Disability in the WorkplaceTesting, testing
PREVENTION Whatever your age, regular check-ups are the best way to prevent serious vision problems developing, writes Yvonne Gordon
When nine-year-old Rachel Danks from York went to the doctor complaining of nausea and headaches, she was diagnosed as suffering from migraines. It was only after an eye-examination that a swelling was detected and it was discovered she was suffering from an arachnoid haemorrhage following a burst cyst. She was successfully treated in hospital for the condition.
Around a million children in Britain have an undetected vision problem. It is estimated that 100 adults start losing their sight every day, half of which could be prevented by early treatment from regular eye examinations. And although qualified optometrists provide thorough eye examinations for people of all ages at high street practices, many people only go when they actually develop eye problems rather than as a preventative measure.
With a lot of advertising promoting fashionable glasses rather than healthy eyes, the importance of regular eye examinations can be overlooked. However, there is much more to eye examinations than just correcting vision. They not only detect many eye problems before symptoms arise, but can also pick up signs of other conditions including diabetes, heart disease, high blood pressure and brain tumours.
In eye conditions such as glaucoma, cataracts and some types of age-related macular degeneration (AMD), treatment may prevent further deterioration. That’s why regular eye check-ups are essential throughout life. Everyone should have a two-yearly eye examination unless advised otherwise. All children under 16 are entitled to free NHS sight tests, which are not always taken up because parents assume youngsters are getting school eye tests.
But nowadays fewer schools provide eye screening programmes. Additionally, these tests only pick up actual visual problems, meaning that potential problems that would be easily spotted during an examinations by a fully trained optometrist can sometimes go undetected.
Karen Sparrow from the Association of Optometrists says good vision in children is vital, because we take in 80 per cent of information through the eyes. She says: “Some children are wrongly labelled as slow learners when they really have an undetected vision condition”.
Optometrist Dr Simon Barnard runs a north-London practice and is a university professor in optometry. In his experience, many people don’t visit eye specialists for preventative care, but only when experiencing problems with vision. He says: “I sometimes wonder whether people think more about spectacles than eye examinations.”
He recommends an initial eye examination at six months and then annually throughout childhood to detect problems including lazy eye or squint, which are treatable by orthoptics – the clinical science of eye-muscle exercise. He says: “Treatment is far easier with early detection. Visual dysfunction in children is sometimes associated with learning difficulties, which is treatable with spectacles, exercises or other interventions. A significant minority can be helped with tinted spectacle lenses following assessment with the intuitive colorimetry instrument, which finds the most appropriate colour.”
Diagnostic equipment includes the Optomap, from retinal-imaging company Optos, which displays 80 per cent of the retina, the delicate lining at the back of the eye.
Managing director of Brookman’s Park optometrists in Hertfordshire, Richard Pakey, thinks the earlier the better for an eye test. He says: “We test children from three years old. If a child is disruptive or has a low attention span, this may be due to visual problems.” Retinopathy affects sight through damage to the small blood vessels on the retina – the only place in the body where they can be seen directly.
Healthcare provider Care UK runs diabetic retinopathy screening clinics. Shirley Welch, lead screener at Care UK’s Portsmouth centre, says it’s very important diabetics have their eyes screened regularly. She says: “Diabetic retinopathy damage can be quite advanced before symptoms occur and treatment cannot replace any sight lost. A more effective strategy is to screen diabetics annually so small changes to the blood vessels can be detected and treated.”
Diabetic screening services can halve the chances of visual loss and any children in whom diabetes is detected should have their eyes checked every year. Cataracts, which cloud vision due to the eye lens hardening through age, can develop earlier in diabetics.
AMD occurs if the retina’s centre – the macula – becomes diseased as people age, resulting in changes to the central vision. Some types of AMD can now be helped with injections if caught early, one reason why eye-care practitioners advise annual checks after 60.
Glaucoma is also more common in the elderly and initially affects the peripheral vision. It results from optic nerve damage and usually develops without symptoms. Further sight loss can be arrested if detected early enough. Underlying serious illness can also be picked up through eye examinations. 
