Problems with floaters?

Problems with floaters?

Floaters are experienced as grey, blurred shapes that appear to float around in your eyesight. Most people have them, most of the time they are harmless and just a little irritating. But if they trouble you badly, what can you do?

First of all, if your floaters have changed recently or suddenly, if you're seeing white lights, lots of small dots or black shadows or curtain effects, all of those should be investigated promptly. The rest of this article is about everyday floaters that most people experience.

Let's establish what's going on. Anatomically, your pupil is the dark spot in the centre of your eye where the light passes in. Behind that is the lens that focuses the light onto your retina at the back of the eye. What fills the space between your lens and your retina is a clear, jelly-like substance called vitreous humour which is created when we are in the womb and stays there for life. If you have them, floaters are probably there for life too.

As we age, the vitreous humour can change. It can become more liquid, so allowing debris to float around more freely. We experience that 'debris' as floaters, since they float around making shadows on our retina, rather like in a small cinema you can reach up and make hand shadows on the screen. With your eye still, floaters will probably (counter-intuitively) sink to the lowest part of your eye, so if you sleep on your back they may settle on your fovea (the part that sees what you're looking directly at) and trouble you more on waking until they are shaken free by normal eye movement.

Vision is an extremely sophisticated brain process and over time, our brains can learn to ignore some of our floaters by combining what we see from both eyes into one image. It's unlikely that you have a floater in the exact same position in both eyes so the brain chooses what it wants before composing the image for you.

Amazingly, it's because floaters float that they are so difficult for our brain to ignore. By contrast, our retina has permanent blood vessels that are completely 'in the way' of us seeing, but our brain knows where they are and ignores them so completely we are unaware of their existence.

In terms of treatment, there's not a lot that can be done medically. In 2% of cases floater trouble is caused by a detached retina, and only surgery can re-attach it.

If you search the Internet for solutions, you might find a couple (neither are available from Pagan & McQuade). There is an operation in which the vitreous humour is replaced. There is also vitreolysis, a laser treatment that converts the floaters to a gas that is re-absorbed. There are risks associated with such treatment, however, so the advice is usually that floaters present no real health risk and it is better to leave well alone.

Having said that, there are some things you can do yourself. Floaters appear worse when you look at a light, plain area such as the summer sky or a white wall. Consider redecorating with rich colours and patterns. Looking rapidly up, down, left and right might move a particularly annoying floater out of the way for a while. Wearing dark glasses can help too because bright light makes the pupil smaller which brings floaters more into focus, less light opens up your pupil and makes the front-to-back distance that's in focus inside your eye much smaller, so there's a lower probability that any one floater is in focus.

Can't sleep at night? Could be blue light from your screens.

Can't sleep at night? Could be blue light from your screens.

There's a lot of interest at the moment in blue light and how it affects us. Particularly interesting is whether the light given off by computer screens, smartphones and televisions, used late at night, could be fooling our brains into thinking it's still daytime and stopping our natural slowdown into bed and sleep. If you're laying awake at night, blue light could be contributing. Irritated eyes? Headaches? It could be blue light.

The rise of smartphones and tablet computers is said to be part of the problem, but it's not the whole story. To really understand, we need to get a little technical.

So what is blue light?

Light reverberates with a frequency, like a radio frequency. We perceive different frequencies in the visible range as different colours. A wavelength is the distance from peak to peak of that wave. X-Rays, UV, visible light, microwaves and radio waves are all the same thing, just with different wavelengths. X-Rays have extremely small wavelengths, while radio waves can have very long wavelengths of a kilometer or more.

Visible blue light tails off into ultraviolet light (UV) at the extreme end of our ability to perceive light. UV is categorised into three types.

  1. UVC is light with a wavelength of between 279 & 200nm (nanometers, a millionth of a millimeter). We needn't worry too much about this as it's filtered out by the ozone layer. It is used to sterilise, for instance in dentistry.
  2. UVB light has a wavelength of between 314 & 280nm. It gives you sunburn, and it is implicated in skin cancer, cataracts and the degeneration of retinal tissue.
  3. UVA has a wavelength between 380 & 315nm and is the sort of UV you might encounter in a nightclub or tanning salon.

Finally we have 'blue light', near UV, which is light between 381 & 500nm in wavelength. About 25-30% of sunlight is 'blue light'.

The UV index provided by the weather forecast is designed to let you know the risk of sunburn, so it concentrates on UVB. Stratospheric ozone loss has led to the penetration of more UVB over the last few decades. Just in case you were thinking of it, don't go above 4,500m high in Bolivia where a UV index of 43.3 has been reported (11 is 'extreme risk', the highest in Scarborough has been about 8.2, however remember that UV intensity can double if you are near reflective surfaces such as water, sand or concrete).

So blue light exists in nature, we've adapted to it so there's nothing to worry about, right?

We are adapted to 'normal' sunlight, of course. The problem is that UV damage is cumulative over your lifetime, and we are living longer. To live longer without increasing the risk of UV damage to our eyes, we need to protect them.

There are a couple of points to make here. Most of the UV your retina will receive during your life is received before age 20, after that the eye lens becomes a natural absorber of light wavelengths between 400 & 320nm (a little 'blue light' and most UVA). This helps to make a case now for giving children UV eye protection. New PNX lenses can filter 100% of the UV and aren't expensive. Also that UV energy, absorbed by the lens of the eye, can contribute to cataracts, so you need UV protection as an adult too. UV is thought to be a contributory factor to macular degeneration (as well as cataracts, skin ageing, immunosuppression, DNA damage and skin cancer).

But let's get back to blue light. Fluorescent tube lighting produces blue light. How fluorescent tubes work is: electricity excites mercury vapour that produces UVC at 254nm, and that light excites a phosphor coating on the inside of the glass that re-emits visible light. Any UVC that isn't absorbed by the phosphor is absorbed by the glass. No problem. But mercury also emits at 365nm (UVA), and that may not be absorbed by the phosphorus and most will pass out into the environment. If you have fluorescent lights at work, you will be getting nearly 14% of your UVA exposure from that alone.

The nub of the blue light problem for optometrists, though, is backlit LED screens (if you can still see your screen at night with the room lights off, it's backlit). The light from those peaks at 460nm (blue light). (Backlit screens emit 3.2 times more blue light than non-backlit screens.) Humans have a novel, non-visual, short-wavelength-sensitive photoreceptor system that drives and resets our circadian pacemaker. In simple terms: we have a specialist blue light sensor that tells our body when it's daytime and when it's night-time. It drives melatonin production, alertness, performance, and raises or lowers brain activation. As we get closer to bed-time, we really want that system to calm us down and edge us towards sleep. Contrarily, blue light shouts daytime! Screen light can tell our brains to stay awake and alert, and our circadian clock can get confused.

So what can we do about blue light? In simple terms, don't use a screen (computer, TV, smartphone, tablet) late in the evening (which is when most people want to use one).

If that seems unreasonable, pop in and talk to us about solutions. Blue Control, a spectacle lens coating, is especially formulated to stop blue light so you can carry on enjoying late night films or social media without interfering with your sleep.

There's another benefit of Blue Control that you might like. White light is composed of a mixture of coloured light. Each colour requires our lens to be set slightly differently for clear focus. That means our eyes are constantly judging the best possible average focus point depending partly on the colour composition of the scene you are looking at. By removing blue light, Blue Control reduces the range of values our eyes are trying to focus for, making focusing easier. The result: clearer sight and less eye strain (athletes wear Blue Control for extra clarity and performance).

UK-wide optician competition winner is from Pagan & McQuade

UK-wide optician competition winner is from Pagan & McQuade

A UK-wide competition offering a trip to Paris or £1,000 of travel vouchers has been won by one of our customers (and the competition went so well they ran it again).

The winner, Jane Ledger, said "I might use it to go to a jazz festival in Brussels. Jazz in the squares with a glass of wine sounds good. My husband is retired now, but was a jazz musician. I've used Pagan and McQuade for maybe 30 years."

Pagan and McQuade submitted the most entries of all opticians practices in the UK in a competition run by Hoya Lens UK that offered clients of independent practices the opportunity to win a trip to Paris in prize draw.

Sam Noble, practice manager, said "we always try to go the extra mile for our clients, and taking the trouble to complete the competition form for everyone eligible is just one example".

Hoyalux iD lenses are created digitally to give the clearest vision across the whole lens. In practice, a lens for indoor use might provide for the TV to be in focus at the top of the lens, and close needlepoint or reading towards the bottom. A driving lens would make sure everything is as sharp as can be in all directions at appropriate distances.

10 ways not to lose your glasses

10 ways not to lose your glasses

(Or ten gift ideas for loved ones who do. Also, 2 tricks for you if you do.)

1. Get a cord or chain and hang them around your neck. We sell some fairly functional ones. We don't recommend beaded chains as they tend to break and/or get tangled, but if you fancy something a bit more special try Etsy (it's a website where craft makers sell their wares. Also we asked Totally Locally Scarborough for their suggestion of the best local shops to try, and they suggested perhaps having something custom made by Mags Hollingworth or Chris Rose Linacre, both of whom have work at the pop up shop in the Stephen Joseph Theatre, or try Luckenbooth in the market vaults.

2. Get a glasses caddy so you always put your glasses in the same place.

3. Get a pair of glasses with indoor lenses. That way, you'll put them on and forget about them. It's reading glasses that are lost most often because they are constantly being taken off and put back on again. Proper indoor lenses, customised for you, can be graded so that when you look down through the lower part of the lens it helps you focus on your book, and when you look up you look through a different part of the lens and can see across the room to your family, friends or colleagues or the TV. So you put them on and leave them on.

4. Store your glasses in the neckline of your top. It's not a perfect solution but it's better than putting them on your head, don't do that, it stretches them, we value our precision fits.

5. Have a bright, visible case you always use.

6. Get a gadget. Something like TrackR or Tile can provide a way for you to find things you lose. They are still a bit big for use directly on your glasses, but at least you could find your glasses case.

7. Train yourself to take care at key places, or when things happen such as interruptions. The most common places to lose your glasses are: the swimming baths, in a taxi, in a night club, on the train, in the library, at an airport, on the beach, in the pub or at a restaurant, in a hotel and at the gym.

8. Buy an eyeglass pin (again, try Etsy).

9. Train yourself to be aware when you put your glasses down. One way is to literally say it out loud "glasses on the sideboard". Hearing yourself say it helps you remember it (our hearing provides extra memory capabilities).

10. Get an eyeglasses stand, and don't put down your glasses anywhere else.

So there you go, ten ways not to lose your glasses. But I promised you two bonus tricks, too, for if you do lose your glasses. Ready? Here goes:

Trick one: Try making a tiny hole in a piece of paper or card, and peer through that. The small aperture helps you focus.

Trick two: If you are short sighted and can't find your glasses in your room, try taking some photographs of your room from where you are, with your smartphone. Being short sighted you'll be able to see the image, which is an in-focus shot of your room .. clever, eh? Zoom in and seek your eyewear.

Do check your glasses are covered by your house insurance.

And never put down your spectacles lens-down. One day, or over time, they'll get scratched right in the middle, where you need to look.

Why you'll love digital lenses

Why you'll love digital lenses

For years, spectacle lenses have been made by taking a stock lens for your main prescription off the shelf, and grinding the rear side to customise it.

Most of our lenses at Pagan and McQuade nowadays are made using 'digital' methods but it's still a new development and the benefits are only now being realised by many. Your next quality lenses are likely to be made this way.

Digital lenses are manufactured by translating your prescription into thousands of precision cuts at 'pixel' positions on the lens surface. A special coating then makes it smooth.

So what?

Four things:

1) When you take your eye test and get your prescription, you're looking straight ahead. In the real world, when you look to the side (for instance, when reversing your car or playing sport), your eye changes angle and requires a different prescription. Digital lenses compensate for that and give you the correct prescription across the whole lens so you get sharpness and clarity wherever you look.

2) Most people's eyes are not round, but rugby ball shaped. This means the prescription up and down may be different to what's needed side to side. Again, it's a bit technical, but lens manufacturers with the new digital manufacturing capability can extract more from your prescription and give you spectacle lenses that compensate. Looking has never felt so comfortable.

3) Years ago it took practice to walk safely while wearing old style varifocals. Modern, digital varifocals minimise swim effects and optimise usability, so you get the prescription you need where you need it across the whole lens.

4) Opticians used to have to correct both eyes individually. With digital spectacle lenses, we can optimise your eyes as a pair, so they work as a team as nature intended.

Wearing spectacles is a new experience today. Maybe it's time to upgrade your specs.

£1 reading glasses, why not?

£1 reading glasses, why not?

Even if you've enjoyed perfect eyesight for your first forty years, you're likely to start to need reading glasses sometime in your forties. That's because the lens in each eye becomes harder as you get older. The muscles that surround your lens and pull it into focus begin to tire and find it hard work and most often this starts to affect close, detailed work. The first sign is usually a frown, or starting to hold your books, newspapers and smartphone at arms length.

If you are not used to opticians, eye tests and to spending money on eyecare, you might have decided to just buy off-the-shelf reading glasses from the garage forecourt or pound shop, just to see what it's like, see if they help, see whether you can get on with wearing glasses. This may work for a time, but sooner or later the problems become obvious.

They don't match your prescription

When you are given a prescription from your eye test, it contains six elements. £1 readers will probably only correct for one of those (leaving the other five uncorrected to cause you eye strain and headaches). So £1 readers are not a proper test of whether you can get along with glasses or not, because they are not correcting your eyesight accurately enough. Worse, it's likely your eyes don't require the same prescription. So between your two eyes, and the six elements, £1 readers probably solve a twelfth of the problem.

They look like £1 glasses

Of course, the best designers don't design £1 readers. You will end up using those £1 readers in public, in a restaurant to try to read the menu. How much do you value your public image? Dispensing opticians have seen thousands of people choose glasses, and they are there to help you find a style that says the right things about you, to dispense glasses that help you in life, rather than hold you back.

They won't fit (they'll slip or keep falling off)

Dispensing opticians take great care to ensure glasses fit properly, here at Pagan & McQuade we have Hoya's visuReal electronic measurement system to ensure we measure everything accurately for the best possible fit.

One of the first considerations is the distance between your pupils (ie. how close or far apart are your eyes). Lenses should be placed so the optical centre of the lens, which is where your prescription is fulfilled most accurately, is right in front of each of your eye pupils. Off the shelf glasses would only manage that by chance and if they are wrong, they'll cause eye strain and prismatic effects, aberrations and viewing discomfort.

Cheap, off the shelf glasses are provided as-is, without any custom fitting of the frames at all, so you're likely to experience problems. For example, they may be too close or too far away from the eye, they may slip or fall off entirely, they could hurt, or they might rub and irritate your nose.

A final consideration is what we call the pantoscopic tilt, which is how much your lenses slope forward. For pure reading glasses, they should lean more than usual, but as qualified opticians we always fit individually for you, so it depends on your prescription, your lifestyle, your particular needs as well as the frame you've chosen.

Glasses should be part of you: they should fit comfortably, be in the correct position for their use, and you should be confident they will stay in place.

They are not coated

One of the major irritations with budget glasses is you'll always be cleaning them because they haven't got an anti-grease (oleophobic) coating. That's an important consideration for reading glasses because you don't put them on and leave them, you put them on, take them off, put them on again .. each time transferring grease from your hands to your lenses. An oleophobic coating helps to keep your glasses clean.

Pagan & McQuade recommends that your lenses are protected by multi anti-reflective coatings .. so when your friends and family look at you, they see the expression in your eyes rather than a reflection of the sky. Reflected light is light you never saw. An anti-reflective coating lets more light in so you'll see better.

The advantage of £1 readers, then, is they cost £1. Of course we say that you get what you pay for and that a properly prescribed, fitted and customised pair of glasses from us will help you avoid eyestrain, you might see and engage more with those around you, and you'll look better for it. Most people come around to realising that £1 readers really don't solve the problem, and you may then invest in a pair of glasses designed by professionals to suit you. When you are ready to take the plunge, just remember: figures show that on average independent opticians save you money over the national chains, so pop in to Pagan & McQuade and upgrade your specs.

Optical Coherence Tomography and you

Optical Coherence Tomography and you

In the last newsletter, we talked about retinal photographs and how important it is that we can take a photograph of the back of your eye and compare it to the photographs from last year and before. If there are any significant changes, we said, we'll spot them and can act accordingly.

Imagine the retinal photograph as a photograph of your skin. That's great, if we take another in a year, we'll be able to see if anything's changed.

It only goes so far, though. What's happening underneath the skin? What if we could see in 3D, under the skin, see the dermis underneath, the fat layer under that, then the muscles and finally bone? That would be much more thorough.

Well, nowadays we can do that with the back of your eye, in less than a second. Our new Optical Coherence Tomography (OCT) scanner (layer scanner to you and me) does all the hard work. Using it, we'll be able to see the layers under the surface of your retina and we'll be able to spot changes earlier and act sooner to protect your eyesight where appropriate.

So whereas a 'normal' eye test can tell you how your eyesight is and give some information about your general health, and an eye test with a retinal photograph can give us advanced warning of significant changes, a layer scan can safeguard your health and provide you with that extra reassurance that you've taken every reasonable precaution to protect your sight into the future.

The scan itself is, of course, quick and comfortable. Here's the promotional video from the manufacturer which shows some of the detailed scans we are now able to provide to help us keep you healthy.

Our OCT layer scanner allows us to provide leading edge eyecare today. Few opticians practices have invested as much as we have in the care of your sight, and we are the first Optician's practice in Scarborough to offer this service.

Download the brochure

The Dangers of Old Blue Eyes

The Dangers of Old Blue Eyes

Of all the options in coloured contact lenses, blue is the most popular. Strange, then, that blue eyes are becoming less common1. Perhaps the increasing scarcity is making them more desirable.

Anyway, blue eyes aren't really blue. There's nothing inside the eye that you can say is 'blue'. The reason they appear blue is .. well, it's a trick of the light. Actually it's the same trick that makes the sky appear blue (and if you go up you won't find any blue bits there either). Seen from space, the sky is black and the sun is white. No blue. No yellow.

(While we're talking about space: moonlight is blue. It's just we don't see the colour2 because at low light we mainly use our retinal rods, and they see in black and white.)

OK so what makes brown eyes? That is a pigment: melanin, the same pigment that makes us tan or makes naturally dark skin. Brown eyes contain melanin and that is perceived as the dominant colour. Blue eyes, then, are eyes that are missing melanin.

So what's the downside of blue eyes?

Blue eyes may be popular, but there's a small problem. Dark colours absorb light, light colours reflect it. Light is energy and energy does all sorts of damage, so the brown around the entrance to the eye absorbs some of the energy and protects those with brown eyes. Blue eyes are less protected, more sensitive. So blue eyed people tend to screw up their eyes more in bright light. Do that often enough, and you'll get crows feet earlier (see crows feet article).

If you move a lot between natural outside sunlight and the interior of buildings, this can be a particular problem. Outside light is about 10 times brighter than indoor light, so a blue eyed person will feel that contrast much more keenly as they walk outside. Consider wearing photochromic lenses that react and assist the eye in coping with glare, especially if you are prone to migraines where light is a trigger.

It's not just light, though. Blue eyes are more sensitive to cold winds and smoky rooms too. Simply put, blue eyed people feel things more.

There's also a more serious problem. A lighter iris colour comes with a higher risk of age-related macular degeneration (ARMD) & progression (so check our article on what you can do to help prevent ARMD) and uveal melanoma.

On the upside, blue eyes are associated with a lower risk of developing cataracts.

Originally, we all had brown eyes. Then one person popped up with blue eyes. Basically all blue eyed people are descended from one person who lived in the northwestern part of the Black Sea region 6,000–10,000 years ago.

The science

(If you really want to know why blue eyes are blue, the melanin of brown eyes exists in a frontal layer and also at the rear of the stroma (the coloured, filamented part of the eye). In blue eyed people, there's less melanin in the front layer, so light passes in to the rear layer of cells, the longer wavelengths of light are absorbed more than the short wavelengths, so the light that is reflected back is bluer. Then that light is subjected to Rayleigh Scattering where it interacts with microscopic particles to create a blue colour. Rayleigh Scattering also gives us blue skies. Check out the Tyndall Effect too: the blue of motorcycle exhaust fumes is the same sort of thing (but it's a little less romantic.))

1 Among American white people, blue eyes are becoming notably less common (approximately 57% of those born around 1900 had blue eyes, 34% born around 1940 had, and now 22% have).

2 Cameras do though

How to prevent crows-feet (and stay young looking)

How to prevent crows-feet (and stay young looking)

Many people take daily action to prevent or reduce wrinkles, using moisturiser, making lifestyle changes and even resorting to surgery. At least one type of wrinkle, however, might be more numerous and deeper because of your eyesight, and even very slight imperfections can cause it.

Few people want crows feet (those angled wrinkles radiating out from the outer edge of the eye), even fewer know that their optician can help them stay young looking.

Let's start with the obvious: good glasses help you see, so by the end of the day, your eyes (and you) don't look so tired. Actually, you won't feel so tired either.
What if you've never had glasses and don't need glasses?

The very first camera was a pinhole camera. It works because everything's in focus when viewed through a small aperture. The pinhole camera didn't need a lens or focus ring, if the pinhole is small enough, everything's sharp.

The same principle applies to us. We can focus more easily in bright light because our pupil becomes more like a pinhole.

If you can see clearly and everything's in focus, your body is doing all sorts of things to make that happen: the muscles around your lens are pulling it into shape, your pupil is adjusting to the light level .. and, your eyelids may be squinting, because squinting makes your eyes smaller, and a smaller aperture helps to get things into focus.

Your small prescription, the slight thing wrong with your eyes that your body is compensating for .. it's there all the time. All day, every day. And over time, your body adapts to the new normal. It becomes how you look. And the lines in your face when you squint .. those become permanent creases, crows feet. Great in their place (on a crow), not so great for us.

So part of your anti-wrinkle regime should be to have regular eye examinations and keep up to date with your glasses and contact lenses. When was the last time you had an eye test?

What was that about eye colour? Simply, blue eyed people are more prone to developing crows feet. Watch this space and we'll explain more another time.

How to choose glasses to suit your face shape

How to choose glasses to suit your face shape

Do you want to carry authority or seem approachable? Do you want to look intelligent, appear can-do, or to be the one people turn to for help? Do you need to look different again when you want to relax?

Choosing the right glasses can help you build your career, find friends and even attract that special partner .. so it's definitely worth getting right. Of course you can come to Pagan and McQuade and spend as long as you like trying different styles but a little knowledge always helps and it's fun, too.

Everyone knows we all judge the new people we meet within the first few seconds of meeting them, and those assumptions we make are very difficult to change, so it really is worth making a great first impression. And what's the first thing people see when they meet you, especially if they look into your eyes? Your spectacles. So let's choose wisely .. in this article you'll find out how.

The first thing to do is take a good, long look in the mirror, hold back your hair if necessary, and decide what shape your face actually is. Most people's faces can be considered one of these four shapes (but you may be a combination of two):

  • Square (eg. Sophie Ellis-Bextor, Brad Pitt)
  • Round (eg. Dawn French, Jack Black)
  • Oval (most of us)
  • Long (eg. Sarah Jessica Parker, Jeremy Paxman)

but instead you might decide you are:

  • Heart shaped (eg. Jennifer Anniston, David Beckham)

If your face shape is still not clear, try outlining your face on your bathroom mirror (using something temporary, lipstick perhaps or condensation). Or take a self portrait (a selfie) and ask your friends online.

Are you ready? Here goes-

The Pagan and McQuade top spectacle shape top tips:

If you're oval faced: congratulations, you can skip class. Most glasses will look great, just make sure they are at least as wide as the widest part of your face.

The basic technique is to try to complement the main shape rather than emphasise it. So with a square face that's angular, choose glasses with no angles: round, oval or aviator styles. Alternatively try wide and narrow or large frames with strong detailing.

With a round face it's the opposite, try styles with angles: rectangular and square. Wayfarers work well. Round faces can also benefit from looking longer, choose narrow frames to do that. Upswept & cat-eye glasses, glasses with thicker top rims and high set sides can draw attention to the upper part of the face, as can branding or embellishment on the sides.

To make a long face seem more rounded, wide, strong frames help. If yours is long and oval, choose squarer shapes, if long and square, choose rounder shapes. Try frames with a strong brow, top line and maybe bold temples with some artistry.

If your face is heart shaped .. glasses sit on the top part of the face and emphasise it still more. To minimise the effect when choosing frames think slender, light, rimless, small. If you can find a frame that is wider or stronger or has (or you can add) detailing at the bottom, that's good, as are lower set sides.

Spectacle shape isn't the only thing to take account of when buying your new glasses. Some styles will be out of bounds because of your prescription. Then there's comfort. And of course, your spectacles have to speak of your character, not just your face shape. Colour is another aspect, and we'll talk about that another time.

Until then, enjoy choosing your new glasses. Why not send us a picture on Facebook or Twitter?

What to say when we ask "Do you want a retinal photograph?"

What to say when we ask "Do you want a retinal photograph?"

When you visit Pagan and McQuade for an eye test, you'll be asked whether you want a retinal photograph. Our job is to keep you healthy and capable, so we recommend it. Here's why.

The retina is the back part of your eye that receives the light and converts it to nerve impulses for your brain to process.

It's the only part of your body where it's possible to see your blood vessels as they are not covered in skin. Opticians, then, are in the privileged position of being able to see the start of numerous problems and help you stop them developing into illness.

Until retinal photography came along, if we saw something unusual in your retina, we'd make a drawing in your notes showing what we had seen. Then when it came to your next checkup we'd do the same thing and try to compare our drawings, or our drawing to that of the previous optician, and try to work out whether it was getting better or worse. As you might imagine, opticians tend to have studied science subjects at school, not art, so this is a less than perfect system. When there was no alternative, that was the best we could do. But technology has moved on, so now .. we like to take a photograph.

What sort of things do we see on the retina?

  • Interestingly, you can have freckles on your retina .. they need to be watched for changes.
  • Your macula, the dense, hard-working part of your retina that you use when you look in detail at something .. when you work, read or watch TV for instance .. that's covered in protective yellow pigments. When they break down, an early sign is clumping. If we spot that early, there are things we can do to protect your detailed sight.
  • Want to know how much cholesterol is lining your arteries? Your optician can see your blood vessels, show you the photograph and give you advice and, by comparing photographs over time, you'll be able to see if that's getting worse or better.
  • Even certain types of brain tumour show up first on the retina. Catching these early is obviously a good thing.

In keeping with our aim to offer the best and most professional service possible, we were the first practice in Scarborough to offer retinal photography and we recommend everyone opts for it even if their eye is healthy, as that then forms a template against which we can judge any future changes.

How to protect your detail vision

How to protect your detail vision

When a lion runs towards you, you want to know about it. Our peripheral vision is optimised to spot movement, not detail.

When you read, watch TV, work on something or stare into someone's eyes on a romantic date .. it's detailed vision that you want, and that's provided by a part of the back of your eye called the macula.

You may have heard of age-related macular degeneration. People suffering from this condition have degraded detailed vision and sometimes can't recognise faces. Imagine trying to see only using your peripheral vision. Approximately 10% of people aged 66-74 years will show some macular degeneration, and that rises to 30% from 75-85 years of age1.

Fortunately, there's something you can do to reduce your chances of losing detailed vision as you get older.

The macula is an area of intense activity at the back of your eye .. it's actually the part of your body with the highest rate of metabolism. It uses the most oxygen, and as a result, it gives out the most free radicals. You may already know, free radicals are ageing and damaging to neighbouring photoreceptors With all that activity, no wonder the macula may wear out as we age.

Nature has a defence.

During the second world war, the British conducted a propaganda campaign, persuading the Germans that our RAF pilots could see at night because they ate more carrots. This is the origin of the idea of being able to see in the dark after eating carrots. The idea is that the carotenes in carrots aided eyesight. The Germans started research into it. Actually, we'd invented radar.

It turns out that only three (of the 700) carotenoids are present in the eye as macular pigments (they are yellow). They are present in specific places, meso-zeaxanthin is dead centre, with zeaxanthin in a band around that & lutein outside that, like a target board.

That carotenes are yellow is important because that filters out high energy (damaging) blue light, present in glaring reflections and also in the light from computer screens and TVs.

Not only that, these carotenoids absorb free radicals, helping to prevent damage to your macula area, and retaining your functioning detailed vision for longer, hopefully for your whole life.

Carotenoids are relevant to keeping your detailed vision. So how do you get them, and how do you know they are working?

From October, we'll be able to test the thickness of your macula pigment layer. It turns out if you're blue-eyed, you're more at risk. Sorry guys, but if you're an overweight, middle aged chap over 40, you stand a good chance of having almost no macular pigments.

Here's how to improve your intake of the key carotenoids: eat spinach & kale (they contain many times more of the visual carotenoids than carrots).

If you're already eating healthily, that's easy to do (but keep reading if you'd rather not). Kale (Sainsbury's in Scarborough sell it reliably) can be turned into an (honestly, delicious) salad by 'rubbing' it with oil and salt (recipes )

We understand that not everyone wants to do that. If that's you, we have multivitamin supplements that provide everything you need to help bolster and protect your macula pigment layer.

You can improve your macular health with some lifestyle changes too:

  • Stop smoking
  • Wear sunglasses and a wide brimmed hat on sunny days to avoid bright light.
  • Eat less red meat with fat in it
  • Take regular exercise and keep a healthy weight.

All this is fine, but how do you know it's working? We can measure the thickness of your macula pigment layer. Ask us to measure it at the start, then again later and we can quantify your improvement so you know whether you need to do more or your macula is safe.

We all want good eyesight. Age related macular degeneration is something we can take action on to improve our chances. It's worth looking after your macula.

1 7 August 2013