CARING FOR THE KING OF SENSES

CARING FOR THE KING OF SENSES

Of the five senses (hearing, touch, smell, taste and sight), sight or vision is regarded as the king of all. It’s the window of life and among the most highly specialised and sensitive organ of the body.

To enable you to see, light rays must pass through the cornea (the front of the eye), pupil (the black hole) and lens to be focused on your retina (at the back of your eye).

Many people have otherwise healthy eyes, apart from refractive errors (long sightedness, short sightedness, astigmatism) that develop in childhood. These refractive errors can readily be diagnosed during routine eye tests and can usually be corrected wearing glasses/contact lenses. In addition, ageing can also affect your eyes, making it progressively more difficult for you to read tiny prints (presbyopia - which can also be corrected with glasses).

Regular eye examinations should be part of your normal health regime from childhood because a simple eye test can pick up eye conditions like glaucoma, cataract, macular degeneration etc. If detected early enough, these conditions can be treated and managed effectively before complications such as sight loss can develop. It could also detect the signs of other conditions including diabetes, hypertension, raised cholesterol etc.

According to World health Organisation (WHO) estimates:

-          About 285 million people are visually impaired worldwide

-          39 million are blind

-          246 million have low vision (severe/moderate visual impairment)

-          Preventable causes are as high as 80% of the total global visual impairment burden

-          About 90% of the worlds visually impaired people live in developing countries

-          Globally, uncorrected refractive errors are the main cause of visual impairment

-          Cataracts are the leading the cause of blindness

The Nigerian national survey on blindness and low vision estimates that approximately one million adult Nigerians are blind and three million people are visually impaired. Eighty one percent of blindness is among adult about fifty years or more.

Poverty works with illiteracy and ignorance to cause disease and blindness. Overall, two out of three Nigerians are blind from causes which could be avoided. It is therefore a sensible precaution to have eye examinations regularly.

World Sight day is an annual day of awareness to focus global attention on blindness, visual impairment and rehabilitation of the visually impaired.

MY VISIT TO MOORFIELDS EYE HOSPITAL LOW VISION CLINIC

I was in the UK on a visit to attend my best friends wedding and what better opportunity to visit the largest eye hospital in Europe. My guide was Michael Crossland (Phd, MCOptom FAAO, Specialist Optometrist). This was actually my first time of meeting him, he came across as a very honest and hardworking fellow. The piece reproduced below was written by Michael for the 'MAGNIFIER' newsletter produced by the Low Vision foundation.

Moorfields Eye Hospital is a government funded specialist ophthalmology hospital in London, England.  It is the largest eye hospital in Europe, and Moorfields also runs smaller outreach clinics around London and South East England.

The low vision clinic at Moorfields Eye Hospital was established in 1969.  Since then, more than 100,000 low vision appointments have been made, and the clinic has grown to be one of the world’s largest low vision centres.¹  Most patients are referred into the low vision clinic by ophthalmologists working in other clinics in Moorfields.  Smaller numbers of patients are referred in from doctors in other fields such as neurology or gerontology, from other hospital eye departments without low vision facilities, and from general medical practitioners.  

Each person attending the low vision clinic is assessed by an optometrist.  The optometrist will take a detailed visual history, will measure the visual acuity for distance and near and will perform a full refraction.   Further magnification is demonstrated in the form of high addition reading spectacles, hand magnifiers, stand magnifiers, and telescopes.  Useful optical devices are issued on a “permanent loan” at no cost to the patient.  The cost of optical magnifiers and high power reading spectacles is met by the National Health Service.  Finally the optometrist will give advice about lighting, glare control, non-optical and electronic aids.    Electronic magnifiers such as closed circuit television systems are not provided by the hospital but in some cases other government agencies fund these (for example, for people in employment or education).

The hospital also employs an Eye Clinic Liaison Officer.  She can refer patients to local social service departments or charitable organisations and provides detailed advice about employment, legal protection of people with visual impairment, and state benefits.  She can also refer people for psychological counselling if needed.  For children with visual impairment, the hospital employs specialist Family Support Workers to provide advice to children and their families.  They will also liaise with schools and education authorities.

In a recent research study we have shown that our one-hour low vision appointment reduces self-reported difficulty on visual tasks by the same amount as a medical treatment which improves visual acuity by more than 5 lines (0.55 logMAR).²  Research from similar clinics has shown significant improvements in reading speed (from 20 to 72 words per minute)³ and in the ability to read  newsprint (from 22% of people before the low vision clinic appointment to 88% afterwards).⁴

In summary, the low vision clinic is an integral part of Moorfields Eye Hospital.  Ophthalmologists from all subspecialties refer patients in to the clinic.  A single one-hour low vision appointment improves the likelihood that people can read, and can improve vision-related quality of life for people with visual impairment.

1. Crossland, M. D. and J. Silver (2005). "Thirty years in an urban low vision clinic: Changes in prescribing habits of low vision practitioners." Optometry and vision science 82: 617-622.

2. Pearce, E., M. D. Crossland, et al. (2011). "The efficacy of low vision device training in a hospital based low vision clinic." British Journal of Ophthalmology 95: 105-8.

3. Nguyen, N. X., M. Weismann, et al. (2009). "Improvement of reading speed after providing of low vision aids in patients with age-related macular degeneration." Acta Ophthalmol 87(8): 849-53.

4. Margrain, T. H. (2000). "Helping blind and partially sighted people to read: the effectiveness of low vision aids." Br J Ophthalmol 84(8): 919-21.