By Dr. Dineshani Hettiarachchi
As we commemorated World Sight Day on Thursday, 13 October, the focus of discussions centred on prioritising eye health by ensuring equitable access to eye care that is both affordable and inclusive.
This year, many events were organised locally and globally to spread awareness of eye health under the theme ‘Love Your Eyes’. Vision 2020 Sri Lanka and the College of Ophthalmologists of Sri Lanka in collaboration with the Ministry of Health organised many activities to mark the event, including media seminars and public awareness campaigns.
According to the World Health Organization consensus, there are nearly 2.2 billion people around the world who are suffering from vision impairment, and at least 1 billion of these cases could have been prevented.
Many deficiencies need to be addressed the world over in terms of unequal coverage of preventive and screening facilities focusing on eye care. Additionally, the situation of treatment and rehabilitation facilities is also dire in certain regions of the world. This is compounded by the lack of well-trained healthcare personnel and poor integration of eye care services into the healthcare system.
World Sight Day aims to address some of these challenges thus identified in the ‘World Report on Vision’. To understand how we can individually safeguard our vision, The Sunday Morning Brunch spoke to University of Colombo Faculty of Medicine Professor and Consultant Eye Surgeon Madhuwanthi Dissanayake.
Several eye disorders including cataracts, glaucoma, and refractive errors are responsible for poor vision. However, with proper care and early intervention, many of these impairments can be avoided or can even be completely cured.
What are the common sight problems you encounter?
This depends on the age and demography of the patients. The commonest cause of blindness in the world is cataracts. In my experience, the common causes of poor vision in Sri Lanka include cataracts, glaucoma, refractive errors, diabetic retinopathy, and age-related macular degeneration.
Among them, refractive errors are common and the public must be aware of its salient features so that they can seek care without delay, as most sufferers are unaware that they have a refractive error and that they could be having better vision.
There are also more reasons why regular eye check-ups are fundamental in safeguarding your vision. Sometimes, poor vision may be the initial symptom of many systemic disorders. For example, blurry or unstable vision may be the first presentation of diabetes mellitus. This is due to the changes caused by rising blood sugar levels, which cause changes in the lens in the eye. Later on, more established diabetic retinopathy changes occurring in the retina may cause poor vision.
Some patients with high blood pressure also present poor vision for the first time and when we check the back of the eye (retina) we see the obstruction of blood vessels (Central Retinal Vein Occlusion). While searching for the cause, they are found to have high blood pressure and high cholesterol.
When they check their vision, many patients find out that they have cataracts, which can initially be managed with spectacles until surgery is performed.
When diagnosed, refractive errors can be successfully treated with spectacles in many patients at a relatively low cost. However, in children, it is very important to check the vision and diagnose and treat refractive errors early to avoid amblyopia or lazy eye. Otherwise, at an older age, they will not be able to improve their vision at all.
Refractive errors can result in impaired vision because of a defective shape of the eye which makes it hard to focus the light correctly on the retina (the light-sensitive tissue layer at the back of your eyes). There are different types of refractive errors. The four common types of refractive errors are:
- Nearsightedness or myopia – This is when far vision is compromised and objects look blurry at a distance
- Farsightedness or hyperopia – This is the opposite of nearsightedness and nearby objects look blurry
- Astigmatism can make faraway and nearby objects look blurry or distorted
- Presbyopia makes it hard for middle-aged and older adults to view near objects
In addition to blurred vision, other symptoms include double vision, seeing a glare or halo around bright lights, headaches, having to squint to see clearly, eye fatigue, and trouble focusing while reading.
If you have any of these symptoms, it’s best to consult an ophthalmologist and get your vision checked. If they detect a refractive error, you’ll be prescribed appropriate glasses or contact lenses. Additionally, if you already wear glasses or contact lenses and have persisting symptoms, you might need to get a new prescription. There are also refractive surgeries that are now available, such as LASIK or PRK.
(The writer is a Senior lecturer and a family physician working at the department of Anatomy, genetics and biomedical informatics at the faculty of Medicine, University of Colombo)