Eye Health Q&A with Expert Laser Eye Surgeon Prof. Dan Reinstein

In our busy modern lives, it can be surprisingly easy to forget about one of the most important assets we have – our eyes. While many of us take our vision for granted every day, expert Laser Eye Surgeon Professor Dan Reinstein is explaining why it is so important to be on our toes when it comes to our eye health.

In your opinion, do people generally take good care of their eyes?

“Unfortunately, a significant proportion of the public are not careful enough about looking after their eyes. A 2014 poll by ICM showed that over a quarter (28%) of adults are not having their eyes examined within the NHS-recommended two-year timeframe. This is quite frightening, given that some eye conditions progress without the person knowing – in fact, World Health Organisation figures indicate that around 50% of people with early glaucoma are unaware that they have it!”

Why do you stress the importance of having regular eye tests?

“The fact is that many eye conditions are treatable with early detection but, if they are allowed to progress beyond a certain point, they can be devastating. We only get one pair of eyes, so this really is too important to ignore.

“An additional reason for having regular eye tests – as if this wasn’t enough! – is that sometimes general health conditions are first detected in the eyes. The eyes are the only organs that you can really ‘see inside’ without invasive procedures, and this means that eye exams can sometimes reveal serious health conditions such as diabetes, hypertension and even some cancers in other parts of the body.”

So why is it so important to take care of your eyes? Are there certain conditions that are preventable?

“The most important examples of eye conditions we can protect against are cataracts, age-related macular degeneration (AMD), and glaucoma. While it’s not possible to completely avoid these conditions, there are steps that anyone can take to reduce their risk of developing sight loss. With cataracts, one of my top tips would be to ensure that you wear sunglasses to block UV rays as much as possible – the most important thing is to ensure that your sunglasses offer the CE Marked label for UV protection.

Smoking is probably the biggest risk factor that can be changed for the prevention of macular degeneration. Quitting smoking may also help with the prevention of the progression of cataracts. While we all know that smoking can make your eyes dry and irritated, the most serious risk is the onset of AMD, which can cause significant loss of the central vision; a 2021 report by the Royal College of Ophthalmologists stated that smokers are more around four times more likely to develop AMD than non-smokers.

“Open-angle glaucoma (the most common type of glaucoma) often presents with no symptoms at all, and vision is usually lost from the periphery first – so may not be initially noticeable. Glaucoma is treatable, but visual damage that has already occurred cannot be repaired. This is why regular eye examinations, allowing early diagnosis, are so important. According to the World Health Organisation, glaucoma is currently the biggest cause of blindness worldwide. Approximately 7 million people are blind from glaucoma and more than half the glaucoma in the UK goes undetected until it is too late to prevent damage to the vision – which explains why it is known as ‘the silent thief of sight’.”

What myths do you tend to hear about eye health?

“There seem to be a lot of myths surrounding eye care and eye health – so this is a really important question. A common myth I hear is that regularly wearing glasses makes your eyesight worse. This simply isn’t true; you may get a headache if your glasses prescription is not accurate, but it cannot harm your eyes. In fact, wearing glasses can actually help to prevent the deterioration of your eyes. This is the case in young children with amblyopia.

Amblyopia (lazy eye) can be treatable if detected early – ideally before the age of 5. The treatment may be as easy as wearing glasses or may involve partial or total temporary patching of one eye. If amblyopia is left untreated beyond the age of 8, there is a much higher risk of developing permanent amblyopia, and of significant visual loss in the affected eye as a result. In fact, amblyopia is the most common cause of permanent visual loss in children in the developed world. Therefore, regular eye examinations for all children are absolutely critical, and are available on the NHS for everyone.”

Are there any diet and lifestyle changes that people can make to improve their eye health?

“Diet and lifestyle are quite relevant to eye health. With respect to Macular Degeneration, a major clinical trial called the Age-Related Eye Disease Study (AREDS) showed a significant link between the antioxidants lutein and zeaxanthin and a reduced risk of AMD. These antioxidants can be found in green leafy vegetables, blueberries, bilberries and tomatoes for example; it’s generally not necessary to take expensive ocular supplements if you’re healthy and have a good diet. Beta-carotene (found in carrots) also had similar effects – so it’s not entirely a myth that carrots can help you see! However, beta-carotene supplements were also shown to produce an increased risk of developing lung cancer in smokers.

Dry eye symptoms are very common in the population. More than half of people suffering from dry eye symptoms actually have something called meibomian gland dysfunction. This is a condition where the tear film quality is low because the oil component is abnormal. Purified Omega 3, found in oily fish such as herring, mackerel, and fresh tuna, can help to reduce dry eye symptoms by improving the oil phase of the tear film.”

What have been the most important technological developments in terms of looking after our eyes?

Technology is extremely important, and there are too many great machines to list them all! For example, the development of OCT (optical coherence tomography) has been very important in allowing us to look at the layers of the retina in much more detail, so we can diagnose problems at the back of the eye more quickly. The Fundus camera – which allows pictures to be taken of the retina through an undilated pupil, can be very helpful for screening for diabetic eye disease. Slit-lamp microscopes can now magnify detail up to 40 times – which is a significant development in terms of the detection and treatment of eye conditions.”

Are there any aspects of eye health that you wish people knew more about?

“I would encourage people to learn more about some of the most common eye conditions. For example, a lot of people think that glaucoma has to do with having high pressure in the eyes but, in reality, you can have glaucoma with a low pressure in the eye. Of course, this emphasises the importance of regular eye examinations, to allow for detection by examination of the optic nerve at the back of the eye.

“Inflammatory diseases are also prevalent in the developed world; arthritis is common, and this can cause inflammation of the eyes – sometimes a serious condition called iritis. If you have an inflammatory condition, it is especially important to have regular eye exams.

“Of course, as a refractive surgeon, some of the most common misconceptions I have to deal with are surrounding the relative safety of contact lenses vs Laser Eye Surgery. Laser Eye Surgery with an expert surgeon using today’s advanced technology is extremely safe. In fact, the safety of modern Laser Eye Surgery surpasses the safety of wearing contact lenses. It’s ironic that some people feel that they’re choosing the safer option by sticking to their contacts!

“Finally, one of the things that most concerns me is that people might ignore a serious eye problem, for fear of making a fuss. Broadly speaking, any sudden significant change in vision, including sudden onset double vision, seeing increasing flashing lights and ‘floaters’, or loss of vision in one or both eyes, should be a cause for concern. People experiencing any of these symptoms should seek urgent medical attention, to rule out potentially serious ocular and general health conditions.”

What is your top tip for people to improve their eye health?

“The main thing I’d like to get across is the importance of having regular eye examinations. Even if you don’t think you have any eye problems, everyone should be having their eyes tested at least once every two years. There are several serious eye conditions – such as glaucoma and retinal holes and tears – which often have no symptoms at all, so the importance of early detection cannot be overstated. It is also important that the eyes are dilated to examine the retina thoroughly, in a full eye examination.”

If you have any further questions about your eye health or would like to learn more about the treatments offered at London Vision Clinic, why not get in touch or Book a Consultation today? We’re always happy to help!