Baker Payne Webb - Optometrists

Cataract

A cataract is cloudiness in the lens of the eye due to a change in the lens material. They are most commonly due to ageing. People older than 65 years often have signs of cataracts. They can also be caused at any age by injury and certain diseases. Occasionally they may be present at birth.

An early cataract may not cause any problems. Typically, over time, the haziness in the lens increases in area and becomes more dense. The time for this to occur may vary from a few months to many years. As the cataract increases, the vision becomes more blurred and sensitivity to glare increases. It is like trying to look out of a dirty window.

Fortunately, just about all cataracts can be successfully removed with cataract surgery which is performed by an ophthalmologist. Most people have an intraocular lens inserted at the time of surgery, with excellent results. A plastic lens replaces the hazy lens. It is usually necessary to wear reading glasses after the procedure.

The decision when to have cataract surgery is dependant on how much the cataract is interfering with the vision and affecting your lifestyle. We discuss this with you and can make a referral to an eye surgeon.
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Glaucoma

Glaucoma is a disease involving increases in the pressure of the fluid in the eye. It causes problems with the blood supply to the retina, the back of the eye. This damages the nerve fibres in the eye, leading to problems in the peripheral (non-central) vision. Untreated glaucoma can cause severe vision impairment.

There are a few different types of glaucoma. The most common type - open angle glaucoma - has no symptoms and can only be detected through an eye examination.

There are three tests which optometrists do to check for glaucoma:

	Measuring the pressure in the eye
	Inspecting optic nerves - This is done by looking at the back of the eye with an ophthalmoscope.
	Assessing visual fields.

The first two tests are performed routinely. If there are any problems, a visual field test will be arranged.

Anyone with a family history of glaucoma is at a much higher risk of developing this disease and must be vigilant in having routine eye examinations.

The risk of glaucoma also increases with age and it is recommended that anyone over the age of 40 should have an eye examination every two years.

Anyone suspected of having glaucoma is referred to an ophthalmologist for assessment and treatment.
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Diabetes

Diabetes is a serious disease which is becoming more prevalent in Australia. The most common form is Type 2 or late onset diabetes. About four percent of the population has diabetes.

One of the most serious complications of diabetes is diabetic retinopathy. Optometrists play an important role in detecting retinopathy in the early stages when they respond best to treatment. Retinopathy is a disease of the retina - the back of the eye. Diabetes causes the very fine blood vessels in the eye to bleed. It can also lead to swelling of the central retina area (the macula). There are different degrees of retinopathy. Some just need monitoring by an eye specialist, the more advanced forms may require laser treatment.

There is a significant risk of developing diabetic retinopathy within 15 years of diabetes diagnosis. The risk of developing retinopathy increases with the length of time you have had diabetes and if the blood sugar levels are poorly controlled. It is recommended that anyone who has been diagnosed with diabetes should have yearly eye examinations with a dilated fundus examination. The optometrist will put some drops in the eyes that widen the pupils. This allows the optometrist to a have better view of the retina, and to check for haemorrhages or other early signs of retinopathy. If there are any problems, the optometrist will refer the patient to an ophthalmologist.

Diabetics also have a higher risk of developing cataracts and glaucoma. These are also conditions which optometrists look for in a routine eye examination.
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Macula Degeneration

The macula is the central part of the retina, which has the highest density of light sensing nerves and produces the sharpest visual resolution.

Macula degeneration occurs when the central part of the retina starts to break down. This leads to major disturbances in the person’s central vision area. This condition affects older people, usually over the age of 60. It is more common in smokers and the condition can run in families. Vision loss may be very gradual or it may be quite sudden.

There are two types of macula degeneration:

	Dry macula degeneration
	Vision loss is more gradual, due to pigment and waste material being deposited around the macula area.
	Wet macula degeneration
	Bleeding occurs at the macula, which eventually leads to scarring. Vision loss is usually more sudden and people often notice distortion in there vision – like wavy lines. This requires urgent medical attention. Laser treatment may be required.

Optometrists can detect early warning signs of macula degeneration by examining the retina. Often they will give clients an Amsler chart, which looks like a printed grid. It allows the client to check for subtle changes in vision which may indicate leaking blood vessels.

Macula degeneration is often difficult to treat but medical techniques are improving. For those who have already lost central vision through this condition, optometrists can help provide advice on lighting and magnifiers and low vision services.
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Pterygium

A pterygium is a fleshy vascular growth from the conjuctiva (a clear membrane over the white of the eye), which extends on to the cornea. They usually occur on the nasal side of the eye but they can also be on the other side.

They are extremely common in Australia as UV light is thought to be a leading factor in pterygia development. Pterygia can distort the cornea (the front surface of the eye), possibly leading to astigmatism (a visual distortion). If pterygia grow too close to the pupil, or if they are very irritating, they may need to be removed by an ophthalmologist.

The best way to prevent the progression of a pterygium is to wear sunglasses and a hat to protect the eyes from UV light.
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Computers and Vision
Just about everyone is using a computer in their work place these days. Computers can cause eye strain or discomfort. Common Complaints include:

	Headaches
	Blurred Vision for near and/or distance vision
	Burning eyes
	Twitching eyelids
	Words swimming in front of the eyes
	Fatigue
	Aching across the forehead.

At Baker Payne Webb we can help by detecting and correcting any refractive errors, that is, long-sightedness, shortsightedness or astigmatism. A person who is longsighted has to focus harder when looking at something close. Even a very small amount of long-sightedness may cause difficulties when doing constant computer work.

The optometrist also assesses binocular vision skills. When the eyes look at the screen, they need to turn in slightly. This is called convergence. Weak convergence can cause eye fatigue. Simple eye exercises can be given to improve this skill.

Sometimes big improvements can be made by changing the set up and lighting at the work station. The optometrist can advise you on this. Some people find that taking rest breaks – looking away from the screen every ten minutes or so - can help.

Mild reading glasses can often make a big difference for people who are constantly using the screen and having problems. The glasses just relax the eyes and make working more comfortable.
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Children's Vision

More than 80% of all school tasks are based on vision. Vision is a key factor in normal childhood development.

Along with a routine comprehensive eye examination for children with learning difficulties and for children who are performing at a less than expected level, Baker Payne Webb offer the opportunity for further analysis of visual perception and visual processing skills.

We create appropriate Vision Therapy programs individually designed for each child's needs. This may involve regular in-office visits and supervised activities or exercises at home. To cover costs a small fee is charged per visit over and above the bulk billed Medicare fee.
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