your eyes look or feel, it is advisable to consult your optometrist for an examination.
Any sudden changes to your vision, such as blurred vision, sudden and severe headaches, eye pain and flashes or floaters should be investigated without delay, either with your regular practitioner, if they have emergency availability or with a doctor at the hospital.
Did you also know that optometrists and doctors may detect a number of eye and systemic conditions when assessing your eyes? Your retina can indicate signs of systemic conditions such as hypertension (high blood pressure) and diabetes.
Please find some information below on common eye conditions that optometrists can detect, monitor and help you with. Please be advised that this list is not exhaustive
Having any eye concerns, or due an eye examination?
If you are experiencing any eye health concerns or you are due for your regular eye examination, why not visit our Members' List and contact a practitioner and practice of your choice? Our members practise optometry across Malta and Gozo, in various clinics. Please get in touch with them to discuss their appointment availability
rEFRACTIVE ERROR
Refractive error refers to the difficulty of your eye to focus an image, either due to its size or shape. Uncorrected refractive error leads to blurred vision, eyestrain and difficulty focussing on objects in the distance or at near.
There are 3 main types of refractive error: Myopia (short-sightedness), hyperopia (long-sightedness) and astigmatism.
Myopia, or short-sightedness refers to when light falls in front of the light-sensitive retina (that transmits signals to your brain), either because the eye is too long, or the eye is refracting the light to fall short of the retina. Because the light is falling in front of the retina, the distance vision appears blurred and a minus (-) prescription is required to correct the vision.
Hyperopia, or long-sightedness refers to when light falls behind the light-sensitive retina, either because the eye is too short, or the eye is refracting the light to fall behind the retina. Because the light is falling behind the retina, the near vision appears blurred, or difficult to focus on and a plus (+) prescription is required to correct the vision and reduce strain.
Hyperopia is not to be confused with presbyopia, which will be discussed in a subsequent section.
Astigmatism is a type of refractive error, where either the lens or the cornea are more curved, rather than spherical. This can cause the light entering the eye to be scattered or distorted. Left uncorrected, astigmatism can cause eyestrain and fatigue as well as focussing issues. It is corrected with a cylindrical lens and may be present alongside myopia and hyperopia.
PRESBYOPIA
Presbyopia is another form of refractive error, which usually affects most people at the age of 40 or above. Presbyopia occurs when the lens of the eye, which helps us focus, becomes less flexible and is not able to change our focus to near. Hence, presbyopia causes difficulty with reading and near vision. It's normal for people to find they have to hold things further away or closer to try and focus when this process occurs. Presbyopia is corrected with a reading addition and a patient may be prescribed reading spectacles (potentially in isolation or in addition to distance spectacles for myopia, hyperopia or astigmatism) or multifocal spectacles including varifocals and bifocals.
GLAUCOMA
Glaucoma refers to a group of progressive eye diseases that causes damage to the optic nerve in your eye, which relays information to the brain. Damage to the fibres within the optic nerve leads to a progressive loss in vision. Glaucoma is sometimes associated with high intraocular pressure (high pressure within the eyes) but can occur without high intraocular pressure. Some people can also have acute glaucoma, which is a sudden onset attack where the pressure in the eye builds up suddenly and causes damage.
Some people are more at risk of glaucoma than others. For example, those with a family history have an increased likelihood. Age, prescription and ethnicity are also risk factors.
Glaucoma is often asymptomatic (meaning you don't know you have it), particularly in the early stages. It is therefore essential that you have regular eye examinations, at least every two years so that your optometrist can screen for glaucoma.
age related MACULAR DEGENERATION
Age related macular degeneration (AMD) is one of the leading causes of sight loss and occurs when the cells within the macular region of the eye (responsible for your detailed and central vision) start to degenerate.
AMD can be 'Dry' or 'Wet'.
Dry AMD refers to when yellow deposits (called drusen) build up behind the macular which can cause blurred or distorted central vision. Dry AMD is usually a progressive change that takes place gradually. There is no treatment for Dry AMD.
Wet AMD refers to when the Dry AMD progresses and abnormal blood vessels grow in the macular region which then leak fluid. This causes a more sudden and drastic change in your vision. It is rarer than Dry AMD and affects a minority of people. However, if you have any sudden visual changes then it is essential that you have your eyes examined as soon as possible. Wet AMD is usually treated with injections to the eyes.
There are a number of risk factors. The biggest risk factor, as suggested by the condition's name, is age. However, there are other risk factors too, such as lifestyle factors like smoking and diet.
During an eye examination, your optometrist can examine your macular for any signs of degeneration.
DRY EYE SYNDROME
Dry eye syndrome refers to a deficiency in the tear film of the eye. This may be because your eyes cannot produce enough tears, or that the tears they are producing are not of good enough quality. Dry eye is usually a chronic condition and so will affect people for long-term, but it may be managed by a variety of methods and may get worse and better from time to time.
Symptoms of dry eye can include a dryness/ gritty sensation in your eyes, occasional redness and intermittent blurred vision. You may also find that your eyes are watering a lot too (as your eyes are trying to compensate for poor quality tears).
Dry eye usually affects those over 65 more and affects women more than men. However, anyone can have dry eye and there are also a number of environmental factors and lifestyle considerations. For example, those using computers for long periods or those on certain medications that are known to affect the tear film.
Dry eye does not usually cause any long-term damage or complications, but could cause scarring or damage to the cornea if it is particularly severe.
There are a number of treatments including:
1. Using lubricating eye drops.
2. Lifestyle adaptations such as reducing screen time and not wearing eye make up.
3. Surgical procedures, in severe cases, to create and improve drainage.
If you have any dry eye symptoms, your optometrist can examine you and give your some advice.
DIABETIC RETINOPATHY
Diabetic retinopathy is when a person's diabetes begins to affect and damage some of the small blood vessels within the body and specifically the blood vessels within the eyes. As the blood vessels become damaged, this causes them to leak fluid and blood and the blood flow to the retina (the light sensitive layer at the back of the eye) is interrupted.
If diabetic retinopathy becomes severe, then it can lead to permanent damage and changes in the vision In order to prevent this, it may be necessary to have laser treatment or injections to the eyes, as well as controlling the diabetes.
Diabetic retinopathy usually occurs when the blood sugars and diabetes are poorly, or variable controlled which damages the blood vessels. There are other risk factors such as how long a person has had diabetes, if they smoke and if they have other health conditions.
If you have diabetes, or are at risk of diabetes, it is essential that you have regular examinations so that your optometrist can check your retina for any signs of diabetic retinopathy or changes to the blood vessels.
CATARACTS
Cataract is when the lens within the eye, which helps the eye focus, is cloudy. The most common form of cataracts are age-related and occur when due to ageing, the lens becomes cloudy. As the lens becomes cloudy, light is not able to pass to the retina (the light sensitive layer at the back of the eye) as effectively and this means people will notice reduced, dim or blurred vision. People may also notice issues with bright lights and glare, particularly with night driving for example. Cataracts are usually progressive and the biggest risk factor for their development is age. However, there other lifestyle factors such as UV exposure and smoking.
If cataracts develop to a point where they start to severely impact the vision, a surgery to replace the lens in the eye with an artificial one can be performed. This is a safe procedure and is one of the most common surgeries that the health service performs.