The Avoidable Blindness

World Diabetes Day is celebrated on 14 November each year. This year, WDD honours the role of nurses who work with people living with diabetes.

Around the world nurses account for more than half of the health workforce. People with diabetes benefit enormously from the education and support they receive from nurses and other health care workers, including optometrists, in managing the impact of this debilitating disease.

Cost of Diabetes

In Australia, it is estimated that 1.8 million people live with diabetes, with 1.3 million diagnosed and an estimated 500,000 undiagnosed with type 2 diabetes.

Every five minutes in Australia someone is diagnosed with diabetes, and a staggering 25 per cent of adults over the age of 25 are living with either diabetes or pre-diabetes.

The disease accounts for more than 10 per cent of all Australian deaths, making it the seventh most common cause of death by disease in Australia.

Enough is Enough

Dr. James Muecke, Australian of the Year and ophthalmologist has declared war on diabetes.

This deadly disease is now the leading cause of blindness in Australian adults.

Dr. Muecke has had enough.

Every year, Dr. Muecke sees an increasing number of patients with eye disease due to diabetes.

It is upsetting to see so many people suffering from the disease particularly as “type 2 diabetes is a preventable, dietary disease,” he says.

“We should not be seeing these blinding, maiming and deadly consequences at all. It’s time to put a stop to it.”

Sugar is Toxic

To reduce the impact of diabetes, Dr. Muecke says we need to go back to the root cause of the disease to “challenge our perception of sugar, our relationship with sugar and the impact it has on the development of diabetes. I want to encourage hard hitting strategies to build greater awareness of the detrimental role sugar plays in our society.”

“Sugar is as toxic and addictive as nicotine.”

By reducing our consumption of “sugar, refined carbohydrates, and highly processed products containing these substances (we) can prevent type 2 diabetes. It’s proven and powerful.”

Through diet and early detection of diabetic eye disease, loss of vision from diabetes can be prevented. Sadly, once vision has been lost it cannot be reversed.

Early detection, by having a regular eye examination is the best way to identify problems before they get worse, and to ensure early treatment.

Diabetes causes far too many Australians to lose their sight each year, but this can be avoided by cutting out sugar from your diet and by having regular eye tests.

Surprisingly, Dr Muecke says that of the 1.8 million people in Australia who have any type of diabetes, “less than half are having their regular eye checks, which is why it’s become such a major cause of blindness in our society.”

If you have diabetes, to avoid diabetic retinopathy, it is important to be proactive about booking an annual appointment to see your local Eyecare Plus Optometrists.

The Process of Diagnosing Dry Eye Disease

With no single treatment regime, dry eye disease, is difficult to treat creating frustration for both optometrists and patients.

Early recognition of the symptoms of dry eye disease are important so do not let the discomforting symptoms continue until they become painful and debilitating.

 We speak with two Eyecare Plus optometrists, Glenn Vessey and Denise Lee, who discuss the treatment process of dry eye disease.

Often underdiagnosed, dry eye is quite a common eye condition. Many people who have the dry eye symptoms are often not aware that they have them. Studies show that the prevalence of dry eye increases with age, occurring in up to 30% of elderly people.

The Treatment Processes

Glen Vessey, an optometrist for more than 30 years, has been particularly focussed on the treatment of dry eye disease since 2013.

“The equipment and technology we have to diagnose and treat dry eye has improved markedly over the last five to10 years… and we are steadily finding new ways to improve its diagnosis and management.

“It is essential to accurately diagnose the condition. Correct classification of the type of dry eye is equally important,” says Glenn.

During the eye examination, your optometrist will look for signs of the disease and ask you questions about their symptoms, including grading their symptoms.

“Once the optometrist accurately diagnoses and classifies the condition, the next step is to determine the most suitable treatment regimen for each patient,” says Glenn.

This leads to a more detailed discussion about dry eye disease and prescribed management.

Optometrist Denise Lee says that “mild cases of dry eye disease are prescribed lubricating eyedrops, whereas moderate to severe cases are invited to return for further testing to ascertain what other management and treatment options should be done.”

Treatment options include “a variety of medications (both prescribed and over the counter), Intense Regulated Pulse Light (IRPL), Blephasteam, heat compresses on the eyes, expression of the meibomian glands and natural oral supplements to improve tear production,” says Glenn.

“As a chronic eye condition,” Denise points out that it is important for patients to be educated, specifically, about “how to slow down its progression”.

Dry eye can become “debilitating for some, and difficult to manage in the advanced stage,” she says.

Treatment Improvements

In the past, management for dry eye involved lubricating drops, gels, and ointments, as well as bandage contact lenses and punctal plugs. Glenn Vessey states that, “if we diagnosed someone with dry eye we simply treated the condition by giving the patient additional (artificial) tears, which only treated dry eye symptoms, not the cause of the dry eye (the tear glands not producing enough tears).”

Now there are many more treatment options for dry eye.

“Now we identify those patients who would benefit from unblocking, stimulating, and rejuvenating the tear glands; reversing the process by which the glands become blocked, stop producing tears, atrophy and eventually die off. This not only provides improvement in the dry eye symptoms but reverses the deterioration of the disease over time.”

Denise Lee says that, “modern day management encompasses a myriad of options depending on the type and severity of dry eye disease”.

Treatment options today include “meibomian gland expression, intense pulse light, scleral contact lenses, amniotic membranes and drops, blood serum drops, and new formula eyedrops that target inflammation, infection, and immune suppression.

As well as these, Denise Lee uses “LipiFlow and Rexon-Eye dry eye treatments”. LipiFlow is an automated thermal heating massaging system and Rexon-Eye is a non-invasive cellular regeneration treatment.

Individual Treatment Options

Dry eye is a multifactorial disease.

The treatment of each person with dry eye disease is unique to their own situation.

Glenn Vessey implores that, “accurate diagnosis of the type of dry eye is essential.” Once that is achieved the best possible treatment can be tailored to the individual patient’s condition using a combination of treatment options.

When seeing an optometrist, you need to ensure that “they are continually updating their knowledge and skills relating to diagnosis and treatment of dry eye disease,” says Denise.

Dry eye is one of the most underrated diseases.

Symptoms in severe cases can be debilitating and have a detrimental impact on a patient’s lifestyle. Like many diseases, prevention is the best form of treatment.

If you want to find out more about dry eye disease book an appointment to see your local Eyecare Plus optometrist.

Dry Eyes in the Age of Covid

Dry eye disease can be extremely frustrating and upsetting for people who suffer from it.

It is a multifactorial condition which affects one in five adults, caused by a chronic lack of moisture to the surface of the eye.

Dry eye symptoms can range from a combination of a stinging or burning feeling, occasional blurred vision, redness, constant tiredness (like you always need to close your eyes) and/or the feeling that you have something like an eyelash in your eye.

Dry Eye Treatment

Treatment for mild dry eye disease can be in the form of artificial tears which lubricate the surface of the eyes.

If you are on the computer for long periods, take a break and look into the distance for 20 to 30 seconds to give your eyes a break. By focusing on a computer screen for long periods most people will blink less. As a result, our eyes become dry. Make a deliberate decision to take breaks from the screen and blink. Blinking renews the tear film which prevents dry spots on the eyes.

Drinking plenty of water, especially in hot weather, can help decrease dry eye symptoms, as will supplements containing omega-3 fatty acids.

For those with more severe dry eye symptoms, as part of an ongoing treatment plan, steroid eye drops are used short-term to treat the root cause of the inflammation.

Other treatments for long-term dry eye sufferers include a warm compress to the closed eyelid to soften and unclog the meibomian glands and intense pulsed light (IPL) treatment which flashes filtered wavelengths of light that are absorbed by the dilated blood vessels to reduce inflammation.

Mask Associated Dry Eye (MADE)

A new source of dry eye problem has arisen during the Covid pandemic – mask associated dry eye (MADE).

That is, a rise in dry eye cases due to the wearing of a poorly fitted face mask.

Wearing a mask helps to reduce the spread of the virus but can, if worn incorrectly, exacerbate dry eye symptoms when a person breathes out, spreading air upward toward the eyes.

Many people wearing a face mask for a long period of time who are not wearing their mask correctly, firmly against their face, are experiencing dry eye symptoms.

This is problematic, particularly for people who have an existing dry eye problem.

When wearing your mask, it is important to wear it snug against your face to help stop the air that you exhale from escaping upwards and over the surface of your eyes. If you wear a loose mask your breath will not only disperse out the sides but also upwards and across the ocular surface which could aggravate dry eye symptoms.

The Centre for Ocular Research and Education (CORE) recommend some simple solutions that can help stop or reduce the severity of dry eye symptoms when wearing a mask.

Dry Eye Solution Tips

  1. Adjust your mask so that it fits firmly around your nose and under your eyes to stop your breath escaping upwards.
  2. Artificial tears will help to lubricate your dry eyes and maintain moisture on the outer surface of your eyes.
  3. Reduce the time you spend in air-conditioned environments
  4. Give your eyes regular breaks from digital devices.

Wearing a mask correctly has played a critical role in reducing transmission of the global virus pandemic.

If you have questions about dry eye symptoms make an appointment to see your local Eyecare Plus optometrist who can advise you on an appropriate treatment plan.

Diabetes, Your Eyes, And Your Mental Health

Diabetes can affect the entire body, including your eyes.

It is a serious complex condition which requires daily self-care and, if complications develop, the condition can seriously impact the quality of a person’s life – even causing blindness.

Diabetes is debilitating. Not only can it lead to blindness, it can cause heart attacks, strokes, kidney disease, limb amputation, depression, and anxiety.

Less visible are the mental health complications of diabetes which impacts almost half of all people living with the disease, with many regularly experiencing moderate to severe anxiety or stress.

To help improve a person’s mental health, Diabetes Australia has launched a new campaign called Heads Up on Diabetes.

Heads Up on Diabetes

The mental and emotional health challenges of living with diabetes are very real.

“Nearly half of all adults with diabetes experience mental health challenges, including diabetes related anxiety, distress and depression during their lives,” says Diabetes Australia CEO Professor Greg Johnson.

Heads Up on Diabetes, launched during National Diabetes Week 2020, is designed to raise awareness of the mental health burden associated with diabetes and encourage people to seek help if they need it.

Living with Diabetes is not only stressful, managing it is time consuming and requires a great deal of organisation to get through each day including keeping track of medications, blood glucose monitoring, and constant ongoing health checks.

Mental Health Challenges

Research shows that living with a chronic condition like diabetes can more than double a person’s risk of developing depression.

“Two-thirds of people with diabetes are worried about their long-term risk of developing serious diabetes-related complications like losing limbs, eyesight, experiencing kidney failure or heart failure,” says Professor Greg Johnson.

“The mental health challenges associated with living with diabetes can make it harder for people to manage their physical health and increase their risk of developing serious diabetes-related complications.”

People living with diabetes need to stay on top their routine health checks including having regular eye examinations, which will help decrease the risk of depression.

KeepSight

A national diabetes eye health register; KeepSight, encourages people living with the disease to have regular eye examinations.

The program has been running for two years and has had a significant impact on the eye health of Australians with more than 66,000 people with diabetes now enrolled in the program.

Receiving these reminders is a great way to help people to stay on top of appointments that are set months, and sometimes, years in advance.

People living with diabetes may not experience symptoms. Many can feel that there is no need to have their eyes examined and that if everything checked out last time, then they can miss their next eye appointment or two.

Diabetic Retinopathy

Diabetic eye disease can cause a range of eye problems, the most common being Diabetic Retinopathy, in which the blood vessels inside the retina at the back of the eye are damaged.

The disease is subtle with no warning signs, so it can be easy to neglect regular eye checks. The problem though is that without annual eye examinations, diabetic eye disease can cause permanent vision loss.

Many Australians with diabetes lose their sight each year, but this can be avoided by having regular eye tests.

To find out more about diabetes visit www.diabetesaustralia.com.au or contact 1800 533 774 to arrange a free conversation with a trained psychologist.

It is important, if you have diabetes to see your local Eyecare Plus Optometrist each year to have a thorough eye examination. Book an appointment today.

Diabetes and Your Eye Health

Diabetes is a serious, complex condition which requires daily self-care and can have an enormous impact on a person’s quality of life. It is the most common cause of vision loss in working-age adults and the most common cause of preventable blindness.

The eyes are one of the main organs affected by the continuous rise in blood sugar levels for a person living with diabetes. If left unmanaged; blurred vision, cataracts, and in some cases, blindness, can occur.

A person who has diabetes requires yearly eye examinations.

Here is essential information related to diabetes and eye health.

Diabetic Retinopathy

The disease can cause a range of eye problems, the most common being Diabetic Retinopathy, in which the blood vessels inside the retina at the back of the eye are damaged.

Many Australians with diabetes lose their sight each year, but this can be avoided by having regular eye tests to detect the presence of Diabetic Retinopathy in the earliest stages.

As Diabetic Retinopathy can cause vision loss, it is important for people who have diabetes to see their local optometrist annually in order for the condition to be identified and prompt eye care treatment can be initiated.

No Warning Signs

Diabetic eye disease often has no warning signs until it has advanced, so people will often put off having annual eye examinations and place them ‘down the list’ of priorities.

“The reality is that a regular diabetes eye check is the best way to identify early problems, and then ensure early treatment,” says Taryn Black, National Policy and Program Director at Diabetes Australia.

“People with diabetes have many regular health checks they need and often diabetes eye checks are put off, or forgotten about, because there are more pressing health issues to address,” said Ms Black.

Early Detection Saves Sight

The important thing to remember is that with early detection and treatment vision loss from diabetes is preventable. Sadly, without early detection and treatment, once vision has been lost it cannot be restored.

Optometrists are at the forefront of how diabetes and eye health is managed in Australia.

By routinely conducting eye checks local optometrists are making a significant contribution to the eye health of more than 1.8 million Australians living with diabetes.

Eye Test Appointment Reminder

KeepSight, launched by Diabetes Australia last year, is an eye examination reminder system for people living with diabetes.

This program will help to significantly increase the number of eye examinations for people living with diabetes and, in doing so, will reduce the number of people who lose their sight.

KeepSight reminds people with diabetes when they are due to have their eyes check. It is also a national register of people who are having regular eye checks and who are not, allowing Diabetes Australia to target its message to those who are not consistently having their eye checked.

Your local optometrist has a very important role to play in ensuring people with diabetes have regular eye screenings and proper eye care treatment to minimise, if not prevent the debilitating effects of this disease.

A Good Safeguard

Deputy Director at the Centre for Eye Research Australia and ophthalmologist A/Prof Peter van Wijngaarden, who is a driving force behind KeepSight says the return visits for eye exams are “far below what is desirable”.

“Many of those who are found to have mild or no diabetes-related retinopathy will not return for follow-up screening at the recommended time.”

Aside from the reminders sent by your local optometrist, KeepSight reminders serve as a good safeguard to ensure people living with diabetes have their eyes checked to save them losing their sight.

The more points of contact, the greater the chance a person will have of attending follow-up examinations.

Go to KeepSight to register with the reminder program.

If you have diabetes or are experiencing other problems with your vision such as blurred vision, now is the time to take action and book an annual eye examination with your local Eyecare Plus Optometrist.

Ita’s Plea: Don’t Let COVID-19 Fears Steal Your Vision

Australian icon Ita Buttrose has issued a passionate plea to senior Australians in a bid to avoid thousands of people going unnecessarily blind during the COVID-19 pandemic.

“I have an important message for our older and more vulnerable Australians living with macular disease, including age-related macular degeneration (AMD), the leading cause of blindness and severe vision loss in Australia,” Ms Buttrose said.

Macular disease covers a range of conditions that affect the central retina (the macula) at the back of the eye. The most common are age-related macular degeneration (AMD), and diabetic retinopathy (DR), including diabetic macular edema (DME).

AMD accounts for 50% of blindness in Australia with one in seven Australians (approximately 1.29 million) over the age of 50 having some evidence of AMD.

“I’m concerned many people who need urgent, sight-saving eye injections for diseases like wet (neovascular) AMD and diabetic macular edema are not keeping their appointments with their ophthalmologists because of fear and confusion around public health protocols.

“Missing an eye injection can seriously and permanently compromise your vision. You must not miss your sight-saving treatment,” she said.

Macular Month Message

Ita Buttrose has been Patron of Macular Disease Foundation Australia (MDFA) for 15 years. She has a family history of AMD, with her father Charles and two of his siblings losing their sight to AMD. Thankfully, Ita’s uncle Gerald Buttrose, has retained his sight due to having regular eye injections for his wet AMD. He is now 96.

In May, during MDFA’s Macula Month, Ita Buttrose advocates for Australians over the age of 50 to see an optometrist for an eye examination, including a check of the macula.

“In a COVID-19 environment, our call to action is even more vital if we are to avoid thousands of people going unnecessarily blind on the other side of this pandemic,” warned Ms Buttrose.

“If you require injections for wet (neovascular) AMD or diabetic macular edema, or other macular conditions, it is essential that you attend your specialist appointment or discuss your treatment options with your ophthalmologist.

“Similarly, if you notice any sudden changes in your vision, or experience eye pain – even if you don’t have a diagnosed eye condition – it could be an eye emergency. It is vitally important that you contact your optometrist or ophthalmologist as soon as possible,” Ms Buttrose said.

Covid Fear Causes Cancellations

Despite reassurances from the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) that eye injections are an essential treatment, ophthalmologists around Australia have seen a dramatic increase in the number of patients cancelling essential eye appointments.

“I understand that some people might be concerned about leaving their homes to get treatments,” Ms Buttrose said, “but I can assure everyone that clinics are sterile environments and stringent clinical guidelines have been put in place to ensure people’s safety.”

“Whether you are at home or living in aged care, these eye injections are vitally important to preserving sight.

“Many of you have lived through times of hardship, through wars, depressions, and times of national insecurity and anxiety. Once again, with the COVID-19 pandemic, we find ourselves in an unexpected time of uncertainty, where clarity of communication and correct information is paramount.

Keep Scheduled Eye Injections

“I want to stress if you have a scheduled eye injection, if you are a family carer or someone who needs to take a person to a scheduled eye injection, and you have not been in contact with COVID-19, you are not breaching public health measures to attend that appointment. Obviously, if you are unwell, please phone first for advice.

“I understand people are apprehensive but keeping your sight must be your priority,” she said.

If you need advice about your eye health or want a free Amsler grid to monitor vision changes at home contact MDFA’s National Helpline on 1800 111 709 or your ophthalmologist or local Eyecare Plus Optometrist.

Macular Degeneration: Act Early to Save Your Sight

When Jessica Falon’s grandmother was diagnosed with age-related macular degeneration (AMD), she understood there was a strong family risk of getting the disease and decided to take an active approach to protecting her own sight.

Jessica (pictured with her mother and grandmother) is 23 years old and visits her local optometrist regularly for a comprehensive eye examination. She doesn’t smoke and has adopted an eye-friendly diet to support the health of her macula.

Jessica’s grandmother, Helen, was diagnosed with wet (neovascular) age-related macular degeneration, a condition that caused rapid deterioration of her central vision. There is effective sight-saving treatment for this form of the disease, but by the time Helen saw an optometrist, her condition was already quite advanced.

Today, Helen is legally blind.

Helen lost her husband many years ago. She is a very independent person who loves cooking but, she started to notice she was making mistakes which were unlike her, “like putting salt in food instead of sugar or not being able to find things,” says Jessica.

Losing her sight was gradual.

“It has been quite hard to watch her lose that independence.”

What is AMD?

AMD is the leading cause of blindness and severe vision loss in Australia. One in seven people over the age of 50 have signs of the disease, and the incidence increases with age. It is a painless, progressive disease that destroys central vision, leaving peripheral vision intact.

Reducing the Risks

There’s no cure for AMD, but you can reduce your risk.

Jessica has made a couple of simple changes to her life in order to help her vision.

“It’s not that big of a change really, but we make a habit of putting spinach in just about everything and plenty of oily fish!” she says.

Jessica can’t guarantee making those changes to her diet will stop her getting AMD but, in making these changes, she is supporting the health of her macula.

“I can get regular macula checks and monitor my vision as I get older. If I can better my chances in any way, it is got to be a big win.”

The Four Major AMD Risk Factors

There are four major risk and prevention factors for AMD:

  1. Smoking

Smokers have a three to four times higher risk of AMD than non-smokers

  1. Age

As you get older, the risk of getting AMD increases dramatically

  1. Family history

If you have an immediate family member with AMD, you have a 50% risk of getting it too

  1. Eye exams

A regular eye exam with your local Eyecare Plus optometrist will ensure early detection of AMD, giving you the best chance of preventing vision loss.

Proactive Lifestyle Changes

Jessica knows that while she’s a long way off the high-risk 50 plus age group, the changes she’s making now will help put her in a great position to prevent or delay the onset of AMD as she gets older.

“I understand the hereditary aspect of the disease and so even though the prospect of macular disease seems in the distant future, my sister and I have talked about our vision. We have an Amsler grid on the fridge, and we are incorporating macula friendly foods into our meals,” says Jessica.

If you know AMD is something in your family, have a conversation about it.

“I have seen just how much AMD impacts Nana and the changes I have made to my diet and lifestyle are so easy,” says Jessica.

The Macular Disease Foundation Australia offers free advice and support for people at risk of, or living with, macular disease, including AMD and diabetic eye disease.

To find out more about macular degeneration, contact your local Eyecare Plus optometrist or call the National Macular Disease Helpline on 1800 111 709.

COVID-19: Helping Kids Reduce the Risk of Early Myopia

It is a number of weeks into self-isolation and as much as you try to get the kids outside to exercise their limbs and minds, they are constantly glued to their digital screens.

With Australian children doing school from home, they are spending significantly more time in front of their screens than they did before the COVID-19 outbreak, as a result parents have virtually given up on placing limits on the use of digital devices.

With all this extra screen time, how will your child’s vision be affected?

Spending more time indoors looking at screens and less time outside, will there be an increase in children developing myopia (short-sightedness)?

Will the increase of a reported 50% more time in front of their screens each day speed up the onset of myopia and increase prescription strength at a faster rate in the coming year?

About 40% of the world’s population has myopia and that figure is expected to rise to 50% by 2050.

Myopia causes objects further away to become more difficult to see. People who develop high myopia are at a much greater risk of developing glaucoma and cataracts much earlier in life.

So, what can you do to help your kids eye health during this time of enforced home isolation?

  1. Spend Time Outside

Take your kids outside to play or exercise for at least one hour (preferably two hours) a day to help prevent myopia from developing and progressing.

  1. Plan Fun Activities

There are hundreds of things you can do with your kids; from board games and puzzles to reading a paperback book, having an indoor camp out to creating an obstacle course in your backyard.

  1. Be a Healthy Screen Role Model

Kids watch what their parents do and reflect their behaviour. Be a role model of healthy screen use to your kids. Reduce the time you spend scrolling through your phone, reduce binge watching TV series and turn off the TV as background noise.

  1. Take Phone Breaks

Make sure that, for every half hour of screen time, your kids take a 10 minute break to walk around and stretch their legs.

  1. Reduce Digital Eye Strain

To help reduce the impact of Digital Eye Strain it is important that the screen is no closer than 40cm from your child’s face.

  1. Unplug from Devices

Allocate times in the day to unplug from devices. At dinner time place all the phones on a table away from where you are all eating. Before preparing for bed, place all your phones on charge in another room and spend some time just hanging out as a family.

  1. Type of Screen Time

Be mindful of both the type of screen time and the people your kids are sharing their screen time with, as well as the duration of time they spend looking at a screen. Excessive amounts of time spent looking at a screen can be harmful to your child’s health.

  1. Natural Light is Best

Encourage your kids to sit near a natural light source when they are on their device. Bright, natural light is better for their eyes. If they can’t sit close to a natural light source, ask them to sit near a window angled perpendicular to their computer screen. At night, have their screen placed to the side of a light source, not directly underneath.

If you have concerns about your child’s eye health or you want to know more about the early impact of myopia, contact your local Eyecare Plus practice.

COVID-19 Confusion Causes Risk of Increased Blindness

Eye Injections Shouldn’t Be Cancelled

As a result of the fear and confusion around COVID-19, there is a massive increase in the number of people who could unnecessarily lose their sight to wet age-related macular degeneration (AMD) due to cancelling eye health and macular degeneration treatment appointments.

Australians are required to stay at home, and only go out under certain conditions, in order to flatten the curve and slow the spread of the virus.

Although people can leave the house for essential services, some older Australians won’t leave at all for fear of contracting the coronavirus disease, even for essential eye health appointments that could help them save their sight.

One in seven Australians over the age of 50 have signs of AMD, and the incidence increases with age.

Wet AMD requires treatment for many years but because of the pervading fear around the virus, 33% of patients are cancelling this essential medical treatment.

Eye Injections Shouldn’t Be Cancelled

“Ophthalmologists are seeing a worrying increase in the number of people cancelling eye injections,” said Prof Paul Mitchell AO, internationally renowned ophthalmologist and National Research Advisor for Macular Disease Foundation Australia (MDFA).

“In my own clinic, up to one third of patients with conditions such as wet (neovascular) age-related macular degeneration (wet AMD) or diabetic macular edema (DME) are skipping these crucial appointments. Wet AMD needs treatment for many years, while DME or diabetic retinopathy mostly needs treatment for one year or so and may also need laser treatment. However, none of these people have, or are suspected to have, contracted the virus,” says Professor Mitchell.

“Projecting from my clinic, that means thousands of Australians are gambling with their vision. Without these regular injections, there’s a high risk that people will go blind or suffer significant vision loss, which is often then irreversible,” he says.

Essential Medical Treatment

Prof Mitchell said eye injections are considered essential medical treatment, while any sudden loss of vision in either eye, was an eye health emergency requiring urgent attention.

Ophthalmologists are rescheduling non-urgent appointments or treatments, but eye injections are “essential medical treatments and need to continue as scheduled,” says MDFA Medical Committee Chair A/Prof Alex Hunyor.

Social Distancing Protocols

Clinics are taking even stricter precautions now to protect patients and waiting rooms must comply with social distancing protocols.

“Many ophthalmology practices are asking patients to wait in their cars and calling them to come in only when required. Call ahead. Ask what extra protocols are in place, and what precautions you can take,” Dr Hunyor said.

People are anxious about possibly being fined for leaving the home to attend a medical appointment.

Prof Mitchell stresses that you shouldn’t cancel an essential scheduled eye injection.

“If you are a family carer, or someone who needs to take a person to a scheduled eye injection, you are not breaching public health measures to attend that appointment. Obviously. If the patient has the virus or has had contact with someone who has been infected, the ophthalmologist should be contacted by phone to re-schedule.’’

Self-Isolation Guidance

The Australian Government’s strong guidance is for all Australians to self-isolate, unless for essential medical or health care needs.

For their own protection, people age 70 and over (over 60 for people with pre-existing medical conditions, or over 50 for Aboriginal or Torres Strait Islander people with pre-existing medical conditions) are strongly advised not to leave home unless absolutely necessary.

Wherever possible, people in this category should ask family, friends, neighbours or community members to shop for groceries or collect medicines for them.

Australians still need to take care of their eye health and attend scheduled treatment appointments during this novel coronavirus crisis.

The last thing anyone needs is to emerge from this pandemic with severe vision loss as a result of not treating a major eye disease like AMD or diabetic eye disease.

It is understandable that people are fearful.

For guidance on your eye health contact your ophthalmologist or referring Eyecare Plus optometrist to discuss your concerns and to ask questions. You can also call the Macular Disease National Helpline on 1800 111 709.

Glaucoma: The Patient Journey

Glaucoma management can be a major challenge for a patient.

Whilst a person must adhere to the advice from their eye care professional about how to take their medication, often, as it is with many other chronic diseases, glaucoma can have poor patient adherence.

In fact, it is estimated that one-third of glaucoma patients don’t take their medication as prescribed.

To help improve care management, there are four key stages a patient goes through in the glaucoma journey.

Stage One: Seeing eye care professionals

Once you’ve seen your optometrist and they suspect glaucoma, they will provide you with a glaucoma treatment plan or refer you to an ophthalmologist. At this stage, adherence is essential but many patients can be left untreated because they don’t follow through with appointments. It is critical that once early diagnosis of glaucoma is confirmed, treatment starts straight away.

Stage Two: 1-3 months post-diagnosis

It can be very scary for a person to discover that they have glaucoma.

There is a lot of information to take on board and an individual can only handle so much in a consultation. This is a stage where you, as a patient, will likely have many questions. Write down your questions when you think of them and have them ready for when you see your eye care team.

It is important at this stage to ask all the questions you have of your eye care professional. They can provide you with answers to your questions.

Glaucoma Australia is also available to provide you with a range of support and treatment resources to help you during this time.

Stage Three: 5-6 months post-diagnosis

Several months after you’ve been diagnosed with glaucoma, you move into the third stage of care.

This stage is a crucial point in the ongoing care of a glaucoma patient.

Glaucoma Australia report that only 36 to 50% of patients adhere to their eye drop regime within the first 12 months.

Adherence to your treatment regime, particularly in those first 12 months, is critical to your long-term eye health.

Glaucoma Australia can help you during this stage by staying in touch to find out if you’re having difficulties with the treatment regimen.

Along with your eye care professional, Glaucoma Australia can provide you with education and support to help resolve any problems you may have.

Your team can discuss the importance of ongoing monitoring for glaucoma so that your treatment regimen can be adjusted if required.

Stage Four: 12 months ongoing

After 12 months of living with glaucoma you are in your treatment routine and it’s all about getting on with life.

Glaucoma Australia can help improve your knowledge of glaucoma by sending you monthly email newsletters and, if needed, you can call their free helpline and educator.

Providing personalised phone-based support and automated email communications at each of these stages improves a person’s knowledge of the disease. It helps highlight the importance of treatment and appointment adherence which is specifically aimed at saving a person’s sight.

Glaucoma Australia can provide patients with information about glaucoma, medication advice and ongoing support including individualised behavioural strategies to help improve adherence.

Don’t allow glaucoma to blindside you.

Patients who are living with glaucoma are not alone. Your local Eyecare Plus optometrist and Glaucoma Australia will work with you to help you on the glaucoma journey.