Sight is one of the five senses.
Eye conditions are common and can be acute or chronic.
Many adults will have experienced an eye condition in their lives.
Some eye conditions do not typically cause vision impairment, but others do.
The common eye conditions that do not typically cause vision impairment include eyelid inflammation, conjunctivitis, dry eye, cyst or stye, benign growth and subconjunctival haemorrhage.
The common eye conditions that can cause vision impairment include cataract, corneal opacity, glaucoma, trachoma, age-related macular degeneration, diabetic or hypertensive retinopathy, and refractive error.
Eye conditions are projected to increase because of various factors like our ageing population, lifestyle and non-communicable diseases (NCDs).
Affects all ages
Impaired vision affects all ages with the majority being over 50 years of age.
The burden of eye conditions and vision impairment is often greater in women, senior citizens, low-income groups, disabled and indigenous people.
Vision impairment can lead to blindness and impact the lives of the affected.
In young children, it leads to lower levels of educational achievement.
In adults, it leads to high depression rates, lower productivity and decreased workforce participation.
The leading causes of vision impairment and blindness are uncorrected refractive errors and cataracts.
Other equally important causes of vision impairment include chronic conditions like diabetes and high blood pressure that cause retinopathy; infections; trauma to the eye; glaucoma; and age-related macular degeneration.
Malaysia has a National Eye Register, with the last report published in 2016.
It was reported in the International Ophthalmology journal in 2014 that half (50.5%) of all cases of childhood blindness in Malaysia were from avoidable causes, with cataracts and retinopathy of prematurity being the main culprits.
Another study reported in Optometry – Journal of the American Optometry Association in 2011, that children with low academic achievement were more likely to exhibit problems in visual acuity, ocular motor balance, visual-motor integration and most of all components of visual analysis skills.
The findings support what the study authors said was the “concept that visual performance is key to learning, and therefore, of chief concern as to school achievement”.
Improving eye care
The World Health Organization’s (WHO) 2019 World Report on Vision provided evidence of the magnitude of eye conditions and vision impairment globally.
It also focused on effective strategies that address eye care and recommended actions to improve eye care services.
The report, which was directed at governments, civil society, practitioners and researchers, recommended integrated people-centred eye care services that provide a continuum of care based on needs throughout individuals’ lives.
The objective of the report was to reduce the burden of eye conditions and vision loss to achieve the Sustainable Development Goals (SDGs), particularly SDG target 3.8 on universal health coverage (UHC).
The WHO estimated that at least 2.2 billion people globally have a near or distance vision impairment, of which about one billion could have been prevented or has yet to be addressed.
The latter includes:
- Unaddressed refractive error (123.7 million)
- Cataract (65.2 million)
- Glaucoma (6.9 million)
- Corneal opacities (4.2 million)
- Diabetic retinopathy (3 million)
- Trachoma (2 million), and
- Unaddressed presbyopia (826 million).
The projected increase, from 2020 to 2030, in the number of people having age-related macular degeneration and glaucoma were 195.6 to 243.4 million, and 76 to 95.4 million respectively.
Risk factors
The risk factors of vision impairment can be divided into non-modifiable and modifiable.
The non-modifiable factors include age, genetics and ethnicity.
For example, the loss of ability to focus on nearby objects (presbyopia) increases with age, and the loss of ability to see distant objects (myopia) is more common in ethnic Chinese.
The modifiable factors are lifestyle-related, e.g. smoking, nutrition, occupational and recreational activities, and environment-related, e.g. hygiene, sanitation and access to clean water.
Vision impairment has an enormous global financial burden.
The annual global costs of lost productivity associated with vision impairment from myopia and presbyopia was estimated in 2019 to be US$244 billion (RM1,130 billion) and US$25.4bil (RM117.6bil) respectively.
In May 2021, the WHO set itself two new global targets for eye care: a 40% increase in effective coverage of refractive errors and a 30% increase in effective coverage of cataract surgery.
The intention was to increase global eye care coverage, and to strengthen the quality of the eye care services delivered.
More importantly, the targets were aligned with, and reflect the pursuit of, UHC and the need to integrate eye care programmes with existing services.
‘Love your eyes’
World Sight Day will be commemorated on Thursday (Oct 13, 2022).
The objective of the day is to focus global attention on vision impairment, including blindness.
The theme this year is “Love Your Eyes”.
The International Agency for the Prevention of Blindness has provided 10 tips for everyone to love their eyes, which are:
When using a screen, look at something 20 feet (6 metres) away for 20 seconds every 20 minutes, to avoid eye strain and headaches.
Children should spend at least two hours a day outside.
This also helps their eyes develop in a healthy way and helps them avoid developing near-sightedness.
Make sure your sunglasses offer UVA and UVB protection to prevent radiation from the sun damaging your eyes.
You should wear your prescription glasses to see clearly and prevent your eyes from having to work harder, which can lead to eye strain and headaches.
Check the expiry date on eye makeup and replace your brushes regularly to prevent the build-up of bacteria that could cause eye infections.
Doing regular exercise can reduce the risk of developing conditions like diabetes or high blood pressure, which can affect your sight.
Eating a balanced diet ensures you have the vitamins and minerals that are essential for maintaining healthy eyes.
Smoking increases your risk of developing serious eye conditions and permanent sight loss.
An eye test can detect an eye condition even before it’s affected your eyesight, so even if you don’t think there’s anything wrong with your eyes, you should book a test to check them.
You need them to last all your life.
Put reminders in your calendar to have regular eye checks, which should be once every one to two years.
The eyes are every person’s prized asset.
Vision impairment and blindness have significant and long-lasting effects on every aspect of life, including school and work opportunities, and the ability to access services.
They impact on socioeconomic development and life outcomes.
So, it is critical to love your eyes as prevention is better than cure.
Dr Milton Lum is a past president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association. For more information, email starhealth@thestar.com.my. The views expressed do not represent that of organisations that the writer is associated with. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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