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Eye health (cataracts, glaucoma etc) - expert Q&A

(105 Posts)
CariGransnet (GNHQ) Mon 15-Apr-19 14:48:58

Have you been experiencing issues with your vision or noticed a change in how your eyes look or feel? Do you have a question about cataracts, want to get to grips with glaucoma or learn more about a symptom you or a close one may been experiencing?

Renowned consultant ophthalmologist, Mr Larry Benjamin, is here to answer your questions as part of blindness prevention charity Orbis’s See My Future appeal. Larry is consultant ophthalmologist at Stoke Mandeville Hospital, Buckinghamshire and has been an Orbis medical volunteer for 15 years, training ophthalmologists in Zambia, China, Myanmar, Pakistan and Ghana and more, with both the Orbis Flying Eye Hospital and within local hospitals.

He has special interests in cataract and diabetic retinopathy management and has served on the ophthalmic committee of the Royal Society of Medicine. In 2016, Larry won an award for his dedication to improving global eye health at the Charity Staff and Volunteer Awards.

Gransnet is supporting Orbis’s See My Future appeal. For three months, until 23rd June, all public donations to the appeal will be doubled by the UK government. To find out more and double the impact of your donation, visit: www.orbis.org.uk/en/see-my-future

Please add your questions on this thread before midday on Monday 29 April, when we will be sending them over to Larry. Answers will be posted here shortly afterwards

MiniMoon Mon 15-Apr-19 15:33:46

Hello Larry, thanks for this opportunity to ask a question.
I have recently suffered posterior vitreous detachment of my left eye, the right eye had the same symptoms two or three years ago. I would like to know if the large, opaque floaters ever disappear. I know that the brain forgets to see them after a while, but will they ever disintegrate?

Zoxa1 Mon 15-Apr-19 17:54:42

Would love to know your opinion on having clear lens extraction to treat primary angle closure.... I will have had my right eye done on 17th April.

travelsafar Tue 16-Apr-19 08:46:44

Hi i also have 'floaters' due to detachment of the gel at back of the eye.I am finding that bright lights or sunshine make this worse. I have been told i have cataracts forming in both eyes and sometimes my eyesight seems misty. I asked if they are ready to be operated on and was told not yet, how long or rather how bad do they have to be before they are??
Thank you.

TwiceAsNice Tue 16-Apr-19 09:05:04

I am diabetic and in Nov my last retinopathy exam showed “background retinopathy” . I have since lost weight and tightened up a lot on my diet so my question is can background retinopathy be reversed ? My GP says with blood glucose improvement ( my levels are ok but am hoping my next review next week show them as much improved) my next test could be normal again. Is this true?

Willow500 Tue 16-Apr-19 10:11:15

I am highly myopic with astigmatism in both eyes and very thin retinas - I had laser treatment for a Neovascularization about 15 years ago which has left a blind spot just below the macular in my left eye. I wear varifocal gas permeable contacts and can see fairly well at the moment - my prescription hasn't changed for the last 3 years (still -15.72 & -16). Glaucoma also runs in the family and a scan at my last optician appointment showed PVD in the left eye and to a smaller degree in the right. I haven't noticed any symptoms with this.

I'm concerned that if cataracts develop (none so far) surgery could cause more damage - I understand I wouldn't be able to have corrective lenses inserted but would clear lenses be possible?

Charleygirl5 Tue 16-Apr-19 15:55:52

I have had Fuchs Endothelial Dystrophy for a few years now as well as dry AMD since 2009. I can still drive but those days are numbered.

I also have mild cataracts- I was led to believe that having Fuchs was a contraindication to having cataracts removed as and when. Has that changed? That to me would mean that cataracts would be most likely to cause severe visual impairment before the other two diseases.

mcem Tue 16-Apr-19 16:38:58

Postcode lottery or outdated opinions when it comes to "being ready"?
My ophthalmologist believes that the op should take place just as soon as the cataracts are diagnosed and that there is no justification for the idea of "ripening".
Do you agree?

baubles Tue 16-Apr-19 17:19:22

My infant grandson has a coloboma in the iris of his left eye. He’s been referred to the ophthalmology department but as yet hasn’t been seen. It runs from the pupil to 5 o’clock. I realise that you can’t tell if his vision will be affected but what can you tell me about it in general terms please?

nannynormal Wed 17-Apr-19 10:48:07

Hi
I get double vision in y right eye if I have been reading or looking at my phone. It lasts for a long time, but it is always there slightly.

wallers5 Wed 17-Apr-19 10:56:32

Why do I wake up with red eyes all the time?

Greciangirl Wed 17-Apr-19 11:13:54

I sometimes experience bright wavy lights to the side of my eyes. Also occasional flashing lights. Is it anything serious.

Christalbee Wed 17-Apr-19 11:44:16

I have been diagnosed with 'narrow angles' and advised that I should have a Laser Iridotomy within two years. Is this necessary, and if it is, how soon should I get it done. Should I have it done now and not wait two years??? Thank you.

ninathenana Wed 17-Apr-19 11:49:54

My question is similar to Twiceasnice's I have had 5 or 6 injections in one or other eye over the last few months for diabetic retinopathy. Is it likely that I will be able to go longer than 4 wks between check ups soon ?
Interesting that TwiceAsNice? was told that improving blood sugar levels could help reverse the problem. I haven't been told that.
I am on insulin for T2

Meg54 Wed 17-Apr-19 11:51:00

My eyelids on both eyes itch like fury top and bottom.
I have used Blephasol, Sodium Cromoglicate, warm eye pads and baby shampoo, all to no avail. This has gone on now for over 3 years, and each morning I wake up feeling like I have been punched in the eyes!
Is there anything I can do?.
Many thanks, Meg.

fizzers Wed 17-Apr-19 11:56:13

Both my parents had glaucoma, what are my chances of getting it? what age range for the onset of glaucoma? I might add I go annually for eye testing and have done for many years

Paul2706 Wed 17-Apr-19 11:58:46

I have been told I have cataracts developing and feel my glasses often look dirty or Misty my optician days there is nothing to worry about but would advise against removal as I have a lazy eye minimal to no vision and feels the procedure would be too risky I would value your opinion on this.

mumagain Wed 17-Apr-19 12:02:40

Hi, for many years I have suffered from Uveitis and as a result of oral medication (steroids) I have suffered from cataracts . The one on my left eye was removed September 2017 and the one on my right eye is nowhere near ready for removal.
I expected my eyesight to improve greatly after the removal of the left eye cataract and was very disappointed to find that it didn't. I asked one of the many doctors I see at the eye hospital every few months about this and was told ' Oh you can't expect a good improvement as the optic nerve has been permanently damaged due to the inflammation. I was very surprised by this as this was the first time I'd been told this. Was there any point then in the cataract op, and is there any point in a future op on the right eye ?

Grannytwo Wed 17-Apr-19 13:20:10

I find that when i’m doing any close work I automatically close my left eye, which is the eye I had a cataract removed from. The optician doesn't seem to take any notice when I tell him. It’s driving me round the bend.

Hazeld Wed 17-Apr-19 14:12:55

I almost always wake up in the mornings with red eyes, the actual eyeball itself is very red with red veins. What causes this and is it anything to worry about please?

Immiesnana Wed 17-Apr-19 14:29:30

I had a Macular hole and lens implant operation in July 2018 and my Consultant is pleased with the result. I however feel that the vision is still slightly distorted which my Consultant says is due to scarring. I would like to know if it will improve with time.

BlueBelle Wed 17-Apr-19 14:37:46

Short sighted -12 ish both eyes, I wear soft contacts for 40 years Astigmatism in both eyes and had torn retinas after a blow to the head some years back repaired twice been ok for a while Now have cataracts and been advised to wait until I really can’t manage because of my previous eye problems I m 74 does this sound right please ?

Secondly one granddaughter Very long sighted about +10 or 11 had a turn which isn’t noticeable in either her glasses (thinned glass very expensive) or contacts is there laser treatment for long sight yet ?
Thank you

GrandmaMoira Wed 17-Apr-19 15:13:57

I have recently been diagnosed with cataracts. My vision is not blurry but suffer a lot from glare which is causing me migraines lasting several days. Is this common and can anything be done, apart from reactive or polaroid glasses which I now have.

ginamat Wed 17-Apr-19 19:15:25

I have suffered with dry eyes and blepharitis for several years and have done all the things I am supposed to do - warm the eyelids, gently massage them and use eye drops, mainly artificial tears. I also use chloramphenicol when needed
as I often get infections. The trouble is that my eyes are very sensitive and don't like me messing about with them too much. Is there anything else you can suggest please as it's driving me mad!

Bamm Wed 17-Apr-19 19:24:31

I have been diagnosed with pigment dispersion syndrome and have to attend the eye hospital to have the eye drainage channels assessed. My appointment is over five months away. Is the risk of Glaucoma such that I should worry about this ?

Candelle Wed 17-Apr-19 23:44:05

Hello

I had macular hole surgery a few years ago.

I was recently 70 and was required to undertake a DVLA eye exam during which I had to score 100% in the peripheral vision test*.

I understand my licence will need to be renewed in three years (as with everyone my age) but could you please tell me if I will have to take the DVLA test again?

*I was told I had three attempts at this test and then.... no licence!
Shaking like a leaf, I first scored 119/120 but told this was a fail.
I had to re-take, managing 120.

Annana Thu 18-Apr-19 06:47:42

Hello Sir,
My 12year old grandson has extreme sensitivity t9 light so much so that his dread on going to the dentist is more from fear of overhead light than the drill. Is that normal and does it carry some risk for future eyesight ?

BradfordLass72 Thu 18-Apr-19 12:21:37

Hello Larry,
I thought I needed new glasses and, as I couldn't afford them, did nothing about my deteriorating eyesight.

Many years later, having been diagnoses as diabetic, I was entitled to a free eye test and they discovered I had AMD.
(there was and still is no damage from diabetic retinopathy)

Since that time I have been having injections of Avastin in my eyes, originally every month, then 2 months and now, after 8 years of regular injections we have come as far as we can. I simply go for checks every 4 months.

I would encourage everyone with any sort of eye problem to have a test because had I been aware of AMD, the ophthalmologist may have been able to slow down my AMD at a much earlier stage.

I also took part in a trial by Auckland (NZ) University.
They were looking for early signs of AMD, and, I believe, found them.

www.auckland.ac.nz/en/about/news-events-and-notices/news/news-2016/03/new-test-for-early-detection-of-eye-disease.html

I do feel there should be much more publicity about catching AMD early.

I can no longer read, paint or drive (books and research were my life, painting and carving my passion and of course my car enabled me to go anywhere) but I had 63 years of these treats and created heirlooms over the years. All my treatment has been free so I am not really complaining. smile

Lili2 Thu 18-Apr-19 16:58:17

What are the signs of cataract forming please. Can you still read with cataracts? drive?

watermeadow Mon 22-Apr-19 21:35:33

I’m another one with cataracts, nearing the stage of needing removal, plus useful vision in only one eye.
Apart from being left blind if anything goes wrong, I’m very worried how I will cope after the operation on my good eye. How much will I be able to see until I can have new glasses? Would I be best kept in hospital overnight when my good eye is covered?

BradfordLass72 Tue 23-Apr-19 08:21:27

Has anyone had a response to their queries yet?

Gagagran Tue 23-Apr-19 09:15:53

Cari said the questions would be passed across on 29 April BradfordLass so I think it will be a while yet!

TwiceAsNice Tue 23-Apr-19 09:25:12

Ninathenana I am type 2 diabetic but am on oral metformin not insulin . I don’t know if that makes s difference

DanniRae Tue 23-Apr-19 13:28:03

I have dry eyes but strangely enough they mainly only trouble me when I am even slightly stressed. For example I can be perfectly fine, the phone will ring and if the call is anything stressful POW I have dry eyes. How can this be? I visited an optician to do with my dry eyes - she did a very thorough examination - but when I told her of my selective dry eye problem she said she had never heard of it. I am sincerely hoping that you have and can help me. Thank you!

shabby Wed 24-Apr-19 11:35:25

Following a cataract operation on my left eye in September 2017 I have been diagnosed with negative dysphotopsia. Although my vision in this eye is fairly good the effects of the condition are not good ie the shadow/dark strip on the left side of the eye and my reaction to sunlight and artificial light. Shopping can be a nightmare because of the lighting in shops. For various reasons it has taken some time to diagnose this condition because it is quite rare - my optician has never heard of it in 40 years of practising! The discomfort I can feel varies from day to day and on a scale of 1-10 can be one or 10 with no discernible reason for the change.

My consultant has offered a lens replacement using a different type of lens and has said he will place the lens slightly differently. However this is not without complications and because it is not known who or why negative dysphotopsia affects neither he or I will know if it will be successful - it could make matters worse. At my last visit to see the consultant he offered a different solution which is I have a cataract in my right eye and he thinks if my lens in my right eye was replaced it could make it the dominant eye which could lessen the problems I have in my left eye. He has no way of knowing however if I could suffer the same condition in both eyes so it would be a leap of faith on my part to have this done.

I really would appreciate your thoughts on negative dyphotopsia and possible solutions to the condition.

Razzy Fri 26-Apr-19 21:15:18

Do you find retired professional pilots are more likely to have faster deteriorating vision? Are there any long term effects of the lower oxygen at altitude?

Moses Sun 28-Apr-19 17:08:25

I have had a few floaters for years, but they have just been a bit annoying . Over the past year however they have increased to the point that they are impacting greatly on my life. They make reading a book really difficult & I can't read a screen comfortably as the brightness makes it worse. I work in a school so this is really making life difficult & depressing . I'm constantly moving my eyes back & forth to shift them . Can I have a laser treatment on the nhs to get rid of them?

Grandma2213 Mon 29-Apr-19 01:18:09

I had a macular repair with vitrectomy a few years ago and it accelerated cataract development for which I had another operation. After this my vision was much clearer (right eye) though the scarring from the macular repair resulted in some distortion. I was discharged from the hospital as a result. Now I find vision in my right eye is blurred even with glasses. Is it possible that the new lens has clouded over? And can it be replaced? I also have glaucoma which is controlled with Timoptol.

BradfordLass72 Mon 29-Apr-19 04:26:49

Gagagran thank you smile

travelsafar Mon 29-Apr-19 09:00:56

Moses didnt realise that laser treatment got rid of 'floaters'. Please can our expert confirm this because if true i will ask at my next appointment with eye consultant as they are a real nusiance!!!!!

Labaik Mon 29-Apr-19 09:48:54

I've been told that I have a cataract developing in one eye. Early stages. Is there anything I can do to slow down the progression; wearing sunglasses etc....

CariGransnet (GNHQ) Mon 29-Apr-19 13:58:43

Hello all - thank you for leaving such a range of interesting questions. We are sending them over shortly and will post the answers as soon as we get them.

Charleygirl5 Mon 29-Apr-19 14:13:48

I agree, Cari, an amazing range so hopefully he will be able to answer our questions.

TwiceAsNice Thu 02-May-19 08:29:13

Mr Benjamin just to update you my blood sugars are now pre-diabetic and in the normal range. Does this mean I have a better chance that my background retinopathy result in my last test has, or will now reverse itself also? The test has previously been normal each time

travelsafar Fri 03-May-19 07:58:02

Anyone had an answer yet to their question?? Not sure if they will be posted on GN or be sent as a private message.

TwiceAsNice Fri 03-May-19 08:34:36

No answer yet

ninathenana Sat 04-May-19 11:46:14

Nor me, I think the answers are usually posted on one thread.

travelsafar Mon 20-May-19 08:07:57

Still no answers to our questions, a bit disappointing.

ninathenana Mon 20-May-19 10:18:54

Yes, it's been so long I'd forgotten about it.

DanniRae Mon 20-May-19 11:25:45

I am disappointed too that we haven't had a reply - I wonder why?

Resurgam123 Mon 20-May-19 12:11:32

I went to my the optician today and the lovely (Alex dishy male) has now written my referral for my Cataract.

I don't know how long a wait it will be but It has at least now been put in for action.
It has been become a real nuisance.

BlueBelle Mon 20-May-19 12:34:21

It is a long time, over a month I d forgotten about I too

shabby Mon 20-May-19 14:13:51

I'm hoping for a response soon as I have some decisions to make.

JohnRNIB Tue 21-May-19 11:02:41

I've hesitated posting here, as I don't want to step all over Mr Benjamin's answers - I'm sure they'll be really helpful, but if anyone does have anything they wanted answering urgently, RNIB's Eye Health Information Service (020 7391 3299) can help with understanding a diagnosis and where to find support, in the meantime.

DanniRae Tue 21-May-19 13:52:42

Thank you John - that is most helpful smile

alchemilla Tue 21-May-19 15:17:56

I will be contacting the RNIB but the GransNet team should bring the response on from Larry Benjamin or explain why not.

NatashaGransnet (GNHQ) Wed 22-May-19 16:11:14

Hi all,

Apologies for the delay in getting the answers to you. This has been because of various factors, but we now have the answers and will be posting them very shortly. smile

LarryBenjamin Wed 22-May-19 16:12:40

MiniMoon

Hello Larry, thanks for this opportunity to ask a question.
I have recently suffered posterior vitreous detachment of my left eye, the right eye had the same symptoms two or three years ago. I would like to know if the large, opaque floaters ever disappear. I know that the brain forgets to see them after a while, but will they ever disintegrate?

The floaters which are just part of the detached vitreous jelly usually do disappear with time as they move further forward in the eye. If not, and if they are troublesome, they can be removed by surgery (Vitrectomy) which cures them. You need to see your local eye department for this.

LarryBenjamin Wed 22-May-19 16:17:01

For travelsafar (Hi i also have 'floaters' due to detachment of the gel at back of the eye.I am finding that bright lights or sunshine make this worse. I have been told i have cataracts forming in both eyes and sometimes my eyesight seems misty. I asked if they are ready to be operated on and was told not yet, how long or rather how bad do they have to be before they are??)

Answer - Cataracts can be removed at any stage of their development. Some Clinical Commissioning groups try to ration cataract surgery by only funding the surgery when the sight drops below a certain level on the sight chart (usually driving standard). However, this is not clinically justifiable and the Royal College of Ophthalmologists and NICE both say that cataracts should be removed when they interfere significantly with the patient’s lifestyle.

LarryBenjamin Wed 22-May-19 16:18:55

For moses and the follow up from travelsafar (I have had a few floaters for years, but they have just been a bit annoying. Over the past year however they have increased to the point that they are impacting greatly on my life. They make reading a book really difficult & I can't read a screen comfortably as the brightness makes it worse. I work in a school, so this is really making life difficult & depressing. I'm constantly moving my eyes back & forth to shift them. Can I have a laser treatment on the NHS to get rid of them?)

Answer - Laser treatment is not widely available in the UK and has a low success rate (around 30%). There is an operation called a vitrectomy which cures floaters. It does carry some small risks but is a well-established operation, routinely used in most eye departments for a range of eye diseases and can be used for floaters if they are troublesome enough.

LarryBenjamin Wed 22-May-19 16:20:04

For zoxal (Would love to know your opinion on having clear lens extraction to treat primary angle closure.... I will have had my right eye done on 17th April.)

Answer - This is now a well-established operation for eyes that are at risk of angle-closure glaucoma. If you are over the age for needing reading glasses, then you wont miss the ability to focus close as you can’t anyway. If you are younger than this then you will need reading glasses for anything closer than 2-3 feet away. Multi-focal lenses (only available privately) are probably not the best thing after a clear lens extraction as the visual quality may not be as good with these as with the standard monofocal lenses (which can be set so that you have good distance vision with no glasses but you will need reading glasses).

LarryBenjamin Wed 22-May-19 16:20:46

For TwiceasNice (I am diabetic and in Nov my last retinopathy exam showed “background retinopathy” . I have since lost weight and tightened up a lot on my diet, so my question is can background retinopathy be reversed? My GP says with blood glucose improvement (my levels are ok but am hoping my next review next week show them as much improved) my next test could be normal again. Is this true?)

Answer - Yes, background retinopathy can certainly improve with better blood pressure and sugar control. It can take some time (up to 2 years) but it is certainly worth it in the long term as controlling blood pressure and sugar are the best ways to protect the eyes (and the rest of the body).

LarryBenjamin Wed 22-May-19 16:21:42

For NinatheNana (I have had 5 or 6 injections in one or other eye over the last few months for diabetic retinopathy. Is it likely that I will be able to go longer than 4 wks between check ups soon? Interesting that that TwiceAsNice was told that improving blood sugar levels could help reverse the problem. I haven't been told that. I am on insulin for T2 )

Answer - Good blood pressure and sugar control are the best ways to protect the body’s organs against the damaging effects of diabetes. The interval between injections for retinopathy depends on many things but as things improve the gap should get longer. If your sugar control improves over the long term then you may be able to stop the need for injections altogether. You should discuss the control issues with your eye doctor and GP.

LarryBenjamin Wed 22-May-19 16:22:19

For Willow500 ( I am highly myopic with astigmatism in both eyes and very thin retinas - I had laser treatment for a Neovascularization about 15 years ago which has left a blind spot just below the macular in my left eye. I wear varifocal gas permeable contacts and can see fairly well at the moment - my prescription hasn't changed for the last 3 years (still -15.72 & -16). Glaucoma also runs in the family and a scan at my last optician appointment showed PVD in the left eye and to a smaller degree in the right. I haven't noticed any symptoms with this. I'm concerned that if cataracts develop (none so far) surgery could cause more damage - I understand I wouldn't be able to have corrective lenses inserted but would clear lenses be possible?)

Answer - Cataract surgery in high myopeds is slightly more risky than in normal sighted eyes but with an experienced surgeon the outcome is still usually excellent. There is no reason why you cannot have your myopia corrected by the new implant. This is done routinely. In some units the astigmatism is also corrected by the implant if it is above a certain level (often around 2 dioptres and above). Each person’s eye is measured before the operation and a calculation done to insert a lens which will leave the eye with good distance vision without glasses. That is what is aimed for - not always achieved, but the myopia should be greatly reduced in any event. If you already have a vitreous detachment then that is protective against a retinal detachment and so this is one less risk for the cataract surgery.

LarryBenjamin Wed 22-May-19 16:22:54

For fizzers (Both my parents had glaucoma, what are my chances of getting it? what age range for the onset of glaucoma? I might add I go annually for eye testing and have done for many years)

Answer - The normal incidence of glaucoma is 1 in 100. If you have a first degree relative with it (Mother/Father/Brother/Sister) then your chance of getting it is 10 in 100. So, 10 times increased risk but, still a 90% chance of not getting it!

Annual eye checks are adequate to pick it up and you get free eye tests after the age of 40 if either parent has it. If picked up early (and it would be if you have annual check-ups), it is very much a manageable condition in most people.

LarryBenjamin Wed 22-May-19 16:23:27

For bamm (I have been diagnosed with pigment dispersion syndrome and have to attend the eye hospital to have the eye drainage channels assessed. My appointment is over five months away. Is the risk of Glaucoma such that I should worry about this ?)

Answer - Glaucoma tends to be a very slowly progressive condition if you have it. Waiting 5 months for assessment should be OK as your Optician will have assessed the urgency of your referral and would have asked for an urgent one if necessary. If your appointment is cancelled or moved it would be worth following it up to make sure it is rebooked soon.

LarryBenjamin Wed 22-May-19 16:24:02

For grandma2213 (I had a macular repair with vitrectomy a few years ago and it accelerated cataract development for which I had another operation. After this my vision was much clearer (right eye) though the scarring from the macular repair resulted in some distortion. I was discharged from the hospital as a result. Now I find vision in my right eye is blurred even with glasses. Is it possible that the new lens has clouded over? And can it be
replaced? I also have glaucoma which is controlled with Timoptol.)

Answer - It is unlikely that the lens itself has clouded over but quite possible that the capsule holding the implant has gone cloudy. This not uncommon and is easily treated with a YAG laser which is quick, completely painless and restores the vision immediately (it won’t improve the distortion though). It is worth being referred back to have this assessed or your optician can also assess it to see if it is the cause of the drop in vision and can refer you back to the hospital for laser via your GP.

LarryBenjamin Wed 22-May-19 16:24:56

For Charleygirl5 (I have had Fuchs Endothelial Dystrophy for a few years now as well as dry AMD since 2009. I can still drive but those days are numbered. I also have mild cataracts- I was led to believe that having Fuchs was a contraindication to having cataracts removed as and when. Has that changed? That to me would mean that cataracts would be most likely to cause severe visual impairment before the other two diseases.)

Answer - The cataract should be removed when it is judged to be causing significant visual disturbance. If the cornea subsequently “decompensates” (goes cloudy) due the Fuchs, then you can have an operation called DSEK which is to replace the inner lining of the cornea. This treats the Fuchs. Sometimes the two are done together, but if the cornea is not too bad from the point of view of the Fuchs dystrophy, then, removing the cataract when it is significant is fine.

LarryBenjamin Wed 22-May-19 16:26:08

For Bradfordlass72 (I thought I needed new glasses and, as I couldn't afford them, did nothing about my deteriorating eyesight. Many years later, having been diagnosed as diabetic, I was entitled to a free eye test and they discovered I had AMD. (there was and still is no damage from diabetic retinopathy) Since that time I have been having injections of Avastin in my eyes, originally every month, then 2 months and now, after 8 years of regular injections we have come as far as we can. I simply go for checks every 4 months. I would encourage everyone with any sort of eye problem to have a test because had I been aware of AMD, the ophthalmologist may have been able to slow down my AMD at a much earlier stage. I also took part in a trial by Auckland (NZ) University. They were looking for early signs of AMD, and, I believe, found them. 
www.auckland.ac.nz/en/about/news-events-and-notices/news/news-2016/03/new-test-for-early-detection-of-eye-disease.html
I do feel there should be much more publicity about catching AMD early. I can no longer read, paint or drive (books and research were my life, painting and carving my passion and of course my car enabled me to go anywhere) but I had 63 years of these treats and created heirlooms over the years. All my treatment has been free so I am not really complaining.)

Answer - I am sorry about your problems and I agree regular eye tests should be encouraged after the age of 40 or if there is a relevant disease such as diabetes. It is probable that your AMD came on later in life (it usually does) but nonetheless, any visual problem should encourage attendance at an optician or eye department to determine its cause.

LarryBenjamin Wed 22-May-19 16:26:56

For mcem (Cataracts. Postcode lottery or outdated opinions when it comes to "being ready"?
My ophthalmologist believes that the op should take place just as soon as the cataracts are diagnosed and that there is no justification for the idea of "ripening".
Do you agree?)

Answer - Ripening of cataracts used to be an excuse used to put off cataract surgery as it was a poor operation many years ago. Now, it is a good, safe, low risk operation and can be offered at any stage of the development of a cataract. My way of deciding is to ask the person who has them if they are interfering with everyday life. Most people tend to adapt to slowly progressive cataract so it can be difficult to tell. Symptoms such as not being able to see road signs so easily, or getting lots of glare whilst driving at night, or difficulty reading without a bright light, can all be suggestive that it is reasonable to consider a cataract operation. No operation is completely risk free, but cataract surgery is very low risk.

LarryBenjamin Wed 22-May-19 16:27:36

For paul2706 (I have been told I have cataracts developing and feel my glasses often look dirty or Misty my optician days there is nothing to worry about but would advise against removal as I have a lazy eye minimal to no vision and feels the procedure would be too risky I would value your opinion on this.)

Answer - The risk is the same as for someone with two good eyes but obviously, the implications of something going wrong are greater. I would discuss it with a local ophthalmic consultant who would be able to weigh up any particular risk in your case. Make sure you have an experienced surgeon doing your operation (you can ask for this) and the risk is low.

LarryBenjamin Wed 22-May-19 16:28:07

For labaik (I've been told that I have a cataract developing in one eye. Early stages. Is there anything I can do to slow down the progression; wearing sunglasses etc)

Answer - There is no known way of halting the progression of cataract but it tends to be slow. Although in some studies sunlight is implicated in their causation, there is not much evidence about progression.

LarryBenjamin Wed 22-May-19 16:28:42

For mumagain (Hi, for many years I have suffered from Uveitis and as a result of oral medication (steroids) I have suffered from cataracts. The one on my left eye was removed September 2017 and the one on my right eye is nowhere near ready for removal. I expected my eyesight to improve greatly after the removal of the left eye cataract and was very disappointed to find that it didn't. I asked one of the many doctors I see at the eye hospital every few months about this and was told ' Oh you can't expect a good improvement as the optic nerve has been permanently damaged due to the inflammation. I was very surprised by this as this was the first time I'd been told this. Was there any point then in the cataract op, and is there any point in a future op on the right eye?)

Answer - Eventually, cataracts will cause complete blindness, so removing them prevents this happening. There are tests that can be done of optic nerve function so this could be done for your right eye to determine if there is any damage. However, even if there is, (your consultant should be able to determine this) it can still be worth removing the cataract, but your team should be able to determine roughly how much improvement you could expect.

LarryBenjamin Wed 22-May-19 16:29:09

For granny2 (I find that when I’m doing any close work I automatically close my left eye, which is the eye I had a cataract removed from. The optician doesn't seem to take any notice when I tell him. It’s driving me round the bend.)

Answer - Ask for a referral to an eye department. You may be getting some double vision from an eye drifting (squint). This can be assessed in a hospital eye department where you would see an orthoptist who assesses this sort of thing.

LarryBenjamin Wed 22-May-19 16:29:51

For Bluebelle (Short sighted -12 ish both eyes, I wear soft contacts for 40 years Astigmatism in both eyes and had torn retinas after a blow to the head some years back repaired twice been ok for a while Now have cataracts and been advised to wait until I really can’t manage because of my previous eye problems I m 74 does this sound right please? Secondly one granddaughter Very long sighted about +10 or 11 had a turn which isn’t noticeable in either her glasses (thinned glass very expensive) or contacts is there laser treatment for long sight yet ?)

Answer - 1). In general, that is a reasonable attitude to cataract surgery but the difficulty is knowing when you are not managing as the cataract can creep up on you slowly and people tend to adapt. In general cataract surgery is a safe procedure with only a small increased risk from being short-sighted. If your retinal tears were due to vitreous detachment (shrinkage of the vitreous jelly inside the eye) which they usually are, then this reduces the risk significantly. Find an experienced surgeon and it would be reasonable to have the surgery when you feel you need it.

2). Yes, laser surgery is available for long sight but not as accurate as for short sight. It is also more accurate (as is that for short sight) for lower levels of short sight. It is always sensible to wait until the eyesight stops changing (usually around the early twenties) before any laser surgery is considered.

LarryBenjamin Wed 22-May-19 16:30:28

For grandmamoira (I have recently been diagnosed with cataracts. My vision is not blurry but suffer a lot from glare which is causing me migraines lasting several days. Is this common and can anything be done, apart from reactive or polaroid glasses which I now have.)

Answer - Glare is fairly common with some types of cataract. Dark glasses or tinted driving glasses can help but if it is a major problem and is affecting your daily life then it is reasonable to talk to an eye surgeon to discuss cataract surgery. If the glare is due to the cataract then the surgery should sort it out.

LarryBenjamin Wed 22-May-19 16:31:05

For lili2 (What are the signs of cataract forming please. Can you still read with cataracts? drive?)

Answer - In the early stages, some forms of cataract change the focus of the eyes – this can sometimes mean that you can read without glasses for the first time in years! As they progress and the lens inside the eye becomes cloudy, then blurring of vision occurs which is not fixable with glasses. It can happen slowly so not always obvious in the early stages, but if the cataract doesn’t affect the vision then it doesn’t matter.

Driving vision (distance vision) can be affected – as long as you can see a number plate at the required distance you can drive but sometimes this is possible with some types of cataract which can affect the vision in different ways- such as increasing glare from headlights/low sun etc. The important thing is to be safe so if the driving is affected it is worth discussing the possibility of cataract surgery.

LarryBenjamin Wed 22-May-19 16:31:38

For watermeadow (I’m another one with cataracts, nearing the stage of needing removal, plus useful vision in only one eye. Apart from being left blind if anything goes wrong, I’m very worried how I will cope after the operation on my good eye. How much will I be able to see until I can have new glasses? Would I be best kept in hospital overnight when my good eye is covered?)

Answer - It is possible to have just a clear shield over the operated eye overnight so you can still see through it. When cataracts are removed, the new lens that is inserted into the eye is calculated to give good distance vision without glasses, so the vision should be pretty good straight away. For reading a pair, off the shelf +3 strength glasses will work well, while you are waiting a few weeks for a proper pair to be made. A senior surgeon should be involved with your care (you can request this) as you only have one useful eye and this should make it even safer.

LarryBenjamin Wed 22-May-19 16:32:12

For baubles (My infant grandson has a coloboma in the iris of his left eye. He’s been referred to the ophthalmology department but as yet hasn’t been seen. It runs from the pupil to 5 o’clock. I realise that you can’t tell if his vision will be affected but what can you tell me about it in general terms please?)

Answer - In general people with an iris coloboma do very well with essentially normal vision in the eye. This is assuming that the eye is otherwise normal and that is the main reason for assessment to ensure that no other abnormalities are found in the eye. The hospital department will usually monitor the visual development in children with eye problems until they reach the age of around 6 or so, which is when the wiring from the eye to the brain is virtually complete and visual development is more predictable.

LarryBenjamin Wed 22-May-19 16:32:59

For nannynormal (I get double vision in y right eye if I have been reading or looking at my phone. It lasts for a long time, but it is always there slightly.)

Answer - It is worth being assessed in an eye department to look for signs of a squint. It may be that you are losing control of the eyes for close focusing and one is drifting. At the hospital you would see an orthoptist and an eye doctor to assess this.

LarryBenjamin Wed 22-May-19 16:33:23

For greciangirl (I sometimes experience bright wavy lights to the side of my eyes. Also occasional flashing lights. Is it anything serious.)

Answer - If the bright wavy lights last a few minutes and then go, they are likely to be a form of migraine. Occipital migraine (which affects the seeing part of the brain) is not usually associated with any headache (although the head can feel a bit fuzzy for a while). Classically the waves or lights grow in size or move and then disappear. This is nothing to worry about. If there is any long term affect on the vision, then it is worth seeing an eye doctor about it but if it goes back to normal each time, then not.

LarryBenjamin Wed 22-May-19 16:33:58

For Wallers5 (Why do I wake up with red eyes all the time?)

Answer - The eyes can look red in the mornings sometimes but with no other symptoms/problems it is unlikely to be serious or significant. When lying down the veins on the white of the eye will fill more with blood than when standing up.

LarryBenjamin Wed 22-May-19 16:34:29

For Hazeld (I almost always wake up in the mornings with red eyes, the actual eyeball itself is very red with red veins. What causes this and is it anything to worry about please?)

Answer - The eyes can look red in the mornings sometimes, but with no other symptoms/problems it is unlikely to be serious or significant. When lying down the veins on the white of the eye will fill more with blood than when standing up.

LarryBenjamin Wed 22-May-19 16:35:05

For Meg54 (My eyelids on both eyes itch like fury top and bottom. I have used Blephasol, Sodium Cromoglicate, warm eye pads and baby shampoo, all to no avail. This has gone on now for over 3 years, and each morning I wake up feeling like I have been punched in the eyes! Is there anything I can do?)

Answer - Itching usually denotes allergy. If the eyelids are red/swollen as well as itchy then you may have a contact allergy (eg to the soap powder you use on your pillows/make up/make up removers/face creams – anything really!). It is worth getting this looked at by an eye doctor or dermatologist to try to work out if it is an allergy. It is always difficult to make a diagnosis without seeing the problem first hand so an appointment for this would be good. It could also be a chronic allergic conjunctivitis but again needs to be seen to be analysed.

LarryBenjamin Wed 22-May-19 16:35:41

For ginamat (I have suffered with dry eyes and blepharitis for several years and have done all the things I am supposed to do - warm the eyelids, gently massage them and use eye drops, mainly artificial tears. I also use chloramphenicol when needed 
as I often get infections. The trouble is that my eyes are very sensitive and don't like me messing about with them too much. Is there anything else you can suggest please as it's driving me mad!)

Answer - Blepharitis is a chronic condition which needs managing – it is often controllable rather than curable. You need to be seen in an eye department if you have not already and they might suggest trying an oral antibiotic such as Doxycycline which can sometimes help with the lids if used for 3-6 months. If other methods are not working, occasional topical steroid cream can also be used but needs supervision in an eye department as it can have other effects on the eye.

LarryBenjamin Wed 22-May-19 16:36:12

For Dannirae () I have dry eyes but strangely enough they mainly only trouble me when I am even slightly stressed. For example, I can be perfectly fine, the phone will ring and if the call is anything stressful POW I have dry eyes. How can this be? I visited an optician to do with my dry eyes - she did a very thorough examination - but when I told her of my selective dry eye problem she said she had never heard of it. I am sincerely hoping that you have and can help me.)

Answer - It may be that stress makes a pre-existing mild dry eye worse for various physiological reasons. There is no syndrome as far as I know to explain this but would suggest using the artificial tears more often when it happens. Using a preservative-free drop (such as Blink or one of the hyalotears preparations) is useful as they can be put in whenever needed, with no side effects.

LarryBenjamin Wed 22-May-19 16:36:45

For Christalb (I have been diagnosed with 'narrow angles' and advised that I should have a Laser Iridotomy within two years. Is this necessary, and if it is, how soon should I get it done. Should I have it done now and not wait two years??? Thank you.)

Answer - It is not possible to predict exactly when this should be done... The reason that it is time dependent is that the lens of the eye grows throughout life getting thicker and thicker. In eyes with narrow angles, the drainage channels which sit in the angles can become obstructed causing an acute form of glaucoma as the lens grows. Putting holes in the iris stops this happening (as does having a cataract out when one is older). If it needs doing there is no particular reason to wait as it reduces the risk of the acute glaucoma happening to almost zero.

LarryBenjamin Wed 22-May-19 16:37:15

For immiesnana (I had a Macular hole and lens implant operation in July 2018 and my Consultant is pleased with the result. I however feel that the vision is still slightly distorted which my Consultant says is due to scarring. I would like to know if it will improve with time.)

Answer - Distortion is usually due to a kink or scar in the retina caused by the macular hole. It can sometimes improve a little with time but is unlikely to get back fully to normal. It also should not get any worse with time.

LarryBenjamin Wed 22-May-19 16:37:50

For candelle (I had macular hole surgery a few years ago. I was recently 70 and was required to undertake a DVLA eye exam during which I had to score 100% in the peripheral vision test*. I understand my license will need to be renewed in three years (as with everyone my age) but could you please tell me if I will have to take the DVLA test again? *I was told I had three attempts at this test and then.... no license! 
Shaking like a leaf, I first scored 119/120 but told this was a fail. I had to re-take, managing 120.)

Answer - It is unusual to have to get 100% on the Easterman field test. There are rules that need to be met but odd missed points are usually allowed. DVLA don’t allow more than two missed points together within the 20 degrees of central fixation (the spot you are looking at centrally) and there are rules about the periphery too but it would be unusual for a maculkar hole in one eye to cause a problem, as most people can drive legally with one in terms of the field of vision. As the Easterman test is carried out with both eyes open you should pass it easily assuming the other eye is normal.

LarryBenjamin Wed 22-May-19 16:38:13

For annanan (My 12year old grandson has extreme sensitivity t9 light so much so that his dread on going to the dentist is more from fear of overhead light than the drill. Is that normal and does it carry some risk for future eyesight?)

Answer - Extreme light sensitivity is not usual. It is worth getting it looked at in an eye department where they can rule out known causes. It is possible that it is normal but just extreme but I would get it checked.

LarryBenjamin Wed 22-May-19 16:39:03

For Shabby (Following a cataract operation on my left eye in September 2017 I have been diagnosed with negative dysphotopsia. Although my vision in this eye is fairly good the effects of the condition are not good i.e. the shadow/dark strip on the left side of the eye and my reaction to sunlight and artificial light. Shopping can be a nightmare because of the lighting in shops. For various reasons it has taken some time to diagnose this condition because it is quite rare - my optician has never heard of it in 40 years of practicing! The discomfort I can feel varies from day to day and on a scale of 1-10 can be one or 10 with no discernible reason for the change. My consultant has offered a lens replacement using a different type of lens and has said he will place the lens slightly differently. However this is not without complications and because it is not known who or why negative dysphotopsia affects neither he or I will know if it will be successful - it could make matters worse. At my last visit to see the consultant he offered a different solution which is I have a cataract in my right eye and he thinks if my lens in my right eye was replaced it could make it the dominant eye which could lessen the problems I have in my left eye. He has no way of knowing however if I could suffer the same condition in both eyes so it would be a leap of faith on my part to have this done. I really would appreciate your thoughts on negative dyphotopsia and possible solutions to the condition.)

Answer - I see a number of such cases and they have so far all been cured by replacing the existing lens with one in what is called the cilairy sulcus. This is a space between the lens and the iris. I use a 3-piece lens (one with thinner legs) which is necessary because of its new position and to date all have been successful. It is likely that you would get the same symptoms in your second eye if you use the same implant so I usually suggest to people to have their second eye done and have a lens placed in the ciliary sulcus. I use an Alcon MA60AC 3 piece posterior chamber lens in the ciliary sulcus not in the capsular bag. Your surgeon will understand this. If this is successful then think about having the first eye lens replaced with a similar one, knowing it will work. There are potential risks with a lens exchange but they usually work well.

LarryBenjamin Wed 22-May-19 16:39:33

For razzy (Do you find retired professional pilots are more likely to have faster deteriorating vision? Are there any long-term effects of the lower oxygen at altitude?)

Answer - There is a little bit of evidence for pilots getting cataracts a bit earlier and this is thought to be due to increased radiation levels (many different wavelengths) found at high altitudes but difficult to prove. Other than cataract formation I haven’t come across any other particular issue.

CariGransnet (GNHQ) Wed 22-May-19 16:40:40

A huge thank you to Larry for providing such thoughtful and detailed answers to such a long list of questions (37!) - and all around his incredibly busy work. Much appreciated

Charleygirl5 Wed 22-May-19 17:10:20

Cari I agree, thank you so much, that was very much appreciated.

DanniRae Wed 22-May-19 18:15:52

Hi Cari ......Please thank Larry for his helpful reply.

shabby Thu 23-May-19 16:47:08

Hi Cari please thank Larry for his reply. I feel more confident about making a decision now that I have his opinion.

Gingoo Thu 23-May-19 17:07:15

I have recently discovered damage to the Macula in my weakest eye (operation for lazy eye age 5 )
The photograph taken in eye hospital shocked me as it looked as if something had burst through it. They explained it as looking “ like a crumpled piece of paper “
Will it repair itself or is my sight likely to deteriorate?
I am currently waiting for a follow up appointment but it seems I might have quite a wait.
In the main time I’m worrying.

Resurgam123 Thu 23-May-19 17:21:35

I am not an expert but I do understand from my eye history that glaucoma has a significant family history.
I think if you have a family history and at about 40 yrs you can get your eye tests free. Or could.

There is run of 5 females in my family to my knowledge.

fizzers Thu 23-May-19 17:30:24

Please thank Larry for his response to my question

Grandma2213 Fri 24-May-19 00:52:39

Many thanks to Larry for his response. I will now do something about my vision loss, armed with this knowledge rather than think I am just being fussy and a nuisance.