Routine Eye Examination

The eye is a vital organ, so precious and it deserves our proper attention. Eye examinations are an important part of health maintenance for everyone. Adults should have their eyes tested to keep their prescriptions current and to check for early signs of eye disease. And eye exams for children play an important role in ensuring normal vision development and academic achievement of all kids. Vision is closely linked to the learning process. Children with undetected vision problems often will have trouble with their schoolwork. Many times, children will not complain of vision problems simply because they don't know what "normal" vision looks like.

If your child is performing poorly at school, be sure to have his or her eyes examined by an eye doctor who specializes in children's vision to rule out an underlying visual cause.

The following are signs of eye problems

1. Unusual trouble adjusting to dark rooms;
2. Difficulty focusing on near or distant objects;
3. Squinting or blinking due to unusual sensitivity to light or glare;
4. Change in colour of iris;
5. Red-rimmed, encrusted or swollen lids;
6. Recurrent pain in or around eyes;
7. Double vision;
8. Dark spot at the center of viewing;
9. Lines and edges appear distorted or wavy;
10. Excess tearing or “watery eyes”;
11. Dry eyes with itching or burning; and
12. Seeing spots, ghost-like images.

The following may indicate a possible serious eye problem that may require emergency medical attention:

1. Sudden loss of vision of one eye;
2. Sudden hazy or blurred vision;
3. Flashes of light or black spots;
4. Halos or rainbows around light;
5. Curtain-like blotting out of vision; and
6. Loss of peripheral (side) vision.

 Conclusion:

It is important to have regular eye examinations, even if you do not have signs of any problems. Regularly eye exam are especially important for individuals who have chronic health problems such as high blood pressure and diabetes. Early detection and treatment of an eye problem can be the key to preventing loss of vision.

If you notice any of the above-mentioned changes in your eyesight or the appearance of your eyes, it is important to have these checked out by an eye doctor.

Dr. Felix Olafisoye

Instructor, Eye Health

FROM THE DOCTOR’S DESK..................SUPREME VISION EYE MAGAZINE, ABUJA
                                             DR. FELIX OLAFISOYE

Knowledge is power. Knowledge is wealth. Knowledge seems to be everything. Little wonder we pay so much to achieve knowledge. No wonder we spend so much to send our children to the best of schools. We so much seek after knowledge but how many of us have enough knowledge?   
People say knowledge is power and wealth. This I quite agree with but I must add that knowledge is also health. Infact, knowledge is life. Lack of knowledge could have so disastrous consequences. It could lead to death.

The profound need to maintain vision has drawn me into publishing magazines on visual care. I am very passionate about the eye and I treasure my patients' eyes. I am particularly pained when I see people going blind due to ignorance. Ignorance is no crime they say, but ignorance is no excuse under law. The blame lies on our faulty health care system in Nigeria. The fault lies on our eye care professionals including me, who have done little or nothing to educate the public. Our professionals thrive and feed fat  on public ignorance.
SUPREME VISION EYE MAGAZINE was launched 2years ago. The first edition was released same year. This is the second edition. This second edition is quite loaded. The topics were drawn from professional experiences and encounters with patients over the years. This is an avenue to provide some answers to those mind bugling questions on eye health.
 Today, Computer technology and other innovations are the best things that have ever happened to human race. The computer age has come to stay in our lives. Everything we do today is computer based. Our offices, homes and schools are loaded with various types of computer and some people work on them for hours. Majority of computer users complain of one eye problem or the other after working on computer. This problem is called Computer Vision Syndrome. This edition will assist computer users on ways to solve this syndrome.

Right and adequate nutrition can have direct impact upon vision. It can prevent and reverse visual problems. Good nutrition has general impact on the body. Many people do not eat good food not because of poverty but due to lack of awareness on the proper nutrition. Most diseases, including that of the eye, could be prevented simply by eating the right food. We have addressed this in our first and maiden edition but was not exhaustive. We have decided to continue on this topic in this second edition.

You are a shepherd of your body and the guardian of your vision. Most diseases are self-afflicted. Our social habits, belief and  ignorance are basis for most diseases suffered by people. Social habits like smoking and drinking have become a menace that no country in the world could find solution yet. Today, we just have to live with them and their accompanying damages to our health. Thousands have died from smoking and alcohol consumption. This menace has impoverished many homes around the world.
We know the factual truth. The truth is; they are dangerous to our health but we just have to live with this addiction. But how many of these facts are you aware of? How dangerous are these two social vices to our eyes? The Federal Ministry of Health in Nigeria warns that smokers are liable to die young: But how serious is this slogan? This edition deals decisively with effects of alcohol and cigarette on our eyes. 

In Ayurvedic medicine, Light or sun is regarded as fire because it damages eye tissues. The eyes have to neutralize fire, that is, the sun and in doing this, so much damage is done to the eyes. Actually, nature did not intend for humans to be exposed to so much UV light. The sun is the enemy the eye cannot live with or live without. The eye needs light for proper vision and excess of it can damage the eye. We wander daily under the sun without knowing the danger the sun pose to our health particularly the eye and skin. People living in the tropics are particularly exposed to so much Ultraviolet radiations from the sun. It is possible to control or eliminate many of the factors that contribute to the development of serious eye diseases. One of those factors is the sun. Cataracts are partly caused by damage from excessive exposure to sunlight. The free radicals produced by sunlight UV radiation cause the proteins in the eye's lens to deteriorate, clump together and harden into a cataract. Wearing sun lenses that protect your eyes against UV light therefore, is one step you can take to help avoid developing cataracts. This is why we have dedicated a full topic to sunshade in this particular edition. This edition has also thrown so much light on the dangers pose by the sun to our eye and how these dangers can be averted.

To many Nigerians, health is of secondary importance. This is far worse among the elites. Car, food, expensive personal effects and businesses have taken precedence over health. People go to doctor only when they are really sick and dying. This has made medical treatment so difficult in Nigeria and reduced life expectancy. Illness does not develop overnight. Most diseases develop gradually with its accompanying symptoms. Symptoms are signs of warning that all is not well with our body. Therefore, the importance of yearly routine eye test and general medical check up cannot be overemphasized. It saves time, money, pains and life.
This edition will throw much light on the importance of yearly routine eye check up. Why do you need regular eye check? What are the body diseases that can be detected by mere routine eye check up? Your eye-care specialist can pick up various body diseases by mere looking into your eyes.  They can tell you what is going on in the body that you are not aware of. That yearly eye check ups have saved so many lives that would have been lost unexpectedly. That diabetes and hypertension you have could make you lose your sight irreversibly.


But quick diagnosis and intervention could save your sight and even life.  Each part of the eye can provide a different type of information about the patient's health and even life style too.  A good eye care practitioner should be able to look into your eyes and understand the patient's state of health. 
 Majority of patients go to doctors not knowing the truth. They go to consultants to seek the truth about their problems. But most patients sometimes end up still not knowing the truth, even after consultation. Most of our doctors do not practice what I could best describe as interactive medicine. Most of our doctors are in an undue haste and do not communicate with their patients enough. Most of us have forgotten that healing a patient requires both drugs and patients cooperation (psychology). The patient and the doctor must share a common believe on the patient's illness. This is the only way a cure could be made possible. Doctor and patient need to dialogue. In medicine, this is regarded as Complementary or while in some quarters, it is called Integrative medicine. However, whatever it is called, healing I know requires the doctor and the patient: a dialogue. I advise every patient who goes out there to consult doctors for one reason or the other to dialogue and insist on knowing the root cause of their problem, treatment plan and future prevention if any.

Most people go for eye examination without knowing what to expect. Some eye doctor only perform sight test and not eye examination. Today, in Nigeria, some hungry eye doctors go about under the impression of providing eye screening to the public. Their targets are mostly government establishments or rich private companies that can afford their glasses. Eye examinations cannot be carried out outside an eye clinic set up and it cannot be done in a jiffy. The eye is a  delicate organ that cannot be handled in a hurry. The public should be wary of these clinics or money-making quacks. This edition will enlighten you on what to expect when you go for an eye examination in a professional eye clinic.

It is also time for you to start eyeing your child’s future sight. Your child having a perfect future vision starts right from today, now that they still have flexible vision. This edition provide you with some knowledge that will assist you in helping your child develop good eye sight and also teach you how to handle emergencies.
 As an eye care practitioner, my job is to treat your eye when there is a problem but I desire for more than this. I desire to see your vision protected and maintained. Good eyesight plays an important role in your mobility and the enjoyment of life. So the importance of this magazine to your sight cannot be underestimated.

Supreme Vision magazine is not just another magazine selling on the street. It is a magazine designed for public enlightenment on visual health.     It is all about vision. All medical terms have been simplified or carefully avoided to provide an easy understanding for the layman.  In-order to make your reading fun, a glossary of terms is attached for those medical jargons that are unavoidable.
 Reading, they say, is fun. Nevertheless, the importance of this magazine to you is not just for the reading but also to digest, assimilate and implement the content religiously. The magazine is to empower you to become the custodian of your eye. You don't have to go blind because of ignorance. But mind you, this magazine is not a substitute for medical consultation and advice. Please, contact your eye doctor for consultation and professional advice on regular basis.

Till next edition,  enjoy your reading!


Dr. Felix Olafisoye
Editor
Supreme Vision Eye Magazine
Abuja

OUR DAILY SUN;  How dangerous is it to our eyes?

The Sun

The sun is the center of our solar system. It is a giant ball of glowing gases and it gives off energy in the form of light and heat. It is about 100 times the diameter of the earth. Without the sun, the earth would just be one cold rock where no plant or animal can survive. Everything on earth needs the warmth and light of the sun to survive. But, also too much of the sun can be dangerous to our health.

The sun emits energy. This energy is measured in waves, just like the waves of the ocean. Some of these waves are fast and some are slow. Some of them are short and some are long. This short-ness and long-ness of the waves is known as Wavelength. The sun radiates three types of rays,  namely:

  Ultraviolet Rays ( most dangerous)

  Visible Light Rays

  Infra-Red rays

 

Our eyes can only see a portion of the whole electromagnetic spectrum of light emitted by the sun. These portions of light from sunlight that our eyes can see are called Visual Spectrum. Visual Spectrum falls between 400nm to 700 nm. Other lights like Ultraviolet [UV] and Infra-red [IR] are imperceptible to the human eye. The eye cannot perceive them just because they fall below the visual spectrum. i.e. the wavelengths fall between 280nm to 400 nm.
Dangers  pose by sunlight to our eyes

 

[Light toxicity ]

Most people are aware of the risk of developing skin cancer from sun exposure but majority are less aware that sun can cause damages to the eye. Sunlight is definitely associated with the formation of cataracts. The invisible UV component of sunlight promotes free-radical damage in the lens. The brighter the sun, the greater the UV radiation dose. The effect of radiation on our eyes, are cumulative throughout life. They add up as we go along. That is why skin cancers can develop four or five decades after major sun exposure. Cataracts (i.e. cloudiness of the eye lens) are similar symptoms of over-exposure to the sunshine. Long time exposure to UV rays is also related to some eye diseases like Macular degeneration, Corneal sunburn (Photokeratitis) and even skin cancer around the eyelids.

 

Changes in the earth's ozone layer mean that more UV radiation is now reaching the earth's surface in higher doses. Therefore, the need to prevent eye problems will also increase. This is why it is advisable for everyone who is exposed to reflected UV light from snow, on beaches or tanning salon to cover their eye area with UV blocking sunglasses to prevent exposure to UV radiation. The eye is so susceptible to damage as a result from heat from Infra-Red in the range of 800nm to 13000 nm. At this range, major damage can occur to the lens and retina. Infrared in form of extended source such as blast furnace can cause the protein in the eye lens to coagulate (i.e. solidify). This coagulation of lens can cause cataract. (as in Glass-blower cataract)

Scientific explanation on the damaging effect of sunlight on the eye
The mechanisms of damage from UV exposure are photochemical and thermal (i.e. heat). UV radiations are of 3 types, namely: UV-A [380 - 315 nm], UV-B [315 -   290 nm], and UV-C [290 - 200 nm]. Photochemical damage to the eye is predominantly caused by the UV-C and UV-B wavebands. The thermal (i.e. heat) damage is caused by the UV-A. Photochemical damage is usually within the internal part (i.e. cell nucleus) of the lens. Damage results when the energy of the UV matches the receptor of the cell. Since the lens inside our eye is a protector against radiations, it must then absorb all the incident radiation of UV to be an effective protector. Thus radiation [UV] absorbed by our lens caused biological tissue damage. This is how cataracts are formed in our lens.

 UV-C is completely absorbed by the Ozone layer in the atmosphere (called Stratosphere} whereas UV-A and UV-B (above 288 nm) are transmitted through the Ozone layer to reach the earth. In the earth, the eye (cornea) absorbs UV-B (below 295 nm). This is what caused many people corneal burns and Pterygium. UV-A can penetrate the corneal quite well but it is significantly absorbed by the lens inside our eye. This is what caused Cataracts. Also, a small but significant amount of UV-B and UV-A (above 305 nm) that could filter through the corneal and lens is absorbed by the Retina. This cause what is known as Solar Retina Burns.

Changes in environment [ozone layer depletion] pose the most serious concern for eye problems from exposure to UV radiation. Yearly loses of Ozone layer has caused an increase in the amount of UV-B reaching the earth (and our eye). Beginning in the early 1980's, the atmospheric ozone layer has been declining by about 3 % per year. According to researches conducted in 1993 by Fredrick, a 1% decline in ozone layer results in a 1.3% increase in biological activity.

The environmental loses in stratospheric ozone results in dramatic increases in UV (especially UVB below 325 nm) that get to the earth and consequently our eye. This dramatic increase furthCombined with cold wind and snow, UVB has the potential to cause snow blindness (photokeratitis), a temporary (lasting 12 to 48 hours) but painful problem in the cornea of the eye.                                                                                                    

Sources of UV Radiations

   The Sun (Natural source: The sun emits the highest proportion)  Electric Arcs (used by welder). This is an artificial source.  Sunlamp (Artificial source). Furnaces (used in steelmaking and glass    blowing. This is an artificial source)

Mild Effect Of The Sun On Our Eyes

The eyes are extremely quite sensitive to UV rays. Even, a brief exposure can result in a painful, but temporary condition known as photokeratitis and conjunctivitis. Photokeratitis is a painful condition caused by the inflammation of the cornea of the eye. The eye waters and vision is blurred. Conjunctivitis is the inflammation of the conjunctiva (the membrane that covers the inside of the eyelids and the sclera, the white part of the eyeball) which becomes swollen and produces a watery discharge. It causes discomfort rather than pain and does not usually affect vision.

Major effect of the Sun on our eyes.

Eye damage occurs due to absorption of radiation by the anterior structures of the eye (i.e. Cornea, Conjunctiva, Iris, etc) and the posterior surface (lens and retina). The eye damage associated with UV-B and UV-A exposure include:

1.  Pterygium - An abnormal tissue growth on the eye
2.  Pinguecula  A yellowish discolouration of the eyeball
3.  Corneal damage  e.g in corneal burns
4.  Lens damage  e.g. as in cataract
5.  Retinal damage  e.g as in retina burns

Ultimately, radiation damage can cause age related macular degeneration. Macular degeneration is one of the most common causes of blindness in the world.er emphasizes the need for eye and skin protection. The increasing access of UV radiation

People who are at risk of eye problems caused by the sun

1.   People with certain retinal disorder
2.    Patient who had just had cataract  operation (aphake)
3.     People with cataract
4.     People with pterygium and pinguecula
5.   People who are placed on photosensitizing drugs           (e.g. Contraceptives, cholorothiazides, Tetracycline,     diuretics, sulpha drugs, tranquilizers, etc).
6.   Workers on vocations rich in UV radiation like Arc   welding, Electronic chips, Graphic arts, Watermen,  Researchers,
7.    People on avocation rich in UV like  Snow skiing,      sunbathing at the beach, mountain climbing, etc
8.  People who spend excessive hours in sunlight: (Sun  exposure above 6 hours a day) E.g. Policemen,   traffic warden, open market women, taxi drivers, etc.
9.  People who use sunlamps or visit solariums:   Solarium sources are rich in UV-A and contain UV- B, and both have been associated with skin cancer.
10.  Children who are exposed to excessive UV in   sunlight. Children are at special risk since their eyes  do not have the same ability as adults to protect from  UV radiation.
11.  Laboratory workers who use bactericidal lamps. 
12.  Physiotherapists who use phototherapy lamps
13.  Welders (UV radiation from welding equipment)
14.  Farmers, Police, Construction workers, Taxi drivers,  Traffic Warden, “Okada” riders, and other outdoor  workers
15.  Lithographic and printing workers (UV from   printing and polymerizing equipment).

 Tips on eye protection from sun exposure

 

Sunglasses offer 90-100 percent protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Sunglasses should cover the entire eye area, including the eyelids, and should wrap all the way around to the temples. Full coverage prevents damaging rays from entering from the side. It is especially important for those who spend hours under sun on daily basis.

Wearing a wide-brimmed hat along with sunglasses will further block rays from the sun. 50% of sunlight comes from directly overhead, and may slip past non-wraparound sunglasses.

UV coatings on contact lenses are important, but do not fully protect the eyes. Contact lens wearers should additionally wear sunglasses.

Certain drugs may make the eyes more sensitive to light. Be sure to read drug labels and take appropriate precautions. If you are on these drugs, wear protective sunglasses when under sun.

Children's eyes need to be protected, as they are more prone to sun damage because their natural lenses are clearer. Sunglasses is especially necessary for children who must spend more time under sun.
It is important to never look directly at the sun, or even to look at reflections of the sun off water, as this can directly damage the retina.
Intra-ocular lens implants after cataract surgery often include a substantial ultraviolet filter. Nevertheless, sunglasses will protect the parts of the eye not protected by the implants.

Professional advice
The primary eye care practitioner is in particular good position to advise the patient or public in general, about the risk of exposure to UV radiation and the protection regime that should be used against UV radiation exposure.
 The wavelength range of the sunlight that reaches   the earth lies between 288nm to 2600 nm and it   contains almost all the sun’s total irradiance. The   hours between 10.00 am and 2.00 pm are    particularly important clinically, because over 50%  of the UV radiation that reaches the earth in any 24  hours period arrives within the hours of 10.00 am to  2.00 pm. Thus a patient can limit exposure to UV   radiation by simply selecting the appropriate hours  for outside activities. When unavoidable, wear   protective sun lenses with UV blockers.
 We can limit exposure to UV radiation by prudent  selection of outdoor activities [like games]. For   example, the beach sand reflects about 35% of solar  UV radiation: whereas the green grass in the lawn   tennis reflects about 3.5% of solar UV radiation.   The freshly fallen snow reflects about 85- 95% of   the incident UV radiation. Also, the snow skier is   at risk of about 15% increase in UV radiation for   each kilometer [3000 ft] of altitude above sea level.  So skiers should always protect themselves when on  the ski slope.
 People on the beach may think they are being   protected from sunlight by lying under an umbrella  but the umbrella itself acts as a collector of UV   radiation from the sunlight being reflected from the  sand and concentrate it to the area underneath the   umbrella. So, when on the beach, protect your eyes  by wearing sunshade with UV blocker.
 Wearing a hat with a 4 inches brim reduces the   ocular exposure to UV radiation in sunlight by   about 50%. This is important for those who spend  long hours under the sun.
 Many Researches have confirmed that Antioxidants  like Vitamins C, Vitamin E, Selenium and the   Carotenoids help to inhibit the damaging effects of  UV light on the retina. Take these supplements as   regular as possible. They are also available in fruits.  Eat them regularly.(Check Supreme Vision mag., 1st     edition , pg 10. )
 Add 6mg of Lutein to your daily supplement. Lutein  and zeaxanthin in plants are known for their   protection against UV light. Also available in some  fruits. 

Conclusion
Light is the great love the eyes can’t live with and  can’t live without. While light allows us to see,  excessive exposure to wrong kinds of light can  severely damage our eyes [and our skin too],   overtime. We live by light, we thrive by light, and  we suffer from too much or too little light. We need  light to reach our retina to produce sight, just as we  need it to reach our skin to produce Vitamin D, an  essential hormone.
The good news is that light allows sight and can   create psychological sense of well being. The bad   news is that too much light, especially UV light, can  damage our eyes and skin.

Written by:
Dr. Felix Olafisoye
Editor
Supreme Vision Eye magazine
Abuja