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AGE-RELATED MACULAR DEGENERATION
Macular degeneration accounts for almost 50% of all visual impairment in the developed world. It usually affects people over 50 years of age and is known as age-related macular degeneration (ARMD or AMD). Macular degeneration can also be caused by eye injury, infection or inflammation. Diabetes can also cause macular disease (known as diabetic maculopathy). There are two types of AMD, wet and dry. Wet-type AMD produces new vessels that leak and cause oedemas (a build up of fluids). This type can be treated with laser. Dry-type AMD does not produce new vessels. There is no treatment at present for this type. Initially only one eye may be affected and symptoms in the early stages may
not be noticed since one good eye can mask the sight problem of the other eye. AMD alone does not result in total blindness. Only the central (reading)
vision is affected and the surrounding vision remains normal. Useful side
vision that allows you to see to get around is retained in both forms of AMD.
DIABETIC RETINOPATHY Diabetes is a common disease and has important implications for the short-term and long-term health of sufferers. Fluctuations in blood sugar can cause temporary visual blurring, particularly if diabetic control is poor. Diabetes can also cause cataracts in young people, or accelerate the development of cataracts in older people. Diabetic retinopathy is one of the commonest causes of blindness in the UK in people between the ages of 30-65, and 12% of people who are registered blind and partially sighted each year have diabetic eye disease. At any one time up to 10% of people with diabetes will have retinopathy requiring medical follow up or treatment. Although the majority of people with diabetes who have had diabetes for longenough will have some degree of retinopathy, eye checks will enable early diagnosis and early treatment. When people first develop diabetic retinopathy they have no symptoms, but, if diagnosed at this early stage, it is a treatable condition, which is why it is important for diabetics to have regular eye tests. Sight tests are free for people with diabetes.
RETINAL DETACHMENT 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 operation is necessary to replace the detached retina in its proper position. The symptoms of retinal detachment include people often describing 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. 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. There are a number of different treatment options ranging from laser treatment to surgery depending on the causes and condition of retinal detachment.
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CATARACTS Inside the eye, behind the iris (the coloured part of the eye) is a lens. In the normal eye, the lens is clear and transparent, and helps to focus light rays on to the retina, the tissue at the back of the eye. When a cataract develops, the lens becomes cloudy and prevents the light rays passing into the retina. The picture that the retina receives becomes dull and fuzzy. Cataracts usually form slowly and people experience a gradual blurring of vision. Cataracts do not permanently impair your vision and you will not go blind from a cataract. An operation will restore your sight. Most forms of cataract develop in adult life, and usually occur as we get older. Cataracts can be caused by injury, for instance, cuts, blows or burns to the eye which cause damage to the lens inside. Cataracts are more common in people with other diseases such as diabetes. Babies can be born with cataracts and these are known as congenital cataracts. 
GLAUCOMA Glaucoma is one of the world's leading causes of blindness. In the UK, 1 in 50 people over 40 have this condition. Glaucoma is not curable, but blindness is preventable if the glaucoma is diagnosed and treated early enough. While there are usually no warning signs, regular eye tests will help detect the onset of the disease. Glaucoma is an eye condition characterised by loss of vision due to damage of the optic nerve. The optic nerve carries sight images to the brain, and any damage to the nerve results in damage to sight. Usually, but not always, the damage occurs because pressure within the eye increases and presses on the nerve, which damages it. Drops and sometimes operations can stabilise the glaucoma, and, with regular check-ups, you will be able to manage the condition. You will experience some degree of sight loss but it will be minimised with effective treatment. Glaucoma can be treated but not cured. Because treatment can only control, not cure, the condition, it must be continued throughout life.
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