‘There is an epidemic of short-sightedness’

There is an epidemic of short-sightedness across the developed world, according to Dr Emma Duignan, consultant ophthalmologist at the Royal Victoria Eye and Ear Hospital in Dublin.

“It is estimated that there will be five billion myopic (short-sighted) people in the world by 2050,” says Dr Duignan, who specifies that time spent on screens and in artificial light (especially LED lights) are contributing factors to the rise in this eye condition.

“A lot of screen time without breaks, lack of time spent outdoors in daylight hours and lack of using your vision to infinity (ie distance vision) are causing the increase in short-sightedness,” she adds. The so-called 20-20-20 rule — which encourages everyone to look away every 20 minutes at an object that is about 20 feet away for a full 20 seconds — is a good one to follow especially for children.

There are now drops available to prevent the progression of short-sightedness and specific glasses for children, which are designed to try to give clear vision while also reducing the progression of short-sightedness. Adults who are short-sighted can be more prone to retinal tears or retinal detachment so if you are short-sighted and have a sudden onset of blurry vision, flashes of light or floaters (shadows across your vision), this requires immediate attention by an ophthalmologist.

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Dr Duignan is one of the eye specialists who will give free advice to members of the public at the Fighting Blindness Retina conference’s Public Engagement Day on Saturday, November 5th in the Radisson Blu Royal Hotel, Golden Lane, Dublin 2 (fightingblindess.ie for registration in person or for remote streaming of event). This public event comes after two days in which eye experts from the UK, the USA join experts in Ireland to discuss the latest developments in genetic testing and gene therapy treatments for rare eye diseases such as retinitis pigmentosa.

Like all hospitals, the Royal Victoria Eye and Ear Hospital had to implement new infection control measures during the Covid-19 pandemic. Eye doctors and nurses also had to find new ways to deal with high volume conditions such as cataracts, glaucoma and Age-related Macular Degeneration (AMD).

“Covid forced innovation for eye care. We were lucky in that the new cataract theatre had recently been opened, which has almost doubled the amount of cataract surgery done in the hospital. Also we have more specialist ophthalmic nurses trained to do the injections for wet AMD,” she explains. The opening of a new ophthalmology clinic in Tallaght, Dublin in late 2021 has resulted in an extra 9,500 patients seen at this clinic rather than at the hospital itself.

The number of patients with cataracts continues to rise as our population ages and cataract surgery is deemed a low risk surgery with a very high satisfaction rate. “It has been described as the most cost-effective surgery to improve quality of life,” explains Dr Duignan.

—  People sometimes pick up nasty eye infections when on holidays in exotic destinations when wearing contact lenses when swimming

The development of new drugs in 2005 to treat wet AMD has resulted in many more people being successfully treated for this eye disease, which is prevalent in older people.

“The success of treatment for AMD is related to how quickly it is treated. It’s best if patients are seen without two weeks of noticing the leaking blood vessels associated with the condition,” explains Dr Duignan.

Currently, one third of patients treated for wet AMD will maintain their vision, one third will have improved vision followed treatment and about one third will have a decline in their vision. Research is ongoing to find suitable treatments for the dry form of AMD for which there is currently no treatment.

Glaucoma is another common eye disorder, which is caused by high pressure leading to damage of the optic nerve at the back of the eye. Opticians refer their patients with abnormal pressure in the eye to the Royal Victoria Hospital. And while many of these patients won’t have glaucoma, it’s important to have it checked out because there are no other symptoms of this condition, which can lead to blindness if not treated by drops.

Listening to Dr Duignan speak about the various conditions is a reminder of how precious our sight is and how important it is to look after our eyes well.

More common conditions such as conjunctivitis are usually caused by a virus and usually go away without treatment. But, if there is sight loss or severe pain from the eye, this becomes an emergency requiring immediate attention.

Dr Duignan strongly advises contact-lenses wearers not to wear their lenses when swimming (in the sea, lake or swimming pool) or when in the shower. “The problem is that fluid can be trapped under the lenses which can contain some of the worst pathogens. People sometimes pick up nasty eye infections when on holidays in exotic destinations when wearing contact lenses when swimming,” she explains.

Her final advice for anyone who suffers from dry eye is to address the cause rather than treat the symptoms with eye drops. “The glands in the eye lids create oil for tears and this oil gets stuck if the lids are inflamed. If you place a hot facecloth on your eye lids for a couple of minutes and then put gentle pressure under your bottom eye lid with a cotton bud, you can express the oil from the gland, which will bring moisture to the eye,” she explains.