HEALTH: Are you taking care of your eyes?

The vision of his right was perfect: 20/20.  But he has problem with his left eye; his best visual acuity was still 20/60 – even with an aid of eyeglasses.  He consulted an ophthalmologist who told him that even if he would undergo a laser surgery, the problem of his left eye won’t be fixed.

“The truth is, you have never own glasses,” the eye doctor explained to the patient.  “The problem of your left eye should have been picked up when you were seven years old.  After seven years old, the connection between nerve cells of the eyes is already established and we could do nothing about it anymore.”

As the 30-year-old man was listening to the doctor’s explanation, he started to cry.  “I am applying for a job in Singapore,” he said, “and I failed the medical examination because I could not read the chart with my left eye.  I have three children and want to get this job to earn more but I will not be accepted if my left eye cannot see 20/20.”

In an interview, the eye doctor told this author: “If only his eye problem was picked up when he was younger than seven years old, given proper glasses and aided by patching his left eye, he would have gotten the job.”

The man is not alone.  In fact, most Filipinos are not paying attention in taking care of their eyes.  “The critical time periods for an eye examination is during the start of schooling (around 4-5 years old), at adulthood (18-20 years of age), and at 40 years and thereafter,” says Dr. Maria Imelda Yap-Veloso, an ophthalmologist at the Asian Eye Institute in Makati.

In fact, eye examinations should start when a child is born.  “Ideally, a child should be assessed at birth, age six months old, agree three years old, then 4-5 years old, and then annually thereafter, if each exam turns out okay,” says Dr. Alvina Pauline Santiago, a consultant in pediatric ophthalmology at the Philippine General Hospital.

Adults should have their eyes examined at least once every year.  “It is important to have regular examinations so you will know the status of your eyes,” Dr. Yap-Veloso points out.  “You will know whether you are at risk for certain eye problems.  You will also be advised by your doctor what you should avoid and how often you should come for check-ups based on your eye findings.”

But can eye problems be reversed once they are discovered?  “It depends on the eye problem,” replies Dr. Barbara L. Roque, a consultant ophthalmologist at the Eye Republic Ophthalmology Clinic. “If the problem involves vital eye parts like the optic nerve, the retina, or the lens, something can almost be done to address the problem but the return of visual function to normal depends on the severity of the condition and the length of time that has lapsed since the onset of symptoms, among others.”

More often than not, Filipinos don’t see an eye doctor until they experience a change in their vision or only when having eye discomfort.  “I believe there are many reasons for this.  One is that they may not be aware that certain serious eye diseases may not have any symptoms until one has already reached the later stages of the disease.  Two, they may think an eye examination is painful and complicated process.  I have some patients who say, ‘You mean, that’s an eye examination?  I was expecting a more horrifying experience than that!’  The third is probably the usual reason why don’t see doctors often – we don’t want to hear bad news.”

The bad news is that an estimated 45 million people are blind and 135 million are visually impaired.  In the Philippines, glaucoma is the second leading cause of blindness – after cataract.   Other forms of eyesight conditions are amblyopia (one eye cannot see well), presbyopia (the eye’s lens loses its elasticity, making nearby objects appear fuzzy), myopia (objects in the distance are blurry), strabismus (when eye don’t align), binocular problems (when eyes don’t work together) and age-related macular degeneration (breakdown of the macula, which controls central vision).

These eyesight conditions can be detected only with a comprehensive examination by an optometrist (an eye-care expert) or an ophthalmologist (a doctor specializing in eye health, who can also do surgery).

Most Filipino ophthalmologists charge similar rates (ranging from P500 to P800 per consultation) for children and adults.  However, if extra tests/measurements or adjunctive diagnostic procedures are needed, there may be additional charges.

The good news is: doctors can now use different treatments to solve all types of eyesight problems while limiting the side effects.  “Thanks to modern science, we now have the solution to most eyesight problems,” points out Dr. Gerard Chuah, consultant ophthalmologist at the Mount Elizabeth Hospital in Singapore.  “Name it and we may have the technology for it.”

In an article which appeared in Reader’s Digest, Jen Matlack offers a host of new treatments for those people whose life is getting blurry.  “Now is the most exciting time in the field of vision care,” Dr. Alan Carlson, director of the Refractive Surgery Service at the Duke University Eye Center, was quoted as saying.

Even for people who wear reading glasses, there’s a new treatment for them.  For instance, people having presbyopia can use the so-called switchable bifocals.  These glasses, being developed at the University of Arizona, can be switched from near- to farsighted vision at the touch of a button.

Myopic people can avail the phakic implantable contact lens.  It’s a pliable lens that’s injected by an ophthalmologist into the eye, where it “unfolds” to correct nearsightedness.  Ask your doctor if you are 21 to 45 years old, suffer moderate to severe nearsightedness and aren’t a candidate for or don’t want laser surgery.

For those suffering from cataracts, they can ask for either Tecnic ZM900 or Alcon ReSTOR.  These multi-focal intraocular lenses are artificial implants that mimic the natural lens, giving patients spectacle-free distance and near vision.

Anecortave acetate is good for those with glaucoma.  It’s a drug that’s injected around the wall of the eye.  It appears to decrease production of myocilin, a protein that clogs the pore system inside the eye where fluid drains.

There are three anti-VEGF (vascular endothelial growth factor) agents that are available against age-related macular degeneration: Lucentis , Macugen, and Avastin.  Any of these are injected into the back of the eye under local anesthesia to stop central vision loss.

“The eye governs a very significant sense  — the sense of sight – our windows to the world and our windows to life,” Dr. Yap-Veloso reminds.  “Taking care of this special sense should take a more active participation on our part.”

A regular eye examination is a part of that eye management.  “Early diagnosis leads to early treatment and prevention of eye complications which may be permanent,” concludes the clinical associate professor at the University of the Philippines College of Medicine.

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