Transcript Slide 1

Making a Move
Vision component
Developed by Vision 2020 Australia’s Vision Initiative program funded by Victorian
Department of Health
• 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
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:
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
• 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
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
• Two out of three people will be affected by AMD in their
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
• 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
• 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
Prevalence and risk factors of cataracts
• Cataracts are a leading cause of vision impairment in
• 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:
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
• 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
• 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
• 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
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 is a disease that affects the optic nerve at the
back of the eye.
• Relieving pressure on the nerve reduces progression of the
• 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
• 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
• For more information on glaucoma visit
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
• 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
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
• If you have concerns about a person’s vision please ensure
that you refer on to the correct services – see who’s who
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.
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
• Part of VISION2020: The Right to Sight a global initiative of the World Health
The Vision Initiative
• A program aimed at raising awareness of eye health and
vision care to the general community and to health care
• 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
• 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
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
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:
• Ophthalmologist are secondary eye health providers.
• Qualified medical doctors often known as eye surgeons or eye
• Provide diagnosis, surgical and medical treatment of eye
• 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
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
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
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
• 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
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
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
Glaucoma Australia
1800 500 880
Keratoconus Australia
0409 664 811
Macular Degeneration Foundation
1800 111 709
Retina Australia
1800 999 870
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
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