Early eye screening prevents vision loss

The importance of eye screening cannot be undermined as it can help detect problems before a condition gets serious, writes Sushma Veeera

 

HUMANS perceive up to 80 per cent of all impressions through sight. Given the importance of our eyesight, it is imperative we take care of our eyes. Sadly, that is something most people often take for granted, until faced with deteriorating vision.

Sunway Medical Centre consultant ophthalmologists Dr Kenneth Fong and Dr Tara George say Malaysians often only see a doctor when it is too late to save their eyesight. Dr Fong and Dr George talk about the importance of eye screening for all ages.

How important is eye screening?

Dr Fong: It is important because good vision helps you work and play safely and comfortably which then leads to a better quality of life. However, our eyes do not generally hurt when something is wrong, particularly in the early stages of ocular disease. A thorough ophthalmologic evaluation can uncover common abnormalities of the visual system and related structures as well as less common but extremely serious ones such as ocular tumours.

Dr George: Most people think they can wait until problems occur before seeking treatment. Eye screening is more than just a sight test. It can also detect, at a very early stage, other health problems. The earlier a problem is detected the greater the chance of successful treatment. Many people are not aware that many eye diseases do not have symptoms such as pain or loss of vision until they have reached an advanced stage. They also think that a regular visit to the optician would suffice and are not aware that this does not replace a comprehensive eye examination.

At what age should children and adults get their eyes checked?

Dr George: Children should have their eyes checked once they reach the preschool age of 4 or 5 years. This will detect any ocular condition and reduce the risk of amblyopia or lazy eye. Adults should have their eyes screened to keep their medications up to date and also to check for early signs of eye disease. Those who are above 40 should have an eye pressure check once a year.

Dr Fong: As eyesight develops gradually from infancy, a comprehensive infant eye exam can detect and treat problems early to prevent developmental delays and permanent vision problems. In young children, early and timely vision screening can detect refractive errors such as nearsightedness, farsightedness and astigmatism. Even when a child's refractive errors are mild, he or she has a higher risk of amblyopia or strabismus which causes problems with depth perception and results in permanent vision impairment. These conditions can occur separately or together, and need to be corrected as early as possible, ideally before kindergarten. If not treated, they can result in permanent vision loss.

Additionally, diabetics require an annual retina eye check. High risk groups include those with diabetes for more than 10 years, pregnant women with diabetes and younger people with poorly controlled diabetes.

These populations require more frequent checks and early and aggressive treatment to prevent blindness. With diabetes reaching epidemic levels in Malaysia, with one in five adults expected to be diabetic by 2020, early eye screening for patients is absolutely critical.

What are the common symptoms of eye problems?

Dr Fong: Red or itchy eyes, discharge, blurring of vision, double vision.

Dr George: Common eye symptoms that require immediate attention are sudden changes in vision such as blurring, distorted vision where lines appear distorted, a patch in the centre of one's vision and floaters.

These symptoms should not be taken lightly and one should see an eye doctor as soon as possible and not later than a week from presentation.

How can early diagnosis help?

Dr Fong: Some diseases like age-related macular degeneration (AMD) and diabetic retinopathy can be treated and outcomes are better with earlier diagnosis and treatment. Glaucoma can be treated with eye drops or surgery and again, your eyesight can be maintained with early detection.

Dr George: Early diagnosis will enable early treatment and prevention of visual loss. This is especially important in diseases of the retina because once the disease is advanced, scarring occurs and we are unable to reverse visual loss. Early diagnosis also enables one to modify and prevent progression by controlling risk factors such as better control of blood sugar in diabetics.

Can you explain more about diabetic retinopathy and prevention of visual loss.

Dr Fong: The global prevalence of diabetic retinopathy indicates that about 35 per cent or one in three people who have diabetes also suffer from diabetic retinopathy (DR). Diabetic retinopathy comprises severe non-proliferative DR, proliferative DR or diabetic macula edema. In Malaysia, among the 3 million people who have diabetes, 1 million have DR and 300,000 will go blind if untreated.

To manage DR, targeted ocular treatment is provided with the aim of preventing visual loss. Among treatment modalities are laser treatment, intra-ocular injections of anti-VEGF agents/steroids and vitreo-retinal surgery.

Dr George: The use of breakthrough technology for screening and diagnosis can be critical in picking up early signs of eye conditions before a patient is aware of any symptoms. It is important to differentiate vision screenings which are limited eye tests that help identify people who are at risk for vision problems from comprehensive eye examinations which are performed by an ophthalmologist, and includes careful testing of all aspects of your vision.

Based on the results of your exam, the doctor will then recommend a treatment plan for your individual needs which may include eyeglasses or contact lenses, eye exercises or surgery for muscle problems, medical treatment for eye disease or simply a recommendation to have your eyes examined again in a specified period of time.

New technology

EMPLOYMENT of advanced technology to test for conditions that may otherwise go undetected is a breakthrough in screening and diagnosis.

According to Sunway Medical Centre consultant ophthalmologist Dr Kenneth Fong, one example is the Daytona Optos Fundus camera at the Sunway Medical Centre's Eye Centre. "A first-of-its-kind in Malaysia, it provides cutting-edge retinal imaging technology, capturing a 200-degree view of the retina in one image in less than one second, without the need for dilating eye drops.

"Patients often find dilating eye drops inconvenient as the vision is usually blurred for a few hours. Testing with this equipment is extremely affordable, it only costs RM70 for both eyes. This camera can help with screening for disease and patients can then have early treatment like laser, to prevent blindness," says Dr Fong.

"The use of modern equipment like the Quantel Supra Yellow laser will allow retinal laser treatment to be performed much faster and with less discomfort. Early detection and timely treatment may prevent or delay loss of vision, but, unfortunately, many of these diseases are often without symptoms until vision loss is extensive. This underscores that regular eye examinations is an important health concern and a priority."