Focus on JulEYE and Top 5 Eye Conditions

As the aging population sets to increase and the number of people suffering from chronic disease escalates, the importance of early detection and diagnosis of eye conditions is of uttermost importance. This month we are using the Royal Australian and New Zealand College of Opthalmologists (RANZCO) Eye Foundation's JulEYE as a month to advocate for eye health and the community of eye health professionals. We have invited Allanah Crameri and Vivan Law who are specialist Orthoptists with Orthoptics Australia to share the top 5 eye conditions people commonly suffer from and some handy tips on what to look out for.
Macular Degeneration
Age-related macular degeneration (AMD) is a degenerative disorder that affects the macular. A common symptom is seeing wavy and distorted lines. An Amsler grid is best to check for this and should be done monocularly. Another common symptom patients present with is seeing blurry and undistinguished faces of people. There are multiple risk factors for AMD including age, race, heredity, smoking, hypertension and dietary factors.
Cataract
As the population ages, we are seeing more and more patients presenting with cataract. This is due to it being a largely age-related condition. Patients are commonly troubled by haloes around lights, especially when night driving, glare and bright sunlight. Patients will often notice their vision deteriorating even with the prescription of new glasses.
Diabetic Retinopathy
Diabetic retinopathy (DR) affects the macular and can cause irreversible damage. DR is more common in type 1 than type 2 diabetics with sight threatening disease present in up to 10% of diabetics. Risk factors include the duration of diabetes, poor control of diabetes, pregnancy, hypertension and nephropathy. Patients can complain of blurry vision and dark spots/patches in the vision that can be caused by bleeds and haemorrhages at the macular.
Glaucoma
There are a diverse group of disorders that come under the umbrella of ‘glaucoma’. All forms however, are associated with progressive visual field loss and intraocular pressure as a key factor. Early signs of glaucoma may be hard to detect, as patients may be asymptomatic. A thorough investigation of the optic nerve, visual field, intraocular pressure, central corneal thickness and angle assessment is required. As glaucoma progresses, patients may present with a deteriorating peripheral visual field, a decrease in vision and varying pupil sizes (late stage glaucoma). The more severe cases may present with haloes around lights (due to corneal swelling), headaches, eye pain and a red eye. This can indicate angle closure glaucoma and the patient must be seen immediately.
Amblyopia & Strabismus
Amblyopia is when there is a unilateral decrease in vision, even with the correction of glasses. A diagnosis is made when there is a difference in visual acuity of 2 or more Snellen lines and an organic lesion can be ruled out. The patient will need to begin patching of the good eye. There are various classifications and causes of amblyopia.

Strabismus is the misalignment or turning of one eye, also known as ‘cross eyed’. It is important to take notice of patients in the waiting room and as you call them in. Look for any signs of an abnormal head posture such as a face turn, tilt or chin elevation/depression. This could indicate the presence of a cranial nerve palsy. Another sign to look out for is a patient presenting with sudden double vision. This should be assessed immediately to rule out a lesion.
As with any patient, it is important to take a thorough and detailed history, which will help guide and direct your questioning and thoughts about helping diagnose the patient.
ABOUT ORTHOPTICS AUSTRALIA
Orthoptics is a discipline in eye healthcare specialising in the assessment, diagnosis and non-surgical management of eye disorders.  Although closely related, Orthoptics does differ from Optometry and Ophthalmology.
For more information about Orthoptics Australia, please visit www.orthoptics.org.au
For more information about RANZCO Eye Foundation's JulEYE, please visit www.eyefoundation.org.au/juleye