Sight is regarded as our most precious sense, yet over a quarter of people don’t go for regular eye tests, which can help to protect it. Pharmacy staff are well placed to encourage customers to go for tests, and to support them with common eye conditions.

Nine out of 10 people agree that a routine sight test could save someone’s sight, according to the Royal National Institute of Blind People (RNIB)’s Eye Health in the UK report, yet 27 per cent of people have not had such a test in the last two years. This equates to around 14 million people and includes those at risk of glaucoma (raised pressure in the eye), such as people with diabetes and those with a family history of the condition.

Poonam Patel, eye health information officer at the RNIB, says: “From research carried out by the General Optical Council in 2016, the main reason for not having an eye examination was because they had no problems with their vision. This implies that many people aren’t aware that an eye examination doesn’t just reveal whether you need glasses or a change in prescription.”

Pharmacy staff are well placed to educate customers about the benefits of eye tests, as well as to advise and support them with common eye conditions.

Focus on testing

By 2030, the number of people living with sight loss is predicted to increase by a third to more than 2.7 million.

The RNIB says that more than 5.7 million people in the UK are living with sight-threatening conditions, largely driven by the ageing population, with 79 per cent of people with sight loss aged 64 or over.

More than six million people in the UK are living with uncorrected refractive error (long or short sightedness or astigmatism) and sight-threatening conditions, says the RNIB, and almost half of sight loss cases could have been prevented.

A sight test is the most important way to protect sight as it can pick up problems early and enable effective treatment to help prevent sight loss.

“Regular eye examinations are important because there are several eye conditions, such as glaucoma and diabetic retinopathy, which do not cause any symptoms until a lot of sight has already been lost,” says Poonam. “At least 50 per cent of sight loss could be avoided if people had their eyes examined regularly. Many older people are living with sight loss due to refractive error and cataract. Both of these can be diagnosed by an eye examination and, in most cases, the person’s sight can be improved.”

Eye Health UK chair David Cartwright says people often wrongly think that no symptoms mean their eyes are healthy, commenting: “Too many people are simply unaware that some eye conditions, including macular degeneration and glaucoma, may not show symptoms until vision has already been irrevocably lost.”

According to Eye Health UK’s Sight over Sixty report, a third of over 60s who miss out on regular sight tests said the quality of their vision caused them to feel depressed and vulnerable. Another UK study of patients attending a low vision clinic found 43 per cent met the criteria for depression.

Protecting sight

The following tips can be passed on to customers to help them maintain good eye health:

  • Give up smoking as it can significantly increase the risk of AMD (age-related macular degeneration). In fact, the link is as strong as the one between smoking and lung cancer
  • Eat a diet low in saturated fats but rich in leafy vegetables and omega-3, as this may help to protect against cataracts and AMD
  • Wear prescribed glasses. Wearing glasses or lenses doesn’t make sight worse – they help the eyes work more efficiently, so if they have been prescribed, encourage people to wear them
  • Take regular screen breaks about every 20 minutes and look at something 20 feet away, for 20 seconds
  • Wear sunglasses as UVA and UVB rays may increase the risk of cataracts.

At risk groups

While it’s recommended that everyone has a sight test every two years, some people are more at risk of problems, says Poonam. “As we get older, we are increasingly likely to develop sight loss. One-fifth of people aged 75-plus and half of those aged 90-plus are living with sight loss,” she explains. Others at risk include:

  • People with a family history of eye conditions (e.g. glaucoma)
  • People with diabetes
  • Certain ethnic groups (e.g. people from Afro-Caribbean backgrounds are at greater risk of developing glaucoma or diabetes)
  • Children who have a squint, lazy eye or wear glasses
  • Smokers are at increased risk of age-related macular degeneration (AMD).

Encouraging customers to have tests

Everyone should have an eye test at least 
every two years

Henry Leonard, clinical and regulatory officer at the Association of Optometrists (AOP) says that pharmacy staff can provide customers with information and “explain the benefits of having regular sight tests and how this can help detect and guard against eye conditions as well as general health conditions.” 

David advises that in order to improve their offering around eye care, “the first step would be for pharmacy teams to talk to their local optometrist to understand what each can offer and encourage cross-referral. Take relevant opportunities to talk about specific eye health issues, [for example] ensure customers who have a positive diabetic test result are made aware of the importance of annual screening, or when dispensing drops to glaucoma patients, mention the importance of family members having regular sight tests.”

Poonam adds: “Advising customers that sight tests are free for certain groups can encourage people to go. People purchasing ready-made reading glasses should be advised they are not a substitute for an eye examination.”

What can an eye test detect?

As well as picking up vision problems, an eye test can detect glaucoma, cataract, macular degeneration, dry eye and inflammation of the cornea. Many people are unaware that an eye test can also detect a range of general health problems including diabetes, high blood pressure, thyroid disorders, auto-immune problems, pituitary tumours, high cholesterol and dementia.

“Sight tests are about more than just eye health. Failing to have regular sight tests means opportunities for the early detection, management and in some cases prevention of conditions such as hypertension, high cholesterol and strokes are missed,” says David.

Supporting customers

“For people diagnosed with glaucoma, pharmacy staff can explain the importance of administering their eye drops correctly and what compliance aids are available if needed. They can ensure people with diabetes know the significance of having regular retinal screening. For those with AMD, there is evidence that some nutritional supplements have been shown to reduce progression of the condition,” says Poonam.

David advises that “clearly and correctly labelling medication with intended dosing in as large a font size as possible,” can also be of benefit to customers with poor sight.

Contact lens care

When it comes to contact lenses, good hygiene is imperative, not only for keeping eyes free from infection, but for comfort and vision too. Contact lens wearers should be advised to:

  • Change their contact lenses as often as their practitioner has advised
  • Never shower or swim while wearing lenses
  • Never wash lenses in tap water
  • Always wash and dry their hands before touching their eyes
  • Never sleep in their lenses, unless advised to do so by their practitioner
  • Apply make-up after putting their lenses in
  • Never wear lenses for longer than their practitioner has advised.

Getting the best from treatments

“If patients need medication to manage their condition, you can support them by explaining the importance of taking their medication as advised and how to use it effectively. Many older patients struggle to use eye drops and you can show them the best way to use these,” says Henry. This involves explaining the need to:

  • Look at the ceiling while tilting head backwards
  • Gently pull the skin of the lower lid between the thumb and index finger to create a “pocket” for the drop
  • Look up and gently release the drop into the pocket.

When using ointments, the technique is slightly different:

  • If applying to the eye’s surface, form a pocket by pulling the skin of the lower lid between the thumb and index finger. Express a quarter to half an inch strip of ointment into the pocket
  • After putting ointment into the eye, blink or close the eye to help spread it across the eye
  • If applying to the edges of eyelids, put a half inch amount of ointment onto a finger and wipe across closed lids near the base of the lashes
  • Use a clean tissue to remove any excess.

For more detailed tips and advice on eye health, visit the AOP website.

Originally Published by Training Matters


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