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Help & Advice

At Silverman Opticians, our optometrists can provide advice on managing and treating blepharits.

Blepharitis is when the rims of the eyelids become inflamed. This can make your eyes red, irritated and itchy. Dandruff-like crusts can appear on your eyelashes. Blepharitis can be caused by bacterial infection or can be a complication of skin conditions such as seborrhoeic dermatitis (a skin condition that can cause itchy rashes on the skin and scalp). When seborrhoeic dermatitis affects the scalp, it’s called dandruff. Another associated skin condition is rosacea, which causes the face to appear red and blotchy.

Evaporative dry eye frequently occurs because the meibomian (oil) glands located in the eye lids are blocked or abnormal. The oily tear layer breaks down allowing the watery tears to evaporate. If the main problem is a blockage of the oil-secreting glands, then the condition may be called posterior blepharitis or meibomian gland dysfunction.

Blepharitis is a chronic condition, meaning that once it develops you’ll probably have repeated episodes. There is no cure. However, there are a range of treatments that can control the symptoms. The most important one is to establish a daily eye-cleaning routine.

At Silverman Opticians in London our optometrists can advise you about cataracts and if necessary refer you for cataract surgery.

Cataracts are cloudy patches in the lens of the eye that can make your vision blurry. They may eventually lead to blindness if they are left untreated. Cataracts can develop in one or both eyes and over time the size of the cataract can get bigger until the whole lens is covered.

The lens of each eye should be clear in order for your eyes to work properly. The clear lens allows light to reach the retina at the back of the eye, which enables you to see things. With a cataract, less light can reach the retina, so your vision is affected. A cataract can be present for a while before you notice you have one. However, having regular eye sight tests can spot cataracts in their early stages, so it’s important to keep up to date with eye examinations.

If you have a cataract, it will continue to develop. The only way to restore your vision is by having the cataract removed by surgery. Cataract surgery is one of the most common and quickest surgeries performed, and many people are able to return to their usual daily routine after 24 hours.

At Silverman Opticians in London our Optometrists can test for colour vision deficiency or ‘colour blindness’ and provide advice on treatment with Chromagen lensesChromagen lens filters work by changing the wavelength of each colour going into one or both eyes, which enhances colour perception and colour discrimination. They can be worn discretely as soft contact lenses or made up as glasses.

Colour vision deficiency occurs when the cells in the retina (the nerve tissue which lines the back of the eye) fail to function normally. Colour vision deficiency is often known as colour blindness. However, true colour blindness is when you can see no colour whatsoever and is rare.

The cells that interpret colour are known as ‘cones’ and are able to process three primary colours: red, green and blue. Using these primary colours, the cone cells can interpret hundreds of different colours, with different shades and hues. If you have colour vision deficiency, the cone cells lack the right amount of chemicals to process colours accurately.

Having colour vision deficiency means you struggle to see colours the same way most people do. You may also have difficulty distinguishing between two different colours. Sometimes it’s difficult to know when you have colour vision deficiency, as there are no obvious or physical symptoms.

Colour vision deficiency affects approximately one in 20 men, and is far less common in women, with only one in 200 women affected. In most cases the condition is inherited, although you can develop a colour deficiency as a result of a pre-existing condition or as a side effect of a medicine you may be taking.

There are three main types of colour deficient vision:
  • Red-green deficiency (deuteranopia) is the most frequently diagnosed deficiency. People with this condition can’t distinguish certain shades of red and green.
  • Blue-yellow deficiency (tritanopia) is rare. This condition makes it difficult to distinguish between blue and green. Yellow can appear as a pale grey or purple.
  • Total colour blindness (achromatopsia) is the rarest of the three. In this condition, no colours can be detected and everything is seen in shades of black, white and grey. People with this condition have poor sight and are extremely sensitive to light.

At Silverman Opticians in London our optometrists can provide advice on conjunctivitis management and treatment.

The white part of your eye and the inner surfaces of your eyelids are covered by a transparent membrane (thin layer of cells) known as the conjunctiva. If the conjunctiva becomes inflamed, you have a condition called conjunctivitis. There are three types of conjunctivitis: irritant, allergic and infective. Each type of conjunctivitis is caused by different factors.

Infective Conjunctivitis

Infective conjunctivitis can be caused by a virus, bacteria or, in rare cases, by a sexually transmitted infection such as chlamydia or gonorrhoea. The most common symptoms include reddening and watering of the eyes. You may also notice a sticky coating on your eyelashes, particularly when you first wake in the morning, which can make your eyes feel like they’re stuck together. Infective conjunctivitis is a very common condition and is responsible for 35% of all eye-related problems recorded in GP surgeries. It is most common in children and the elderly. Infective conjunctivitis rarely requires any medical treatment because the infection will normally heal by itself, usually within one or two weeks. For most people, the condition does not cause any complications. Those most at risk of developing complications from infective conjunctivitis are newborn babies, who are 28 days old or younger. An infection in the eye at a very young age can cause permanent damage. If you have infective conjunctivitis that is caused by a sexually transmitted infection (STI), your condition may last several months, rather than weeks.

Irritant Conjunctivitis

Irritant conjunctivitis occurs when an irritant such as chlorine or an eyelash gets into your eyes. This can make your eyes sore and if you rub them it can irritate them more. Avoiding the irritant and not rubbing your eyes will help. However, if your eyes are very red and painful, you should seek medical help immediately.

Allergic Conjunctivitis

Allergic conjunctivitis occurs when your eye comes into contact with an ‘allergen’. An allergen is a particular substance that makes your body’s immune system react abnormally, causing irritation and inflammation in the affected body part. The most common form of ocular allergy arises from pollen, with hay fever now affecting more than 25% of the UK population.

Advice if you suffer from itchy eyes  with hay fever:
  • Try to avoid exposure to pollen, staying indoors and refraining from parks and gardens when the pollen count is high (the Met office publishes a 5 day forecast).
  • Wrap around glasses or sunglasses can help prevent pollen from entering your eyes.
  • If you are exposed, then remove the pollen as quickly as possible by washing your hands, face and hair. Unpreserved lubricating eye drops such as Lubristil can help to wash it out of your eyes.
  • Try to avoid rubbing your eyes as it can make things worse and don’t wear contact lenses or eye make up.
  • Cold compresses such as refrigerated eye lid masks, ice packs or slices of cold cucumber can help to alleviate symptoms.
  • Antihistamine eye drops such as Otrivine, or mast cell stabilisers (preventing the histamine response) such as Sodium Cromoglicate are available from pharmacists without prescription. They should ideally be unpreserved in individual vials because the preservatives used in multi-dose bottles can themselves cause inflammation.
  • There is evidence that steroid based nasal sprays (also available from pharmacists) can give relief to red itchy eyes and there are numerous antihistamine tablets to help with the general symptoms of hay fever. It is extremely important to seek advice from the pharmacist, before using any of these medicines, because each formulation has different pros and cons and they may interact with other medication.
  • If one or both eyes remain red or sore in the absence of hay fever symptoms then you should see your eye care practitioner or if you are unable to manage your hay fever symptoms then see your GP.

Diabetes is a metabolic disorder that refers to the group of diseases that lead to high blood glucose levels due to defects in either insulin production or insulin action in the body. Diabetes can damage blood vessels around the body. When the small blood vessels inside the eye get damaged, this is referred to as diabetic retinopathy.

In many areas there are local arrangements by the NHS for diabetic retinopathy screening. This screening service usually involves a measurement of how well you can see and retinal photographs. The results are then forwarded to your GP.

At Silverman Opticians our diabetic eye examinations go that little bit further

and give you a comprehensive assessment of your eyes. A diabetic eye examination will include:

  • Consultation with a specialist optometrist
  • A measurement of your vision
  • Tests to determine if your eyes are out of focus and require spectacles
  • Tests to determine how well your eyes are coordinating together
  • Dilated retinal examination using both digital retinal photography and the latest clinical techniques
  • Measurement of your eye pressure
  • Measurement of your visual field
  • An eye health check to detect any other problems not related to diabetes
  • INSTANT results
  • Comprehensive report to GP

A diabetic eye examination with dilation is not covered by the basic NHS eye examination. Please contact us regarding the current fees.

At Silverman Opticians, our optometrists can give advice on the treatment and management of dry eye syndrome. Dry eye syndrome (also known as keratoconjunctivitis sicca, or simply dry eyes) occurs when there is a problem with the tear film that normally keeps the eye moist and lubricated. Diagnosis of dry eye syndrome can be made from the symptoms and an examination of the front of the eye.

Dry eye syndrome

Dry eye syndrome is the most common eye disease affecting around 5% of the population. The condition occurs when the eyes do not make enough tears, or more commonly because the tears evaporate too quickly.

Treatment for dry eyes

Ocular lubricants such as artificial tears, drops, gels and ointments can be very effective at relieving the symptoms, whilst treatment is directed at the underlying cause. In extreme cases specialist treatment may be required.

We offer a Dry Eye assessment to find the best treatment for you.

Floaters are shapes which people can see drifting across their vision. The exact form of these is very variable – they may appear as small dots or irregularly shaped strands.

What Causes Floaters?

The eye is filled by a jelly-like substance, the vitreous. As the vitreous ages, strands of a protein called collagen become visible within it. These strands swirl gently when the eye moves, giving rise to the perception of floaters. In some people, usually over the age of 40, the vitreous can separate from the retina. When this happens it tugs on the retina, causing the eye to see flashes of bright white light. A sudden increase (shower) of floaters is usually seen at the same time. This is called posterior vitreous detachment and may lead to retinal detachment.

Are Floaters Serious?

Generally, people should not be concerned about seeing one or two floaters in their vision, particularly if they have been there for some time. A sudden increase in the number of floaters, especially if you also see white flashing lights, is seen with posterior vitreous detachment. If you see this you should make an urgent appointment for an eye examination or go to A&E to ensure you are not getting a retinal detachment.

Can Floaters be Removed?

It is technically possible to remove floaters by performing an operation to remove the vitreous; a vitrectomy. Unfortunately, this operation carries significant risks to sight because of the possible complications, which include retinal detachment and cataract. Most eye surgeons are therefore reluctant to recommend this surgery unless there is a threat to sight.

At Silverman Opticians in London we routinely screen for glaucoma.

Glaucoma is the name given to a group of eye conditions that affect vision. Research suggests that a form of glaucoma affects about two out of every 100 people in the UK who are over 40. Because the risk of glaucoma increases as you get older, it’s important to have your eyes tested regularly.

Glaucoma often affects both eyes, usually in varying degrees. One eye may develop glaucoma quicker than the other. If glaucoma is left untreated it can cause blindness. However, if it’s diagnosed and treated early enough, further damage to your vision can be prevented.

There are four main types of glaucoma:
  • open angle glaucoma (chronic glaucoma)
  • acute angle closure glaucoma (acute glaucoma)
  • secondary glaucoma
  • developmental glaucoma (congenital glaucoma)
Open Angle Glaucoma (Chronic Glaucoma)

Open angle glaucoma is the most common type of glaucoma. It develops very slowly, so you may not realise it is happening. Open angle glaucoma occurs when the drainage tubes (trabecular meshwork) within the eye become slightly blocked, preventing eye fluid (aqueous humour) from draining properly.

When the fluid can’t drain properly, pressure builds up (intraocular pressure) which can cause damage to your optic nerves and the nerve fibres from your retina. The term ‘open angle’ refers to the angle of space between the iris (coloured part of the eye) and the sclera (the white outer covering of the eyeball). The fact it is an open angle means there is no physical obstruction blocking the drainage: it is the tubes that have a blockage.

Acute Angle Closure Glaucoma (Acute Glaucoma)

Acute angle closure glaucoma refers to a narrowing of the angle between your iris and sclera. The narrowing often happens quickly, causing a sudden and painful build-up of pressure in your eye. Acute angle closure glaucoma is rare.

Secondary Glaucoma

A secondary glaucoma may occur as a result of an eye injury or another eye condition such as uveitis. Secondary glaucoma can be open angle or closed angle.

Developmental Glaucoma

Developmental glaucoma is rare, but it can be serious. It’s usually present at birth, or develops shortly after birth. Developmental glaucoma is caused by an abnormality of the eyeball.

Macular degeneration is a painless eye condition that causes you gradually to lose your central vision (the ability to see what is directly in front of you). You use your central vision during activities such as reading, writing and driving. Macular degeneration occurs when the part of your eye that is responsible for central vision (the macula) is unable to function as effectively as it used to. Macular degeneration doesn’t affect your peripheral vision (your outer vision, sometimes known as “side vision”), so the condition won’t make you completely blind.

Types of Macular Degeneration

There are two types of macular degeneration, dry and wet. Dry macular degeneration affects your eyes gradually. Although there is no treatment for dry macular degeneration, there are ways you can learn to cope with it. Wet macular degeneration is more serious than dry macular degeneration, and can develop very quickly. It requires treatment as soon as possible.

Who is Affected by Macular Degeneration?

Macular degeneration most commonly affects people over 50 years of age. Macular degeneration in older people is referred to as age-related macular degeneration. Approximately 2% of people over 50 years of age have age-related macular degeneration. In people over 65 years of age, the number rises sharply to 80%, with about 20% of those over 85 years of age having the condition. In fact, in older people, age-related macular degeneration is the most common cause of visual impairment. Macular degeneration is more common in women than in men, although the reasons for this are not fully understood. In rare cases, young people can also be affected. This is usually caused by a genetic condition.

When a retinal detachment develops, a separation occurs between the retina and the wall of the eye at the back of the eye. This is similar to wallpaper peeling off a wall. The part that is detached (peeled off) will not work properly and the picture that the brain receives becomes patchy or may be lost completely. An urgent operation is necessary to replace the detached retina in its proper position.

What are the Symptoms?

People often describe seeing ‘something black’ or ‘a curtain’, ‘cobweb’ or ‘flashing lights’. In older people, these do not necessarily indicate a serious problem, but the sudden appearance of floaters and flashes requires a full eye examination to exclude the presence of retinal holes or tears.

What Causes a Retinal Detachment?

Nearly all retinal detachments develop because of a hole or tear in the retina. This usually occurs when the retina becomes ‘thin’, which can occur in short-sighted people, or if the vitreous (the jelly-like substance that fills the eye) separates from the retina. Other eye or health problems such as diabetes and injuries such as a blow to the eye can occasionally be the cause of a retinal detachment. Cataract operations can also cause retinal detachment.

What Should I do if I suspect I have a Retinal Detachment?

If you think that you have the symptoms of a retinal detachment you should go straight to the nearest eye hospital accident and emergency department.

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