Eye health
Life before the drought
(1999)
Julie Weekes
Acrylic on archer paper
This artwork is provided by the Edith Cowan University Art Collection.
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The painting:
Basically the painting tells the viewer that life is controlled by the change of the environment. This change has taken place within thousands of years, yet man within an eye blink can cause the same change in the land for the sake of development.
The artist:
My mother is fifth generation Australian of European descent and my father a Torres Strait Islander. I grew up knowing I was an Islander but had no knowledge of my family or culture.
Plain language
Information has been provided here on background information relating to eye health.
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Plain language
- What is known about the eye health of Indigenous Australians?
- » What is known about eye health?
What is known about eye health?
If you have problems with your eyes and can’t see properly it can be difficult to do things like cooking, reading, watching TV, or mixing with other people, or finding a job. It may also mean that you have to depend on services and on other people in day-to-day living.
The health of your eyes can get worse through:
- old age
- sickness
- smoking cigarettes
- injury
- exposure to sunshine
- not having a healthy diet
- illness passed down from your parents or grandparents
- being born early, before the due date (prematurely)
For 8 out of 10 people in the world who become blind their blindness could have been prevented [1]. For many eye problems, treatment doesn't cost a lot and is often successful.
In Australia, the percentage of the population over the
age of 50 years is increasing. The risk of eye problems increase
as people grow older and it is expected that by the year 2030
the number of people who have problems with their eyes and
can’t see properly will be double what it is today [2].
A study in Melbourne found that for people aged 40 years or
older there were five major causes of eye problems:
- eyes couldn’t focus normally (refractive error)
- cataract (the lens of the eye becomes cloudy)
- eye damage caused by ageing
- eye damage caused by diabetes
- glaucoma (disease which causes damage to eye nerve cells) [3]
Eye focussing problems (refractive error)
For a person to be able to see properly, the image of an object needs to be focussed on light-sensitive tissue at the back of the inside of the eye (the retina). If the image is not focussed correctly, it will look blurred (not clear).
The main types of focussing problems are:
- long-sighted vision (hyperopia), which occurs when the eyeball is too short and light rays focus behind the retina, making close objects look blurred.
- short-sighted vision (myopia), which occurs when the eyeball is too long and light rays focus in front of the retina, making distant objects look blurred.
- astigmatism, which is due to the shape of the front surface of the eye (the cornea) not being normal, causes blurred images at all distances. Astigmatism often occurs with long-sighted and short-sighted vision.
- focusing problems for older people (presbyopia), are usually noticed over the age of 40 years. These problems are caused by the lens of the eye losing its flexibility and being less able to change shape, making it harder to see close objects.
People should have regular eye tests - by an optometrist or doctor - at least once every five years. If you suddenly develop a serious eye problem your eyes should be examined without delay. Spectacles or contact lenses can be used to correct refractive error. Surgery is also available for some refractive error problems.
Eye problems caused by diabetes (diabetic retinopathy)
If a person has diabetes, it can cause a problem with their eyes called diabetic retinopathy. Diabetes is a sickness that happens when the body does not produce enough insulin (a hormone which controls the amount of sugar in our blood).
Diabetes can cause damage to small blood vessels in the light-sensitive
tissue at the back of the inside of the eye (the retina), which
affects the ability to see properly. The blood vessels that
supply the retina may expand and leak fluid [4].
A person may not notice any change in their vision when they
develop the early form of the disease.
Further problems can be caused by leaking fluid gathering
in the eye. This can make reading and other viewing difficult.
Sometimes delicate new blood vessels may grow on the surface
of the retina and can cause serious vision problems. Scar
tissue may also develop, which can pull the retina away from
the back of the eye and possibly cause blindness.
If you have diabetes, you will need to have regular eye checks.
Early treatment can prevent eye problems getting worse. The
longer the time a person has diabetes, the more likely they
are to develop eye problems.
To prevent diabetic retinopathy, a person with diabetes needs
to follow treatment advice from a health professional.
Some people with diabetes, such as pregnant women and those with high blood pressure, have a higher risk of developing diabetic
retinopathy
[4].
Trachoma
Trachoma is an eye infection caused by a type of bacteria.
In some parts of the world, it is a common eye disease that
causes blindness and millions of people need treatment. In
Australia, it mainly affects the Indigenous population in
northern and central parts of the country and is due largely to
poor living conditions [5].
The early stage of trachoma usually occurs in young children,
most commonly aged 2 to 3 years, but can occur in older children
up to the early teenage years [5].
If not treated, trachoma can damage the
eyes and eyelids [4]. This can make the eyelashes turn inwards and damage the front of
the eye (cornea), which becomes 'cloudy'. Eventually a person
can become blind. Trachoma can be treated by taking antibiotics
(medicine).
A strategy that is recommended to prevent trachoma (developed
by the World Health Organization) is known as SAFE,
which stands for:
Surgery for in-turned eyelashes
Antibiotics (medicine)
Facial cleanliness and
Environmental improvement [6].
Gonococcal conjunctivitis
Gonococcal conjunctivitis is a highly infectious, painful
and sight-threatening condition caused by a type of bacteria.
Symptoms include intense inflammation of the eye and discharge
[7].
This type of bacteria is usually passed between people through
sexual contact, but it can also be passed by non-sexual contact.
It only survives in warm, moist conditions and dies rapidly
in a dry cold atmosphere.
Medical tests are needed to see if a person has the disease. Antibiotics are used for treatment.
Eye damage due to the ageing process (macular degeneration)
As people get older they can develop macular degeneration, which is damage to the macula (a small part of the retina) that helps a person see fine details. It is a disease that affects the centre of the field of vision and is a common reason for poor eyesight for people aged 60 years or older. People who smoke are more likely to develop age-related macular degeneration than those who don't smoke [8].
Cataract
A cataract is a 'clouding' of the clear lens of the eye
that prevents light from reaching the retina at the back of
the eye. In its early stages, a cataract may cause reduced
vision but eventually it can cause blindness. People are more
likely to develop cataracts as they grow older.
Cataracts can also be caused by:
- smoking cigarettes
- sun exposure
- diabetes
- injury to the eye
- some drugs
An eye test will show if a person has a cataract. If an operation is needed, the lens of the eye is replaced with an artificial lens. Usually the person only needs to go to hospital for a day. This operation usually helps a person to see again, but they may need to wear glasses.
Glaucoma
Glaucoma is a condition that leads to poor drainage of the
clear liquid that normally flows in and out of the front section of the eye. This
causes increased pressure that can damage the nerve cells
and lead to loss of eyesight.
The symptoms are usually not noticeable to the person affected
until damage has been done to eye. To see if a person has
glaucoma, an optometrist or doctor examines the eye's nerve
fibres and drainage network and measures eye pressure (using
an instrument called a tonometer).
The risk of getting the most common form of glaucoma increases
with age. Unfortunately, half of those people with glaucoma
do not know that they have the disease and do not receive
treatment. Without treatment, they will lose vision and once
this vision is lost it cannot be restored.
A family history of glaucoma increases the risk at least four
times [9]. People with glaucoma need to tell
their brothers, sisters, sons and daughters (first-degree
relatives) about their family risk of developing glaucoma.
People who have a family history of glaucoma need to have
their eyes checked regularly.
Pterygium
A pterygium is a triangle-shaped thickening in the inner
corner of the eye [10]. It does not produce
many symptoms, but in some cases the eye may become red and
inflamed. A pterygium can grow over the iris (the coloured
part of the eye) and can damage eyesight if it extends over
the pupil, through which light has to pass to the retina on
the back of the inside of the eye.
It is likely that a pterygium is caused by sun exposure and
affects people who live in the warm, dry regions of Australia
and those who spend most of their time outdoors.
Other reasons include:
- allergies
- irritants such as wind, dirt, dust, air pollution
- some chemicals
- possibly family risk
The pterygium growth needs to be removed by a doctor if it is growing inward towards the pupil because it could damage a person’s eyesight permanently.
References
1. Holden B (2000) The right to sight
[editorial]. Clinical Experimental Optometry;83(3):113-115
2. Foran S, Wang J, Rochtchina E, Mitchell
P (2000) Projected number of Australians with visual impairment
in 2000 and 2030. Clinical and Experimental Ophthalmology;28(3):143-145
3. Taylor HR (2003) Eye Care for the
future: the Weisenfeld lecture. Investigative Ophthalmology
and Visual Science;44:1413-1418
4. Office for Aboriginal and Torres
Strait Islander Health (2001) Specialist eye health guidelines
for use in Aboriginal and Torres Strait Islander populations.
Canberra: Commonwealth Department of Health and Aged Care
5. Taylor HR (1997) Eye health
in Aboriginal and Torres Strait Islander communities: the
report of a review commissioned by the Commonwealth Minister
for Health and Family Services, the Hon. Michael Wooldridge,
MP. Canberra: Commonwealth Department of Health and Family
Services
6. Communicable Disease Network Australia
(2006) Guidelines for the public health management of
trachoma in Australia. Canberra: Department of Health
and Ageing
7. Matters R, Wong I, Mak D (1998)
An outbreak of non-sexually transmitted gonococcal conjunctivitis
in Central Australia and the Kimberley region. Communicable
Diseases Intelligence;22(4):52-58
8. Mitchell P (1999) Smoking is a major
cause of blindness. Medical Journal of Australia;171:173-174
9. Taylor HR (2002) Eye care for the
community. Clinical and Experimental Ophthalmology;30:151-154
10. Thomson N, Paterson B (1998)
Eye health of Aboriginal and Torres Strait Islander people.
Aboriginal and Torres Strait Islander Health Reviews, Number
1. Perth: National Aboriginal and Torres Strait Islander
Health Clearinghouse
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