Local optometrist raises awareness of the importance of driving with good vision

With news that Olympic gold medal winner, Bradley Wiggins, and his mentor, Shane Sutton, have both ended up in hospital after being in collision with vehicles in separate incidents, local optometrist Colin Tonner, from Leyland Opticians in Leyland, is helping to raise awareness of the importance of driving with good vision by urging people to have a sight test during Road Safety Week. Coordinated by charity Brake, Road Safety Week is the UK’s flagship road safety event which takes place from 19-25 November 2012.

New research, by RSA Insurance Group (RSA), has found that road crashes caused by poor driver vision cost the UK an estimated £33 million a year and result in nearly 2,900 casualties, with official tests to identify and rectify the problem in need of urgent reform.
Colin said: “Changes in vision can occur gradually over a period of time and, as such, a
driver may not realise they have a problem with their vision. The NHS recommends that
adults have their eyes tested every two years yet many drivers fail to look after their eyesight.”
The Association of Optometrists (AOP) is part of a sector-wide Optical Confederation initiative calling for tougher and more frequent checks on drivers’ eyesight. Given the
importance of being able to drive with good vision – so that drivers do not put themselves
and others at risk unnecessarily – the Confederation believes that all drivers should undergo basic screening for distance vision and field of view, before they get behind the wheel of a car.
David Craig, AOP director of marketing and business development, said: “The AOP has been concerned for some time about drivers’ vision. The issue reared its head again this year, with the death of 16-year-old Cassie McCord, who was killed by an 87-year-old driver who had, days earlier, failed the number plate test after a minor accident. This case illustrates only too clearly the risks that we run with the current system which requires drivers with poor vision to report themselves. It really is time that a regular, compulsory test was introduced which is consistent, repeatable and designed specifically for drivers. Surely, we can no longer tolerate a system that allows the needless deaths of innocent people like Cassie McCord.”

Julie Townsend, deputy chief executive, Brake, the road safety charity, said: “We’re caling on optical professionals to help make roads safer by engaging customers and the wider
community on this critical issue during Road Safety Week. It’s a perfect opportunity to raise awareness about driver vision and encourage your customers to do everything they can to protect others when they’re at the wheel. Our theme for Road Safety Week is ‘slower speeds = happy people’. We’ll be urging drivers to slow down to 20mph in communities to enable families to get out and about on foot and bike, for their health and enjoyment, without being endangered. Optical professionals can help to reinforce this vital message: we need drivers to slow down and look out to prevent tragedies and enable safe walking and cycling.”
“The Road Safety Week website is full of ideas: log on now to register for your e-action pack to help you get involved in this life-saving, awareness-raising event.”

For more information about Road Safety Week and to register for a free email action pack, visit www.roadsafetyweek.org.uk. For information about the Optical Confederation’s Driving and Vision campaign, please contact Ben Cook, Optical Confederation Deputy Head of Public Affairs, email bencook@opticalconfederation.org.uk or call 07702 904058.

Brake

Brake is an independent road safety charity. Brake exists to stop the five deaths and 66
serious injuries that happen on UK roads every day and to care for families bereaved and
seriously injured in road crashes. Brake runs awareness-raising campaigns, community education programmes, events such as Road Safety Week (19-25 November 2012), and a Fleet Safety Forum, providing advice to companies. Brake’s support division cares for road crash victims through a helpline and other services.

RSA Insurance Group

RSA, one of the world’s largest insurance companies, is calling for the regulations around driving and vision to be changed. The proposal is to scrap the current number-plate test and make a specific driving-vision test compulsory before a licence is issued – and repeating this test every ten years. The report, commissioned for RSA’s ‘Fit to Drive’ campaign and launched at a Parliamentary event in Westminster in November, aims to raise awareness of the dangers of driving with poor vision and is calling for a change in UK law.

Eye health

Optometrists are eye health professionals and the services they provide are far wider than a simple test to determine whether spectacles or contact lenses are required to correct vision.
Some also have additional certification to medically treat eye problems. Dispensing opticians dispense, fit and supply spectacles; and with additional training and certification can fit contact lenses.
A sight test is not just about getting a pair of glasses – it is a vital health check for your eyes. A sight test includes (by regulation) a number of other health tests. Many conditions can be detected, including: glaucoma, cataract, diabetes, age-related macular degeneration – the most common cause of blindness in the UK – some forms of cancer, as well as other conditions not usually associated with eyes, such as high blood pressure and brain tumours.

It is the No 1 cause of vision loss in the over fifties  – more common than glaucoma – and affects around half a million people in the UK. As shown in the picture, it damages your central vision affecting your ability to see faces, read, watch television and drive. It won’t affect your side vision so, whilst a visual handicap, it is not blinding.

Like Glaucoma there are two main types of AMD:

……… Sudden onset (or Wet)

……… Slow onset (or Dry)

Risk factors – these include age, family history of AMD, pale eye colour. All of these you can do nothing about.

Being overweight has an effect on your Cholesterol, blood pressure and ability to exercise. Loosing a few pounds helps with all the above.

Smoking increases your chances of getting AMD more than all the above. Stopping is the single best thing to reduce your risk.

A diet high in refined sugars and fats doesn’t help.

Not eating enough dark green veg, other coloured fruit and veg or fish

Not having regular eye tests

Not protecting your eyes from the sun by wearing CE marked sunglasses and UV absorbing spectacles, if worn.

Wet AMD  is less common than Dry AMD

but  ……..     gets more publicity because it can be aggressive and have a devastating effect on vision in a short time period.

but  ……..     in the last decade new treatments have helped, the main one being Lucentis.

Lucentis is very expensive per treatment and accounts for 1% of the NHS drug budget (£90million). Each treatment costs about £1000 for the drug alone and can require several months of treatment.

…….   1 in  3 are unresponsive to treatment

…….    but 2 out of 3 improve!

DRY  AMD:  ‘at the moment there is no treatment for dry AMD’.  (RNIB website)

‘a balanced diet with plenty of fruit and vegetables is good for your general health and may (my emphasis) also help your eye health.’  (RNIB website)

but …….. is this advice too pessimistic?

Research and experience over the last ten years demonstrates that a lot can be done. Scientists now believe that up to 50% of early to moderate DRY AMD can be halted or improved by taking appropriate action.

So what is DRY AMD?  It is far more common and quite different to WET – it progresses slowly, tending to affect at an older age and is a breakdown in the removal of waste from our light sensing cells. It is possible for DRY AMD to turn to WET.

It is now well documented that certain foods in adequate quantities help provide the eye with the tools to prevent or reduce this waste accumulation. These vision preserving tools are known as caretinoids and are vitamin A-like compounds. The knowledge that certain foods are beneficial has been known since the early 1990s. However, scientists have been cautious about making claims about them till the process has been better understood.

So, what are these foods?

Dark green leafy vegetables – spinach, kale, broccoli, sprouts, green beans, peas – provide us with LUTEIN

Coloured vegetables & fruits like Mango, sweetcorn, red Apple, orange, kiwi, orange & green pepper, red grapes: provide us with ZEAXANTHIN

AND at least a weekly portion of fish ( mackerel, tuna, salmon, herring). These supply omega 3s which help reduce inflammation and are involved in delivering essential nutrients to the eye.

Egg also is a good source of both essential caretinoids, so egg two-three times a week, is a great addition. (Egg was previously frowned on as it was thought bad for your cholesterol – this is now known not to be the case).

It is possible that you can supplement your diet by taking carefully formulated eye supplements. These have been developed over the last fifteen years or so and are based on large scale AMD studies and other scientific data. I believe it is better to improve your diet first as there is little cost in doing so. You can have your macular pigment measured and monitored, if not adequate or improving, supplementation can be considered.

The above pictures are of the same eye, taken about a year apart, before and after a change of diet.  The one on the Left has yellow/white spots (called drusen – trapped cellular waste or DRY AMD) which are mostly absent from the Right picture.

Does a healthy diet really help the eyes? Of course, it does. Look at poorer, less developed countries, see the diet related eye problems that exist and it is easy to realise that good food is important.

So being lucky enough to live where we are well fed, do we have to worry? Does our diet really make a difference? We are told to eat vegetables and fruit, all as part of our ‘five a day’. What more can we do?

A traditional British dish might be ‘meat and two veg’ and the two vegetables may be potatoes and cauliflower or carrot: good for energy maybe but not great for the eyes. Yes, carrots may be good for you but their benefit was overblown as propaganda in world war 2.

But what vegetable, fantastic for eye health, was well known about the same time and promoted by the cartoon character, Popeye?  Spinach!

Spinach is rich in the antioxidant Lutein that:

–  stops damaging UV from reaching the light sensing nerves at the back of the eye
–  soaks up the damaging free oxygen radicals released during the energy intensive light sensing process
– helps waste removal that happens every night when we are sleeping (after 40yrs old, this process starts to fail and cell waste deposits in the eye, leading to dry macular degeneration)
– improves our ability to go from light to dark, and vice versa
– sharpens our daytime vision

The link between levels of Lutein in our blood and the eye, and being protected from dry macular degeneration has been known for over twenty years. Major population health studies in the US have consistently shown individuals with high blood serum lutein levels, showed less macular damage, and those with macular damage also had less Lutein in the eye than those with no damage.

More recently, scientists have been able to measure the amount of Lutein and other macular pigments that are essential for healthy eyes into our retirement. All the benefits listed have been independently verified by UK, Dutch, Irish, American and other researchers. Recently, I had a case of a lady with Dry Macular Degeneration reverse some macular damage and improve her vision (published in The Optician, 7th March, 2012).

Measuring Lutein was very much a laboratory process not easily done elsewhere. Medical instrument maker, Carl Zeiss, have now produced the first simple eye scanning procedure that allows your Lutein levels to be measured, quickly and easily.

With this information along with other risk factors, you can discuss with your optometrist how to preserve your vision. There are lots of supplements that you can buy to help prevent macular degeneration. By having a discussion about diet and your individual risk factors it is possible to adjust (maybe not by much) your diet and make improvements to your eye health without the need for expensive supplements. If you don’t like spinach .. not a problem as there are other, equally, beneficial vegetables to eat.

Extra benefits from these same antioxidants, is protection for your arteries! Healthy diet.. Healthy eyes.. Healthy life!