By Ana Tavares
The saying that “the eyes are the window to the soul” is more accurate than we think. Complex organs that detect the light and change our perception of electric impulses, the eyes can reveal the presence of other conditions, such as neurological or even orthopaedic disorders. However, amongst the countless yearly check-ups we have to do, our eyes are often not our first priority, meaning that many diseases go undetected until it’s too late. Specialists are quick to warn: more than glasses or prescriptions, there’s one thing that eyes really need, and that’s prevention.
“I think people have this idea that if they go to the optometrist, they won’t leave without glasses,” says Surali Neville, who has worked in the Optometry field for over 20 years. “But it’s a medical examination that’s just as important as any other,” adds the optometrist, who worked in the UK for many years before opening SN & N Optico in Lagos in 2010.
Ideally, eyesight check-ups should be done every one to two years, if there are no problems detected. For people with deteriorating pathologies, appointments can be made biannually or even quarterly, and with children, the recommended age for the first exam is from four years old, if there are no suspected problems or family history.
The important thing is to always go to a qualified professional: not all optometry technicians in Portugal are licensed in Optometry, a course only available at the universities of Minho and Beira Interior.
A real optometrist can not only determine the type of glasses you need, but also do the necessary eyesight check-ups and then refer the patient to an ophthalmologist, neurologist or even an orthopaedist, depending on the problem found. An ophthalmologist is a doctor who specialises in Ophthalmology, and can only work as an ophthalmic surgeon after further studying. So whilst the optometrist is able to diagnose certain conditions, they must always be treated by an eye specialist.
“Especially until the age of 20 and after 50, people should be seen annually by a doctor,” says Dr Carlos Moedas, an ophthalmologist at the Hospital Particular do Algarve (HPA) in Alvor since it opened 16 years ago. The eye specialist justifies this need with the fact that eye diseases are often worsened by conditions such as diabetes or high blood pressure. “We mustn’t forget that diabetes is the first cause of blindness in developed countries,” he underlines, adding that eye diseases are “deceptive”.
One of the most subtle and common disorders today is glaucoma, where intraocular pressure rises and affects the optic nerve, causing black spots to appear in the peripheral vision. For this reason, many people don’t notice the disease until it’s too late, when they already have tunnel vision. Once again, prevention is crucial: “If detected early, glaucoma is very treatable, by using drops that lower the tension in the eyes,” ensures Surali Neville. If detected later, the damage is irreversible.
“Eyesight care is essential and it’s changing,” warns Luísa Matias de Freitas, owner of Kykus Eyecare in Albufeira and with a masters in Optometry and Vision Science. “As we have a longer life span, diseases we weren’t used to have appeared, such as diabetic retinopathy and age-related macular degeneration.” Besides glaucoma, these are two of the most severe diseases of the century when it comes to blindness, explains the optometrist.
Therefore, we must be aware of the risk factors such as family history, diabetes and high blood pressure, as well as symptoms like distorted eyesight, change in colour perception and blurred vision or flashes of light.
Another important risk factor is over-exposure to the sun, which increases the appearance of cataracts and age-related macular degeneration (AMD). “People here [in the Algarve] very often don’t realise that they live in the place with the most sun in Europe,” Dr Carlos Moedas points out. “The eye is more sensitive to the sun than the skin, and the sun is the main cause of AMD.” Very often put down to age, AMD destroys the central vision area, making tasks like threading a needle or simply reading impossible.
Therefore the best protection is avoiding prolonged sun exposure, especially between 11am and 4pm, as well as wearing sunglasses all year round and a wide brim hat. “Glasses must have UV protection and shades of brown are the best filters, followed by black and green. Grey isn’t an effective filter,” says Luísa Matias de Freitas. “On the beach, glasses also protect you from the sand on windy days, which can cause scratches on the cornea,” adds Surali Neville. “Thanks to EU regulations, even the cheapest sunglasses have UV protection in Europe. But when buying from a street vendor, we don’t know what we’re actually buying,” warns the owner of SN & N Optico.
Although Ophthalmology has seen dramatic progress in recent years, particularly in the diagnostic and therapeutic field, many patients still see laser treatment as the ultimate “magic wand”.
Laser is effective in the treatment and curbing of certain disorders, such as low myopia, ocular diabetes and premature glaucoma, but the results aren’t as immediate as people think (going to work on the same day isn’t recommended, for example), and the postoperative is smooth but not inexistent. Dr Carlos Moedas also notes that there are other alternatives for patients with fragile corneas or with high myopia prescriptions, astigmatism or farsightedness: implantable contact lenses, in which HPA is a pioneer.
In fact, laser surgery in short-sighted patients should only be done after their prescription is stabilised and preferably after the age of 20, in mild or moderate cases. “Laser treatment is effective,” says the eye specialist, “but it has to be used carefully, in the right places, by the right people”.