Slide 1

Report
Making a Move
Vision component
Developed by Vision 2020 Australia’s Vision Initiative program funded by Victorian
Department of Health
Overview
• Eye health in Australia
• Preventing sight loss
• Anatomy of the eye
• Common eye conditions
• The relationship between falls and eyesight
• Who’s who in eye care and where to get help
Eye health in Australia
• More than 500,000 Australians have vision loss.
• Prevalence of eye disease predicted to double over the
next ten years.
• 75 per cent of vision loss is preventable or treatable.
•
Vision loss increases threefold with each decade over 40
years.
Eye health in Australia
• Eighty per cent of vision loss is caused by five conditions
(listed alphabetically):
• Age-related Macular Degeneration (AMD)
• cataract
• diabetic retinopathy
• glaucoma
• under-corrected and uncorrected refractive error.
Blindness and vision impairment in Australia
Preventing sight loss - what you can do
• Encourage your clients to have an eye examination
especially if:
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there is a family history of eye disease
the client is over the age of 40
the client has diabetes
the client has noticed a change in their vision.
• Early detection and treatment is essential.
• Medicare covers most of the costs associated with visiting
an optometrist or ophthalmologist.
Preventing sight loss - what you can do
• Talk to your clients about their vision.
• Vision loss may be an underlying cause for another
condition.
• Conduct a visual acuity test or refer to an appropriate
health professional.
• If you are concerned about a clients vision discuss this
with the treating general practitioner or eye health
professional.
Preventing sight loss
• People with vision impairment are at a greater risk of
suffering from secondary conditions:
• falls
• depression
• early special accommodation
• increased risk of hip fracture
• increased early mortality
• social isolation.
Preventing sight loss
• Advise your clients to:
• QUIT smoking
• protect their eyes from injury
• protect their eyes from ultraviolet light by:
• wearing a hat
• wearing appropriate sunglasses
• maintain good general health.
The anatomy of the eye
Function of the eye
• Light enters the eye through the cornea, which refracts
the widely diverging rays of light and bends them through
the pupil.
• The iris limits how much light enters the eye by expanding
or contracting the pupil.
Function of the eye
• The eye functions like a camera.
• The light enters the eye then is focused through the lens.
•
The lens can changes shape depending on the distance of
the object from the eye to, “fine-tunes” the focus.
• The light then travels through the vitreous to the retina.
• The photosensitive retina is stimulated and converts the
image into an electrical signal, which is sent through the
optic nerve to the visual cortex of the brain.
• The brain analyses the information and interprets the
signals as an image.
Common eye conditions
• 80 per cent of vision impairment and blindness is
caused by five conditions (listed alphabetically):
•
•
•
•
•
Age-related Macular Degeneration – 10 per cent
cataract - 14 per cent
diabetic retinopathy - 2 per cent
glaucoma - 3 per cent
under-corrected or uncorrected refractive error 62 per cent.
Age-related Macular Degeneration
Age-related Macular Degeneration (AMD)
• A chronic degenerative condition that affects the central
vision. Progression is likely.
• Ten per cent of the people with macular degeneration
have the “wet” form which may respond to treatment.
• The majority of people have the “dry” form of macular
degeneration.
• Two out of three people will be affected by AMD in their
lifetime.
Prevalence and risk factors of AMD
• Ageing is the greatest risk factor with prevalence of AMD
trebling with each decade over 40 years.
• AMD is present in thirteen per cent of people between the
ages of 70-75.
•
It is the leading cause of disease related to vision
impairment in Australia.
• Smoking increases the risk of developing AMD.
• Family history is also risk factor - genes have been
identified and linked with AMD.
Functional implications of AMD
• Loss of central vision which results in:
• having difficulty distinguishing people's faces.
• having difficulty with close work.
• perceiving straight lines as distorted or curved.
• being unable to differentiate between the footpath
and road.
• having difficulty identifying the edge of steps if there
is no colour contrast.
• being unable to determine traffic light changes.
• having difficulty reading, with blurred words and
letters running together.
Prevention of AMD
• Early detection of AMD is crucial - some forms of
the disease may be arrested with early treatment
by an ophthalmologist.
• Regular eye examinations are the key to early
detection of disease before vision loss occurs.
• If your client notices any change in the quality of
their vision, advise them to talk to their GP to
arrange an appropriate referral to an eye health
professional.
• Advise your clients to QUIT smoking.
Treatment of AMD
• Treatment options are improving with new
technology such as Lucentis.
• When new vessels grow under the retina, surgery
may be an option.
• Laser surgery can reduce vision loss if caught early
and aims to prevent further vision loss.
• Often however, lost vision cannot be recovered early detection and treatment is the key.
• For more information on AMD visit
www.mdfoundation.com.au
Cataract
Cataract
• A Cataract is a clouding of the lens inside the eye, light
cannot be focused properly as it enters the eye.
• Thirty one per cent of the population over the age of 55
has cataract.
• Everyone will develop cataract and half will need cataract
surgery if they live long enough.
• The rate of cataract surgery doubles with each decade of
life.
Prevalence and risk factors of cataracts
• Cataracts are a leading cause of vision impairment in
Australia.
• Increasing age is the most significant risk factor for
developing a cataract.
• Other risk factors include:
• diabetes
• corticosteroid use
• trauma
• smoking
• sun exposure.
Functional implications of cataracts
• Clouding of the lens results in:
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blurred vision
reduced contrast
having difficulty judging depth
seeing a halo or double vision around lights at night
seeing images as if through a veil
being particularly sensitive to glare and light
having dulled colour vision.
Prevention of cataracts
• Advise your clients to:
• QUIT smoking
• protect their eyes from ultraviolet light by:
• wearing a hat
• wearing appropriate sunglasses
• protect their eyes from injury by wearing:
• protective work wear
• protective sports wear.
Treatment of cataracts
• Regular eye examinations and updated glasses may
delay the need for surgical treatment.
• Surgery:
• Initial consultation is required to measure the eye for
the correct replacement lens.
• Usually in and out of hospital on same day.
• No general anaesthetic is required (in most cases).
• The lens inside the eye is removed, except for the back
capsule.
• a new intraocular lens (IOL) is inserted.
Diabetic retinopathy
Diabetic retinopathy
• This disease is a complication of diabetes.
• It affects the small blood vessels of the retina.
• Blood vessels begin to leak and bleed inside the eye.
Prevalence and risk factors of diabetic retinopathy
• It is estimated that three per cent of the population aged
over 55 years have diabetic retinopathy.
• Twenty two per cent of people with known Type 2 diabetes
have some form of retinopathy related to their diabetes.
• Within 15 years of being diagnosed with diabetes, almost
three out of four diabetics will have diabetic retinopathy.
• People who have had diabetes for many years, have
diabetic kidney disease or have Type 1 diabetes have a
greater risk of developing diabetic retinopathy.
• Diabetic retinopathy is the primary vision threatening
condition for Aboriginal and Torres Strait Islander people.
Functional implications of diabetic retinopathy
• Changes to the retina results in:
• having difficulty with fine details e.g. when
reading or watching television
• experiencing visual fluctuations from hour to hour
or day to day
• seeing images as rippled e.g. straight lines appear
bent
• experiencing blurred, hazy or double vision
• losing some patches in the field of vision
• having difficulty focusing.
Prevention of diabetic retinopathy
• Early diagnosis and treatment can prevent severe vision loss.
• Your clients should get their eyes examined at least every two
years (or as directed by their eye care professional) if they have
diabetes.
• A diabetic eye examination should always include pupil dilation.
• In addition to regular eye examinations, important factors to
reduce the risk of developing diabetic retinopathy include good
management of blood sugar, blood pressure, cholesterol
levels.
Treatment of diabetic retinopathy
• Early detection and treatment is essential.
• Up to 98 per cent of severe vision loss can be prevented
with early detection and prompt laser treatment.
• Laser treatment to the retina can slow the progress of
diabetic retinopathy in some cases.
Glaucoma
Glaucoma
• Glaucoma is a disease that affects the optic nerve at the
back of the eye.
• Relieving pressure on the nerve reduces progression of the
disease.
• Early detection and treatment can slow the vision loss.
Prevalence and risk factors of glaucoma
• People over the age of 40 are more likely to develop
glaucoma than younger people.
• Almost three per cent of the Australian population over 55
years are affected.
• Glaucoma can run in families, people with a blood relative
diagnosed with glaucoma should regularly visit their eye
health professional.
• People with extreme refractive error, people with previous
eye injuries and people who have taken corticosteroids
are at greater risk of developing glaucoma.
Functional implications of glaucoma
• Optic nerve damage results in:
• a gradual loss of peripheral vision
• having difficulty adjusting to lighting changes e.g. between
indoors and outdoors
• experiencing occasional blurred vision
• seeing haloes around lights
• being particularly sensitive to glare and light
• having difficulty identifying the edge of steps
• being unable to differentiate between the footpath and
road
• tripping over or bumping into objects.
Prevention of glaucoma
• Regular eye examinations to ensure early detection and
treatment are the only way to control glaucoma and
prevent vision loss.
• Fifty per cent of people with glaucoma are unaware that
they have the condition.
Treatment of Glaucoma
• Lost vision can not be recovered.
• Treatments to prevent further loss are available
but early detection is the key.
• Early glaucoma is often asymptomatic which is
why examinations are critical.
• Glaucoma is managed by medication, laser and
surgery.
• For more information on glaucoma visit
www.glaucoma.org.au
Refractive error
Prevalence and risk factors of refractive error
• All age groups can be affected by refractive error.
• People over the age of 40 should have regular eye
examinations to eliminate refractive error as a cause
of vision impairment.
• Family history of refractive error is a risk factor.
Functional implications of refractive error
• Functional implications depend on the type and severity of
refractive error.
• Long-sightedness (hyperopia or hypermetropia) results in
difficulty seeing near objects.
• Short-sightedness (myopia) results in difficulty seeing distant
objects.
• Astigmatism results in blurred vision at all distances.
• Presbyopia (focus difficulty after the age of 40) rresults in
difficulty seeing near objects.
Treatment of refractive error
• Refractive error is often treatable with:
• glasses
• contact lenses
• laser eye surgery
• Low vision aids assist people maximise vision where
other treatments no longer improve vision.
Glasses and falls - prevention
• New glasses can take a while to get used to. People may
feel unsteady at first. Advise clients to wear them in safe
familiar environments (indoors at first).
• Slowly build up wearing time.
• Bifocals and Multifocals may cause distortion and blur
when looking down.
• Remind clients to move their head more when looking
down to look through the correct part of the lens.
• Advise clients to take care going up and down stairs and
gutters.
Glasses and preventing falls
• Transition (photochromatic)lenses change colour in the
sun. These lenses take time to fade when indoors.
• Advise clients to take the glasses off for a few minutes
when they go indoors, or sit on a chair inside near the
door for a few minutes while they become clear again.
• If clients have persistent problems advise them to discuss
this with their optometrist.
The relationship between falls and eyesight
• Vision disorders account for approximately three per cent
of the burden of disease.
• People with a vision impairment have:
• twice as many falls
• three times the risk of depression
• the risk of hip fractures increased by eight fold.
Vision assessment - how to reduce the risk
• The Vision Assessment tool has been developed by the
Vision Initiative to be used at the beginning of the Making
a Move program.
• It has been designed to identify participants whose
eyesight may increase the risk of falling.
• It will trigger a referral to an eye health professional as
needed.
• If you have concerns about a person’s vision please ensure
that you refer on to the correct services – see who’s who
section.
Who’s who in the eye care sector
• The following slides provide a brief introduction to who’s who
in the eye care sector, the services they offer and how to
access them.
• More information is also available on the
Vision Initiative website.
www.visioninitiative.org.au
Vision 2020 Australia
• National peak body for the vision care and eye health sector.
• Represents close to 60 members and associate organisations.
• Provides a platform for collaboration across the eye health and vision are
sector.
• Part of VISION2020: The Right to Sight a global initiative of the World Health
Organisation.
www.vision2020australia.org.au
The Vision Initiative
• A program aimed at raising awareness of eye health and
vision care to the general community and to health care
professionals.
• Funded by the Victorian Department of Health .
• Victoria’s public health response to the National
Framework for Action to Promote Eye Health and
Prevent Avoidable Blindness and Vision Loss.
• For more information visit www.visioninitiative.org.au
Optometrist
• An optometrist in a primary eye care provider.
• Medicare provides a full rebate on most optometry consultations.
• Patients do not need a referral to see an optometrist.
• Little or no waiting period for appointments.
• Will fast-track referrals to ophthalmologists if necessary.
• Many have therapeutic endorsement allowing optometrists to
prescribe certain topical eye medications.
• To locate your nearest optometrist, please visit
www.optometrists.asn.au
Australian College of Optometry
• The Victorian Eyecare Service (VES) is coordinated by the
Australian College of Optometry.
• It provides low cost eye care and glasses for people:
• on low incomes
• with Pension Concession Cards or Health Care Cards.
• Interpreters are available upon request.
• For more information visit
www.aco.org.au
Australian College of Optometry
• Glasses start from around $33.50 for single vision reading or
distance glasses and $47.00 for bifocals.
• Metropolitan locations:
Carlton, Broadmeadows, East Preston, Braybrook, Frankston,
Doveton, Victorian Aboriginal Health Service, Outreach (aged
care, SRS, disability).
• Participating VES private practitioners in country areas are
listed at: www.vco.org.au/vco.docs/VESdir.pdf
Ophthalmologist
• Ophthalmologist are secondary eye health providers.
• Qualified medical doctors often known as eye surgeons or eye
specialists.
• Provide diagnosis, surgical and medical treatment of eye
disease.
• Referral from a GP, medical specialist or optometrist is required
in order to obtain the Medicare rebate.
• Waiting time for appointments can vary according to the
condition (if urgent, a GP, optometrist or specialty
ophthalmologist can bring this forward).
• For more information on ophthalmologists visit
www.ranzco.edu
Royal Victorian Eye and Ear Hospital
• Victoria wide teaching, training and research health service.
• Specialising in eye, ear, nose and throat (ENT) medicine.
• Accident and Emergency is open 24 hours, seven days a week no referral is needed.
• Referrals are required to be seen in the outpatients clinics.
• Contact details:
Crn Victoria Parade and Gisborne Street
East Melbourne
Phone 9929 8666
www.eyeandear.org.au
Low vision services
• Approximately 180,000 Australians have a vision impairment that
can not be corrected by glasses.
• The number of people who are blind or vision impaired is
expected to increase to approximately 800,000 by 2024.
• Low vision services assist people when glasses and medical
treatment are no longer satisfactory.
• They help people to maintain their independence.
• Low vision services are usually free.
• For more information on low vision services visit
www.visioninitiative.org.au
Guide Dogs Victoria
• Guide Dogs Victoria provide services to Victorians who are
blind or vision impaired, enhancing their safety,
independence and quality of life at every stage of life’s
journey.
• No referral needed - enquiries from individuals, family
members and health professionals are all welcome.
• Specialised services are available including, children’s
mobility, acquired brain injury mobility, orientation &
mobility, occupational therapy, and guide dog mobility.
• For more information on guide dogs visit
www.guidedogsvictoria.com.au
Vision Australia
• Vision Australia offers a wide range of services to assist
people who are vision impaired across their life span.
• Clients can be referred by a health professional or they
can self refer.
• To assist health professionals in referring clients, Vision
Australia has a referral form on their website.
• For further information on Vision Australia visit
www.visionaustralia.org.au
Telephone: 1300 VISION (1300 847 466)
Support groups
Vision loss support organistaion provide support and information for people living
with vision impairment and blindness.
•
Blind Citizens Australia
1800 033 066
www.bca.org.au
•
Glaucoma Australia
1800 500 880
www.glaucoma.org.au
•
Keratoconus Australia
0409 664 811
www.kerataconus.asn.au
•
Macular Degeneration Foundation
1800 111 709
www.mdfoundation.com.au
•
Retina Australia
www.retinaaustralia.com.au
1800 999 870
Acknowledgement
Vision 2020 Australia would like to thank:
•
Genevieve Napper Australian College of Optometry
•
Kellie Michel Royal Victorian Eye and Ear Hospital
•
Kent Snibson Optometrists Association Australia
•
Nicholas Brislane The Royal Australian and New Zealand College of
Ophthalmologists.
•
Nikki Robbins Vision Australia
•
Sandie Mackevivius Vision Australia
•
Fiona Scoullar Vision 2020 Australia
•
Robyn Wallace Vision 2020 Australia.
Thank you
For more information please contact:
Robyn Wallace
Vision 2020 Australia
(03) 9656 2020
[email protected]
Or visit www.visioninitiative.org.au

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