Looking after your eyes

Most research has focused on vitamins A, C and E. These are thought to maintain healthy cells and tissues in the eye. They are found in many fruits and vegetables, such as oranges, tomatoes and in green leafy vegetables. They can also be found in nuts, seeds, dairy products and other food types.

More recently, interest has grown in another antioxidant, lutein, and a similar substance, zeaxanthin. Both of these are yellow plant pigments, which give certain fruit and vegetables their colour, for example the yellow and orange in peppers, sweetcorn and saffron. Surprisingly perhaps, green leafy vegetables such as kale, spinach and broccoli also have high levels of lutein (you can actually see the lutein as the vegetables age and turn yellow).

The human body cannot make lutein or zeaxanthin; they have to be eaten. Several studies suggest that consuming at least 10mg of lutein per day has the most beneficial effects on macular pigment levels.

It’s important to have a wide range of foods in your diet.

Eggs contain high levels of lutein and zeaxanthin, and they may be easily absorbed by the body because they are eaten with the fat contained in the egg. Zeaxanthin is also found in orange and yellow fruits and vegetables.

Some studies are looking at the effects of omega 3 on eye health, which is an essential fatty acid found in oily fish, as well as some nuts and seeds such as walnuts and flaxseed.

Studies into the benefits of taking supplements for eye health are conflicting. It is widely agreed that if you eat a healthy diet, including at least five portions of fruit and vegetables a day, you should not need a supplement. In reality, most people do not eat the recommended amounts.

Regular eye examinations can detect problems with your eyes and many other diseases, before you notice any symptoms.

A regular eye examination is an important health check for everyone. You should have an eye examination every two years or as often as recommended by your optician, even if you don’t have any problems with your sight.

An eye examination can often detect the early signs of many eye and general health conditions before you become aware of any symptoms. This includes glaucoma, diabetes, raised blood pressure or cholesterol levels.

If you have a macular condition it is still important to have a regular eye examination with your optician to monitor any changes.

You are entitled to a NHS free eye examination if you are:

• Over 60 years old
• Registered severely sight impaired or sight impaired
• A person with diabetes or glaucoma
• Aged 40 or over and have a close relative with glaucoma
• Considered to be at risk of glaucoma by an ophthalmologist
• Under 16 or under 19 and still in full-time education
• Needing a prescription classed as complex lenses
• Needing a prescription classed as complex lenses
• Receiving the following benefits: income support, income based job seekers allowance, pension credit guarantee or income-based employment & support allowance (or your partner is receiving them)
• Entitled to, or named on, a valid tax credit exemption certificate or a HC2 certificate
• Living in Scotland.

There are restrictions on how often you can have a free eye examination. If you have more than the amount permitted you will be charged the private eye examination fee.

If you are on a low income but are not covered by any of the above categories ask your optician or GP for a HC1 form or telephone 0845 850 1166.

NHS-funded mobile eye tests

If you are housebound you may be entitled to an NHS-funded mobile sight test, where the optometrist comes to visit you:

• In your own home
• At a residential or care home
• At a day centre

Call NHS Direct on 0845 4647 to find out the contact details for providers that cover your area.

Sun protection

Protecting your eyes from the sun from an early age can help prevent damage. Glare causes people with macular disease particular discomfort.

Sun protection

It is important to protect your eyes from blue and ultraviolet (UV) light all year round, not just in the summer. There are three types of ultraviolet radiation (UVR): A, B and C. UVC is generally blocked by the earth’s atmosphere, however, 90% of UVA and UVB reaches us.

Most people are aware of the damage UV light can do to the skin, but not to the eyes. Wearing sunglasses and a broad brimmed hat or cap helps to protect your eyes. When choosing sunglasses, look for a European CE mark or British Standard BSEN 1836:2005 to ensure good quality lenses. Lenses with insufficient UV protection are more harmful than not wearing sunglasses at all. Around 80% of damage from UV and blue light occurs before the age of 18, so it’s important children also wear hats and sunglasses.

Close-fitting or wraparound frames stop more sunlight getting to your eyes. Alternatively an ‘overshield’, with built-in sides and brow shields, can offer a lot of protection. Clear UV filters can also be added to ordinary prescription spectacles and even contact lenses.

Blue light

Blue light is responsible for the haze on a bright, sunny day. It increases dazzle, glare and blur for some people with macular conditions. Many people with macular conditions find that dark lenses reduce their level of vision. Blue blocking lenses reduce glare without making everything darker. Blue light tends to make images hazier, so blue blockers sharpen images and improve contrast. Blue blocking lenses are usually yellow or orange, although other tints can be added to improve their appearance. Some people use paler, yellow lenses for indoor use because they work well in artificial light and darker lenses outside. The lenses can be ordered from many mail order companies, low vision services, sensory impairment teams and resource centres for visually impaired people.

Coping with glare

Some people find that bright white paper can cause glare when they are reading. To overcome this you could try using transparent plastic ‘overlay’ sheets (your optician or low vision specialist can help you find the best colour for you) or using a typoscope. To reduce computer screen glare look for the ‘alternative view’ settings to change to a yellow background with black text, a black background with yellow text or a black background with white text. Lighting at home should be bright but even to help with glare. For more information about lighting go to in the home.

Smoking

Most people know that smoking causes lung cancer, but not many know that smoking also causes blindness. Current smokers are up to four times more likely to have AMD than people who have never smoked.

Most people know that smoking causes lung cancer, but not many know that smoking also causes blindness. Current smokers are up to four times more likely to have AMD than people who have never smoked.

Smoking is the biggest ‘modifiable’ risk factor for AMD; by stopping smoking you will reduce your chance of getting the condition and your chances of it progressing. There is also evidence that smokers being treated for wet AMD do not respond as well to treatment as non-smokers. Passive smoking can also increase the risk of developing the condition.

Cigarette smoke contains 4,700 chemicals, which are extremely toxic. Repeatedly exposing delicate retinal cells to these oxidants effectively fast-forwards the ageing process. At the same time as increasing oxidant levels in the body, smoking decreases the levels of antioxidants and therefore reduces the body’s ability to protect itself.

Smoking also causes the blood vessels to narrow. This affects the blood vessels to the eye and increases overall blood pressure, which is another risk factor for macular degeneration.

Some research suggests that smokers have lower levels of the macular pigments lutein and zeaxanthin, which are thought to protect the macula from the damaging effects of sunlight.

If you need help to stop smoking please talk to your GP or find out more at Smokefree:  http://www.nhs.uk/smokefree.