Disparities exist within this population, with Black children having lowest screening rate
Young children with autism are much less likely to receive vision screening than their peers, despite high risk for serious eye disorders, according to a study by Nemours Children’s Health published in Pediatrics.
“I noticed that many of our patients with autism have never had vision screening, even though it’s recommended for all young children,” said the study’s senior author Brittany Perry, DO, a pediatrician at the Nemours Swank Autism Center. “So, I wanted to study whether this might be a broader disparity – whether kids with autism receive vision screening less often than other kids.”
The study found that only 36.5% of children with autism had completed vision screenings at well visits, substantially less than the 59.5% rate for children without autism . Moreover, among children with autism, the screening rate for Black children (27.6%) was considerably lower than that for White children (39.7%) and for children classified as multiracial (39.8%).
Early childhood is crucial for vision development, and early detection and treatment of eye problems can prevent long-term vision loss. The research team examined data from 63,829 well visits of children ages 3 to 5 from 2016 to 2019, across a primary care network encompassing Delaware, Pennsylvania and Florida.
Researchers said that the Florida facilities had much higher rates of vision screening for kids with autism (45.7%) than those in the Delaware and Pennsylvania (28.1%). They noted that 80% of Florida medical practices used the vision-testing method of photoscreening, compared to only 13% in the Delaware and Pennsylvania.
Photoscreening, which uses a specialized camera or video system to capture detailed images of a child’s eyes, is particularly helpful for children with autism because they cannot always understand and verbally respond to instructions or questions in conventional visual acuity tests. The American Academy of Pediatrics (AAP) recommends annual instrument-based vision screening particularly for children with developmental delays. The researchers said that reimbursement is necessary for greater photoscreening use in primary care – a concern that AAP has also noted.
“Increased use of photoscreening may prove to be a great tool for reducing disparities and increasing vision screening in more vulnerable populations with autism,” Perry said.
“The key takeaway from this study for providers is to be aware that these disparities exist for all children with autism, so we can work to provide better care,” she added. “And for parents, it may help them to better advocate for their children with autism and to request a vision screening at a well visit, or a referral to an eye specialist, if their child is overdue.”
Constant video conferencing could be creating a hidden epidemic of eye issues.
Blepharitis
Blepharitis is a common eye condition causing inflammation of the eyelids. Usually affecting both eyes at once, although sometimes being worse in one eye, the condition can be categorised into two types. Anterior blepharitis results in inflammation at the base of the eyelid and can be caused by bacteria like staphylococci, or seborrhoeic dermatitis. Posterior blepharitis, on the other hand, results in inflammation of the meibomian glands, which help to produce tears1.
Pharmacist Sultan Dajani and advisor to Golden Eye®- makers of a range of drops and ointments to treat conjunctivitis, styes and blepharitis says: “Blepharitis is estimated to account for around 5% of eye-health- related GP visits and a survey of eye health professionals in the US found blepharitis in 37% of ophthalmology (the diagnosis and treatment of eye disorders) cases and 47% of optometry (the examination of the eyes to detect vision defects and eye health issues) cases2. So, while it may seem like a mild irritation, blepharitis is no small issue – especially when you consider that those figures were gathered before the pandemic turned the world upside down.”
All eyes on Zoom culture
For many of us life has changed dramatically, in all sorts of ways, since March 2020, with one of the biggest adaptations for office workers being a shift to working from home for 100% of their working week. While this may bring certain wellbeing advantages to some, such as eliminating gruelling commutes, and freeing up more time to sleep and to prepare nutritious meals, there are also wellbeing disadvantages to leaving office life behind.
Pharmacist Sultan Dajani
adds: “People
who used to physically
go to work in an
office each day
are missing
out on a
lot
of their former in-person
social interaction. Work matters once discussed
over a cuppa in the office kitchen are now resigned
to video conferencing calls. This in itself
may not seem like a huge issue (some may even
prefer it this way) but when
you add it to the other 7+ hours workers
are
now spending in front of a screen,
it
doesn’t leave much
respite for the eyes.”
“According to a recent study, 93.6% (381/407) of people increased their digital device time after lockdown was put in place, equating to an average increase of 4.8 hours a day, and raising the average amount of screen time per day to 8.65 hours3. Sitting in front of a screen all day, focusing our eyes on one place, may cause us to blink less often4. This can present a big problem for the eyes as blinking is essential to spread tears over the ocular surface. If this isn’t happening at the required rate, the tear film can evaporate, which can irritate the cells lining the cornea, leading to inflammation and discomfort.”
“Adding insult to injury, the blue light from a screen is a powerful
suppressor of melatonin, which we need to secrete to get
a good
night’s sleep5. Being
exposed to it for prolonged periods, especially before bedtime can
mean it takes us
longer to get to
sleep, and result in poorer quality sleep. This, in turn, can
have an effect on how well our
body’s immune system is able to fight off infections6 like blepharitis.”
Fighting
inflammation with the dermatitisdietAtopic dermatitis
is
a condition that can
similarly be worsened by a weakened immune system due to a lack of sleep,
and this common skin
condition can actually be the cause of blepharitis7.
However, there are some dietary considerations to experiment with, which
may help alleviate
irritated skin, and eyes.
These include
checking you’re not sensitive to common
allergens, such as dairy,
eggs, soy, gluten,
nuts, fish and shellfish. Foods
containing trans fats, like shop-bought cakes, margarine and
processed foods, and
those high in sugar, such as sweets,
soft drinks and desserts can cause inflammation in the body8 and result
in dermatitis flare ups.
However, there are also some foods that it might be good to get more
of, to help balance
the body’s inflammatory response mechanism9. These include omega-3-rich oily fish, such
as salmon, mackerel, anchovies, sardines, herring and trout. Similarly, quercetin, a natural chemical
found in plants like spinach,
broccoli, apples and blueberries, is an antihistamine and antioxidant, which may help
bring the inflammatory response under
control in the event of
a dermatitis flare
up10.
Due to the strong link between good gut health
and a properly functioning immune system, it’s also a good idea
to feed your microbiome to
help your body combat
dermatitis11.
Probiotic foods such as natural yoghurt,
pickles, fermented cheeses, kefir, sauerkraut and
kombucha are great sources of food
for your beneficial
bacteria. Your immune system will also thank you for including
a wide variety of colours
and
types of vegetables and fruits in
your daily diet, helping
you achieve optimal
levels of key micronutrients to
maintain good health.
Keep it clean
If
you do find yourself prone to bouts of blepharitis, wearing
contact lenses and makeup
– especially eyeliner – should be
avoided during flare ups. One of the most effective
things you can do to alleviate the symptoms
is to keep your eyes clean.
The
NHS12 recommend cleaning
your eyes at least once a day, even once your symptoms have started to
clear up, and break
it down into three simple steps:
Soak a clean
flannel or cotton
wool in warm water and
place it on
your eye for
10 minutes.
Gently massage each eyelid for
about 30 seconds.
Clean each eyelid using cotton wool or a cotton bud.
They also suggest that
it might be
helpful to use a small amount of baby
shampoo in the water. A
separate cotton
wool pad or flannel
soaked in water should
be used for each eye,
wiping from the corner nearest the nose outwards to avoid spreading the infection to
the other eye, if possible.
New research shows how half of Brits are suffering from dry eyes thanks to screen marathons and totally oblivious to the health peril
UNKNOWN EYE HEALTH SYNDROME SUFFERED BY MILLIONS
Millions of Brits are putting their eye health at risk as pandemic working hours and frequent use of devices for leisure have led to screen times soaring. However, most sufferers are totally oblivious to the eye health perils of dry eye syndrome.
v
A research poll[1] by world experts in eye-care – Rohto[2] – has revealed that almost six out of ten adults now suffer
from dry eye, a clinical cause of eye irritation, fatigue and discomfort.
And a similar proportion claim that their use of screen-based
devices has increased since the lockdown, with a National Bureau of Economic
Research survey confirming that the average working day is now nearly an hour
longer.
Over half (55%) of adults questioned in the Rohto survey
stare at a screen for five to seven hours a day, while a staggering 36% do this
for 8 to 12 hours a day. Yet just 7 in 100 took the recommended amount of
screen breaks.
“It’s vital to tackle this problem early – with regular use of dry eye relief drops which address as many aspects of the condition as possible and therefore break the vicious cycle of dry eye to avoid long-term damage to the cornea. The eye health brains from the world’s number one eye care brand2, Rohto, has launched the very latest science backed innovation to treat dry eye – New Rohto Dry Aid. It is a product innovation that is a must have for all dry eye sufferers. A scary 20% of people with dry eye end up with severe dry eye disease, affecting night vision, driving and reading. More on Rohto Dry Aid in a bit.”
v
The new
research poll commissioned by Rohto also found that half of adults complained
of irritated eyes and itchiness, while four in ten said their eyes were red,
tired and sore. The frequency of these complaints was linked with the amount of
screen time, with those
enduring 51-60 hours a week being 50 per cent more likely to experience eye
problems[4].
Why
our eyes need 20 20 20 love
Francesca
Marchetti comments: “Experts like me recommend that we give our eyes a break
from screens every 20 minutes by looking at a distant object (20ft away) for 20
seconds and blink for 20 seconds – it’s called the 20 20 20 screen break rules
(including usage of multiple digital devices). Yet, only a minority are doing
this so it’s no wonder that four out of ten Brits say their lockdown screen
habits are making their eyes feel worse than ever before.”
Contact lens wearers most at risk
UNKNOWN EYE HEALTH SYNDROME SUFFERED BY MILLIONS
Symptoms
of dry eye are a particular problem for contact lens wearers as three quarters
(74%) say they suffer from dry eye. Yet they could do more to help themselves
as over a third admit sleeping in their contact lenses, whilst 43% have taken a
shower wearing them!
Ageing
also impacts since our body produces less hyaluronic acid from our 40s onwards
and this is key for retaining moisture in the eyes. Hormonal changes before and
during the menopause, and regular use of antihistamines, antidepressants and diuretics,
also affect the amount of moisture in the eye.
INTRODUCING THE VERY LATEST EYE HEALTH, SCIENCE
BACKED INNOVATION: New Rohto Dry Aid treats 8 symptoms of dry eye
The eye health brains at Rohto, have developed a new
clinically-proven product to help manage dry eye. And new Rohto Dry Aid
provides effective, soothing relief for up to 12 hours and is non-blurry. The ‘8
in 1[5]’ treatment for dry eye
helps to tackle:
Dryness
Soreness
Itchiness
Irritation
Burning
Grittiness
Stinging
Tiredness.
Optometrist,
Francesca Marchetti notes: “Many people suffer one or more of the main symptoms
of dry eye but they don’t realise they have the condition. That’s why it’s
great news that the New Rohto Dry Aid offers Tearshield Technology™ to hydrate,
protect and restore the natural tear film, even in contact lens wearers and as
a result, addressing key issues of dry eye and breaking its vicious cycle.”
NEW
Rohto Dry Aid – the formulation includes:
Povidone
is a polymer with a wide range of pharmaceutical and medical applications.[6] It lubricates, protects, and soothes the surface of
the eye, and works as a carrier to ensure that other active ingredients
are integrated into all multi layers of the tear film. By bolstering the
tear film, it also reduces water loss and protects the cornea.
Propylene glycol is a well-tolerated synthetic liquid which attracts
water and is clinically proven to help hydrate the tear film,[7] particularly the mucin area. By reducing friction, it
prevents damage and subsequent inflammation of the mucin area.
Sesame oil
has a long history of use as a safe carrier for medicines delivered by
intramuscular injection.[8]
Sesame Oil also spreads more evenly over the eye, which ensures a greater
uniform coating versus mineral oil, which is what most other eye drops
use. More recently, it is one of a number of lipids with proven, and well
tolerated, ophthalmic applications — particularly enhancing membrane
permeability and cellular uptake of lipophilic molecules.[9] It has a very similar chemical structure to the lipid
area of the tear film, an affinity which helps repair and maintain it.
This also prevents evaporation from the aqueous area.
PEG-10 Castor oil is another lipid with proven ophthalmic benefits, with
studies showing it reduces corneal drying and helps stabilise and thicken
the tear film. Trials confirm it also reduces tear evaporation,[10] and it extends dry-eye symptom relief by reducing Tear
Film Break Up Time (TFBUT).
Poloxamers are thermoresponsive,
and when dispersed in water,
turn into hydrogels. In Rohto Dry Aid, they work in two
distinct modes: their lipid-friendly lipophilic block protects the ocular
surface by binding to membrane lipids on the corneal epithelium cells or
lipid area, while their hydrophilic blocks are water-retentive, contributing
to tear film stability, all helping the surface of the eye.
Electrolytes
in the form of potassium and calcium create a positive environment for the
corneal stem cells which allow it to repair and replace damage. This is
achieved by maintaining a loser tear osmolarity, which reduces fluid loss
from the cornea’s epithelial cells.
Menthol is
added to create a gentle cooling and refreshing sensation when the drops
are applied.
Polyhexamthylene biguanide is a mild, gentle, eye-friendly preservative used in
contact lens solutions and eye drops, to ensure that the product remains
safe to use for a certain period of time after its first opening. Rohto
Dry Aid can therefore be used safely for up to 3 months after the bottle
has been opened for the very first time. This ingredient also has proven
antiviral and antibacterial properties.
Magnesium sulfate has been shown to improve ocular blood flow and reduce
oxidative stress. It is also being investigated as a possible treatment
for glaucoma.[11]
In a
recent 14-day trial[12], 94 per cent of
trialists reported that Rohto Dry Aid was effective at soothing and hydrating
their eyes, while 93 per cent would be very likely or likely to recommend the
product to others. More than 8 out of ten found the product to be long lasting,
while more than 9 out of ten agreed it was non-blurry. In just seven days –
half the amount of time during which the study was conducted – 78 per cent of
research respondents claimed their eyes were now comfortable all day.
Francesca
Marchetti concludes: “Dry eye is now a major issue thanks to our growing screen
use but most of us have no idea we are a sufferer of it. As well as people
checking in with opticians, taking regular screen breaks and ensuring we are
drinking plenty of fluids, a key step to more comfortable eyes is the regular
use of clinically-proven dry eye relief drops. New Rohto Dry Aid offers the
very latest in eye health innovation and technology, providing up to 12 hours
relief and an 8[13] in one solution to
dry eye.”
[1] Global Perspectus,
Spring 2021; 1,109 nationally representative consumers questioned.
[2] Euromonitor
International Limited; Consumer Health Eye Care definition, retail value share,
2020 data
[3] Tears are made up
of several layers: the oily layer on the outside, the watery layer in the
middle, and the inner, mucus layer. These layers together are known as the tear
film.
[4] 47% of adults with
<10 hours screen time per week suffer from dry eye compared with 69% of
adults with 51-60 hours of screen time per week.
[5] Rohto Dry Aid helps relieve up to eight of
the most troubling dry eye symptoms
[12] Independent consumer user trial of Rohto
Dry Aid conducted over 14 days during winter 2020 with males and females aged
between 20 and 66, including contact lens wearers; UK[13] Refers to 8 dry eye symptoms
Choose eye health for your New Year’s resolution and make it the one you won’t break
A fifth (21%) have not had a sight test within the last two years[i] but regular checks protect sight by making sure eye conditions are picked up and treated early
Over one million people in the UK are living with avoidable sight loss.[ii]
As well as an eye health check, a sight test can detect signs of general health conditions, such as diabetes, high cholesterol and high blood pressure
Losing weight, more exercise, saving money and learning a new skill all make
the top 10, but keeping to your New Year’s resolutions is conspicuously more
difficult than it seems.
Around 30% of us will make a New Year’s resolution[iii] but according
to research, over half of the UK (66%) will last a month or less, while 80% of
people give up on their resolve by the end of March.[iv]
This is why the Association of Optometrists (AOP) is challenging the public
to keep just one resolution in 2020 – to have regular sight tests.
Speaking about the value of sight tests,
optometrist Roshni Kanabar, Clinical and Regulatory Adviser at the AOP said:
“Eye health is one of the easiest resolutions you can make and keep –and the
benefits are huge. Regular sight tests can’t promise 20/20 vision, but they
will make sure that any problems or symptoms of eye disease are picked up early
and it could end up saving your sight. At least 50% of all sight loss is
avoidable so having checks, regularly, is the most important thing you can do
to protect it.”
Other New Year’s resolutions that are kind on your eyes
Stop smoking
Many people are unaware of the link between
smoking and eye disease. Smoking significantly increases the risk of
developing eye diseases, such as cataracts and age-related macular
degeneration.
Eat healthily
Eating a healthy, balanced diet reduces your
risk of eye disease. Include lots of omega-3 fats, found in oily fish, and
lutein, found in dark-green, leafy vegetables such as spinach and kale.
Vitamins A, C and E are also helpful, so eat at least five portions of
fruit and vegetables a day.
Wear prescribed glasses
Many eye and vision problems develop or increase
as we get older. Contrary to the myth, wearing glasses and contact lenses
doesn’t make your eyesight worse – they help your eyes work more
efficiently.
Wear sunglasses
Sunshine may seem a distant memory at this time
of year but as well as making your vision more comfortable, sunglasses
protect your eyes from UV light. When choosing sunglasses, you should
always make sure that they carry the CE or British Standard marks.
Launching on 27 December, the AOP’s 20/20 eye health campaign, which
includes posters displayed in opticians, GP and dental surgeries nationwide,
reminds people to have a sight test every two years, or more often if their
optometrist recommends it.
NHS sight tests are available for children under 16, those aged 60 or over,
and other key groups. As part of the campaign, the AOP has produced patient
leaflets explaining who is eligible for NHS-funded sight tests in England,
Northern Ireland, Scotland and Wales. For more information, visit www.aop.org.uk/patients
Floaters are small shapes that some people see floating in their field of vision.
They can be different shapes and sizes and may look like:
tiny black dots
small, shadowy dots
larger cloud-like spots
long, narrow strands
You may have many small floaters in your field of vision or just one or two larger ones. Most floaters are small and quickly move out of your field of vision.
Floaters are often most noticeable when you’re looking at a light-coloured background, such as a white wall or clear sky.
Do floaters affect vision?
Floaters sometimes occur without a person noticing them. This is because the brain constantly adapts to changes in vision and learns to ignore floaters so they don’t affect vision.
Floaters are usually harmless and don’t significantly affect your vision. However, it’s important you have your eyes checked by an optician regularly (at least once every two years).
Larger floaters can be distracting and may make activities involving high levels of concentration, such as reading or driving, difficult.
Floaters are small pieces of debris that float in the eye’s vitreous humour. Vitreous humour is a clear, jelly-like substance that fills the space in the middle of the eyeball.
The debris casts shadows on to the retina (the light-sensitive tissue lining the back of the eye). If you have floaters, it’s these shadows you’ll see.
Floaters can occur as your eyes change with age. In most cases, they don’t cause significant problems and don’t require treatment.
In rare cases, floaters may be a sign of a retinal tear or retinal detachment (where the retina starts to pull away from the blood vessels that supply it with oxygen and nutrients).
Floaters can’t be prevented because they’re part of the natural ageing process.
When to seek medical help
Visit your optician immediately if you notice an increase or sudden change in your floaters, particularly if you notice white flashes and some loss of vision.
Your optician may refer you to an ophthalmologist (a specialist in diagnosing and treating eye conditions) who can check your retina for tears or retinal detachment.
Even though floaters are usually harmless and don’t significantly affect your vision, it’s important you have your eyes checked regularly by an optician (at least once every two years).
In most cases, floaters don’t cause major problems and don’t require treatment. Eye drops or similar types of medication won’t make floaters disappear.
After a while, your brain learns to ignore floaters and you may not notice them.
If your floaters don’t improve over time, or if they significantly affect your vision, a vitrectomy may be recommended. This is a surgical operation to remove the vitreous humour in your eye along with any floating debris and replace it with a saline (salty) solution.
If your retina has become detached, surgery is the only way to re-attach it. Without surgery, a total loss of vision is almost certain. In 90% of cases, only one operation is needed to re-attach the retina.
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