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The healthy eye guide

Good Eye GuideNine out of ten people would prefer to lose a limb than the use of their eyes.  Now, thanks to advances in treatment and prevention more than half of all age-related sight loss is avoidable 

While getting older is the single biggest risk factor associated with vision problems, sight loss is no longer an inevitable consequence of ageing.  Not only have researchers uncovered diet and lifestyle measures that can impact eye health, but if caught early through rigorous testing, most common age-related eye problems are now avoidable.

6 things that protect your eyes from damage

Antioxidants Vitamins A, C, E, are key in slowing down the development of age-related macular degeneration (AMD) and the formation of cataracts.  These are found in oranges, kiwis, grapefruit, dried apricots, raw carrots green peas, peppers and green leafy vegetables such as kale and spinach.  More recently two antioxidants, lutein and xeaxanthin, have been found to play a major role in the health of the macula, the central point of the retina that is responsible for focused vision, by helping protect it against free radical attack and toxic damage.  Lutein is found in yellow peppers, mango, bilberries, kale and spinach and xeaxanthin is found in broccoli, corn,lettuce, spinach, tangerines, oranges and eggs. If you don’t eat enough such foods, there are high antioxidant supplements proven effective for eye health available such as Vitabiotics VisionAce Plus £14.95 for 30 from Boots.

Fish  A study in the American Journal of Clinical Nutrition showed that people who eat one serve of oily fish such as salmon, herring, kippers, sardines or mackerel just once a week have a 50 per cent less chance of developing Age-Related Macular Generation (AMD), the most common form of age related vision loss.

Not smoking The strongest risk factor for AMD and cataracts is smoking and according to the Royal National Institute for Blind People (RNIB), smoking is the number one threat to eye health.  Heavy metals in tobacco smoke have been shown to accumulate in the lens with direct toxic effect that contributes to serious sight loss.  Smokers not only double their risk of AMD, they are more likely to develop it earlier and a recent study has suggested that passive smoking over a period of five years can almost double the risk of AMD.

The right sunglasses  Your eye is home to some of the most active cells in your body but the more light that gets into it – be that on a sunny or cloudy day – the more this sophisticated system breaks down.  Each part of the eye absorbs different types of UV light so you need to wear sunglasses whenever you’re outside to protect from this.  For peace of mind, make sure you choose a pair with a CE Mark, to ensure it passes European standards for UV protection.  If you do lots of outside sports such as golf or skiing, ask your optician about specific amber or blue tints that protect from UV rays without being too dark.

In fact, up to 50 per cent of UV light reaches the eyes from the back and sides of sunglasses lenses so Boots Opticians have just launched Boots UV Protect Plus sun protection for your eyes.  It’s a coating placed over sunglass lenses that offers 100 per cent protection against UV light reflected into the eye from the back of the lens surface as well as through the front of the lens giving 360 degree protection, the highest protection from UV available in a spectacle lens. It’s available on any lens in the Boots Opticians range including prescription or standard sunglasses and costs £79.

The right tests An RNIB report found that six million older people are risking their long-term sight by not having regular eye tests.  Not all sight loss is preventable through lifestyle changes and there is a large genetic element in eye disease so an  important step to prevent sight loss is regular eye tests.  But wait until you have symptoms and you could be leaving it too late. Crucially, eye problems such as AMD and glaucoma have early signs that don’t include sight loss and this is the point at which they can often be prevented.  The RNIB recommends anyone aged between 16-59 should have an eye test every two years.  But children and anyone over 60 should have an eye test every year.  If you have a family history of glaucoma, you should have an eye test annually.

How can I access an eye test?  If you are over 60 or have particular risk factors such as a family history of glaucoma, you will be entitled to a free eye test on the NHS, all you need to is walk into (or phone) an optician, who can test you on their premises or come to your home.  Additionally, if you use a computer screen at work, your employer is obliged by law to provide and pay for an eye test.  Private eye tests cost between £15-30.

What can go wrong with my eyes?

Age related macular degeneration (AMD)  AMD is the leading cause of sight loss in the UK. The macula, at the centre of the retina, is responsible for seeing details and as it degenerates, people lose their central vision, needed to recognize faces and colour and to read and write properly.  There are two types of AMD, wet and dry.  Over 90 per cent of sufferers will have the dry form, which progresses slowly and is more commonly associated with age.  For this, early detection is key as there is no treatment for its advanced form but lifestyle changes such as supplementation with high-dose antioxidants (see above) have been shown to halt its progression.  The wet form which often strikes sufferers more suddenly, perhaps over a few months, has more dramatic symptoms such as bleeding and scarring.  Although more serious, there are effective treatments for wet AMD including laser and a treatment called Lucentis, available on the NHS which involves a series of injections into the eye.   Some 10 per cent of dry AMD can progress to the wet form, so people diagnosed with the dry form should monitor and report any sight changes to their specialists.  Early symptoms include blurred or distorted central vision and straight lines seeming wavy or dizzy.  If you ask for a full eye test at your optician, you should be tested for AMD.

Glaucoma  Two per cent of the population over 40 – including some 500,000 people in the UK – suffer some form of glaucoma, which tends to have few symptoms but can slowly and painlessly destroy sight if it is not detected and treated.  It happens when the pressure of the fluid in the eye is abnormally high, causing obstruction of the small blood vessels that nourish the retina and gradual loss of vision. Glaucoma tends to start with no symptoms just after 40 and this is the time when you need to catch it if sight loss is to be prevented.  People of African-Caribbean origin have four times the risk and if you have a family history of glaucoma, you are entitled to annual test on the NHS.  The International Glaucoma Association recommends ensuring you arrange a sight test that includes all three glaucoma tests: Opthalmoscopy, tonometry and perimetry.  Treatment is usually with eyedrops but in some cases laser treatment or surgery may be necessary.  The good news is, once glaucoma is detected and treated early, most people retain good usable vision over a lifetime.

Cataracts While cataracts are largely treatable with sophisticated but common surgery, one in four cases of blindness in people over 75 is still due to cataracts. A cataract is a natural clouding of the lens of your eye, rather like a ‘bubbly bathroom window’, difficult to see out of.  There’s no medicine, laser or eye drops that can make it better so, if you want to see brighter and more sharply then a cataract operation will be necessary.  The biggest risk factors for cataracts are a history of high sun exposure, smoking and diabetes, so if you tick any of those boxes, you should be tested regularly.  Symptoms include blurry or cloudy sight, being dazzled by light and colour vision that has become washed out or faded.  The most effective treatment for cataracts is surgery, which is available on the NHS but subject to waiting lists, but diet changes (see above) might slow the growth of age-related cataracts.

 Help and advice

The Royal  National Institute for Blind People (RNIB) Helpine 0845 766 999 or

International Glaucoma Association SightLine 01233 64 81 70

The Macular Society Helpline 0854 241 2041

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