have been carried out by Orbis-trained health workers..
Hay fever is a common allergic condition that affects one in five people at some point in their life. Symptoms of hay fever can include itchy, red or watery eyes, a runny nose and sneezing.
Affected people may experience hay fever symptoms if they have an allergic reaction to pollen. Pollen is fine powder released by plants and when these tiny particles come into contact with your eyes, nose, mouth and throat, they can trigger an immune response causing the body to react with swelling, irritation and inflammation
Some people’s eyes can be particularly sensitive to pollen. Our body’s natural response is to wash the pollen out, which is why some people end up with watery eyes. They can also become red, itchy, and sticky as the immune system reacts.
There is no cure for hay fever, but many people find their symptoms improve as they get older. Symptom relief treatment is available to use during the pollen season.
You can treat your hay fever symptoms with over-the-counter medications from your local pharmacist. Anti-histamine nasal sprays and/or tablets are one of the best ways to relieve symptoms and should be taken before the hay fever season starts for the best results.
Eye drops containing antihistamine are also available from your pharmacy. These should reduce the inflammation in your eyes and relieve the itching. Sometimes, allergic reactions may need review by an eye specialist and treatment with medication that dampens down the immune reaction such as steroids.
Badrul Hussain, consultant eye surgeon, gives his top tips for reducing hay fever symptoms
Yes – but your laser eye surgeon will emphasise that your squint (which is a ‘turn’ in one eye, usually present from childhood and treated with patching or eye surgery) will remain unchanged and will appear just as it does when wearing the correct spectacle or contact lens prescription. In other words, laser eye surgery should be considered equivalent to spectacles or contact lenses – it’s a third alternative – but it can’t be expected to cure your squint.
Because of a tendency to ‘squint’ some patients need an optical element termed a ‘prism’ built into their spectacles to achieve visual comfort. Laser eye surgery cannot copy the effect of this prism and therefore you may still require spectacles (of a much lower power but including your prism) after the treatment.
The same applies to treating a patient with a ‘lazy eye’ from childhood. If one eye has never seen as well as the dominant or leading eye (with the best spectacle or contact lens prescription the optometrist can supply) then it will not be improved beyond that level with laser eye surgery.
The laser cannot restore vision that wasn’t there in the first place – it can only provide the equivalent of the best vision possible with spectacles and/or contact lenses prior to the treatment.
Yes – but your laser eye surgeon will take into account the type of diabetes you have, how successful its management has been, and how long you have been diabetic. Particular attention will be paid to the stability of your spectacle prescription, as this can change with fluctuations in your blood sugar. In other words, poor diabetic control can affect the accuracy of your treatment.
Careful examination of the natural lenses in your eyes for any evidence of cataract, which can occur early in diabetics, and your retinas for any signs of damage to the blood vessels at ‘the back of the eye’, will be carried out. Skin layer healing can be slowed down in diabetes.
Any concerns about the healing of the specialised layer of skin at the front of the eye (corneal epithelium), might lead your surgeon to advise LASIK rather than a surface laser treatment like LASEK or TransPRK. This is because surface treatments are more reliant on healing than LASIK in which the corneal epithelium is kept intact using a thin protective flap.
The risk of infection, which is extremely rare in laser eye surgery, is very slightly greater in diabetics. This can usually be treated successfully with timely diagnosis and tailored antibiotics.
Laser eye surgery normally leaves you with life-long freedom from spectacles for sport and socialising. But your eyes are not made of plastic, and natural changes in your spectacle prescription can occur at any age. If you experience a shift in your vision after laser eye surgery, there are normally good repeat treatment options for every age group.
How vision changes affect people in different age groups
If you have short sight (myopia) corrected in your early 20s, and particularly if you have a higher level of short sight, it is more common to need repeat treatment after a few years. This is because the level of short sightedness may not stabilise until your mid or late 20s. We like to see that your spectacle prescription has been stable for two years before we go ahead with laser eye surgery in younger patients, but if you do have a natural shift in your prescription, even many years later, repeat laser eye surgery can usually be performed safely.
If your vision has been corrected in your 20s or 30s, you will start to need reading glasses from your mid-40s onwards. This is a normal age related change caused by stiffening of the natural lens in the eye (presbyopia).
Loss of focus flexibility affects all of us, with or without laser eye surgery. Long-sighted (hyperopic) people are most affected. This is because they are already using up at least some of their diminishing reserve of focus flexibility in order to compensate for being long-sighted. If you have long sight, you lose your reading vision first, and then find yourself dependent on distance glasses as well. For this reason, many long-sighted people end up wearing varifocal glasses.
Vision correction for the over 40s
Laser eye surgery works particularly well if you are in the 40+ age group, whether you have long sight, short sight, or astigmatism. But rather than aiming for a clear distance vision in both eyes, if you are over 40, we normally offset the focus in one eye to sharpen the near range.
Although distance vision will normally remain good after laser eye surgery with this approach, you may notice a gradual decline in clarity for the sub-50cm range, particularly in poor light, as you get into your 50s. This is because the natural lens stiffens up completely as we get towards our 60s.
Read More: Is there an age limit to laser eye surgery?
For many of us, the natural lens, which is the part of the eye most affected by aging, will start misting up in our 60s and 70s. This misting in the eye is called a cataract when it starts to interfere with our vision. The next stop for patients having laser eye surgery in their 40s or 50s, who are troubled by the loss of reading clarity, is a version of cataract surgery called refractive lens exchange (RLE), in which the natural lens is exchanged for a lens implant. Modern laser vision correction systems produce a more natural focusing shape in the cornea. This combines well with newer extended depth of focus lens implants if RLE or cataract surgery is required later in life.
When you go for an eye test, you end up being given a set of figures known as a prescription. The test is called a refraction, and the results are expressed in a standard format:
Refraction testing measures the strength of spectacle lens needed to give you a clear distance focus.
If you need spectacles or contact lenses, the power of these lenses is measured in units called dioptres, usually expressed as “D” in the prescription. There is a range of lens powers and lenses can either increase or reduce the focusing power of the eye.
If you are hyperopic or “long-sighted” you need extra focussing power. Lenses which increase the focusing power of the eye are convex in shape and have a plus (+) sign before the number, saying how strong they are.
If you are myopic or “short-sighted” you need to reduce the focussing power of the eye. Lenses which reduce the focusing power of the eye are concave and have a minus (-) sign.
Most eyes are not perfectly spherical but have a degree of irregularity called astigmatism. This is often compared to the difference between a football which is spherical and a rugby ball which has two different curvatures. The amount of long or short sight is measured in the first (X.XX) number of your spectacle prescription, and the amount of ‘rugby ball shape’ or astigmatism is measured in the second number.
To correct astigmatism, the rugby ball shape lens has to be in the right orientation in your glasses. This orientation is expressed in degrees (0-180°) and is the third number (xZZ) in your spectacle prescription.
Most young people have enough natural additional focusing power for near vision. This flexibility of focus is called accommodation, and is based on flexibility of the natural lens within the eye.
If you are in your mid-forties or older, you will start to need additional (+) focusing power to help bring near objects into focus. This is because older people have a less flexible lens in the eye, and a less flexible focus. The strength of the extra (+) lens is called the reading addition. The reading addition can either be put into the bottom segment of bifocal or varifocal glasses, or worn separately as a dedicated pair of reading glasses.
At Moorfields Private, we offer the full range of laser and implant techniques for correcting your spectacle prescription. Whether you are younger or older, short-sighted or long-sighted, have astigmatism, or need reading glasses, we will be able to advise you which treatment will safest and most effective for you.