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I enjoyed this four line poem, called a quatrine, by British Poet Lemn Sissay. A collection of these poems, which he wrote each morning for over ten years, has been published: Let the Light Pour In. The poems are untitled.
Where are my glasses? Where are my glasses?
My glasses are gone my glasses are gone
I have lost them again I have lost them again
I have got my glasses on.
SightScore testing is a polygenic risk score which estimate a person’s genetic risk of developing Primary Open Angle Glaucoma. This can be the risk of future glaucoma, or, if someone already has glaucoma, the risk their glaucoma might progress to more severe disease, relative to others in the community.
SightScore assists us to identify individuals at highest genetic risk of glaucoma. This means these people can be appropriately prioritized and managed, to increase the likelihood that any glaucoma or glaucoma progression can be detected earlier. It may also help us identify those at lower genetic risk of glaucoma.
Humans share the same genetic code apart from some differences, called genetic variants, that make each of us unique. Some of these variants are known to increase the risk of developing glaucoma, while others reduce the risk. It is possible to combine the risks from hundreds or thousands of these genetic variants to estimate a person’s genetic risk of developing glaucoma, either in the future or, if they already have glaucoma, the risk their glaucoma might get worse, relative to others in the community.
This information may be useful in a range of patient management decisions. Used in combination with a your medical history, clinical risk factors and eye examination the Sightscore information can help in considering:
How often someone should be monitored for glaucoma,
Management strategy for someone with glaucoma, including some treatment decisions such as whether to begin medicine (drops) to lower eye pressure, and
Whether blood relatives (parents, brothers/sisters, adult children) should be checked for glaucoma.
Sightscore is a saliva test. We have the kits here, and you can either do the test at home or we can do it here in practice for you.
Results come through after 2-3 weeks, in the form of report, see the example below. You can discuss this with us, and take the report along if you see an ophthalmologist.
Blephasteam, treatment for dry eye.
Blephasteam for dry eye relief
Are you struggling with dry eyes that just won’t improve with warm compresses and lubricating drops? There’s more we can do for your dry eyes, right here in our practice.
What is Meibomian Gland Dysfunction (MGD)?
Your eyelids contain tiny oil glands called Meibomian glands. These glands produce oils that keep your tears from evaporating too quickly. When the glands become blocked or don’t function properly, your eyes can feel dry, sore, and inflamed. This is known as Meibomian Gland Dysfunction.
We advise many people to use warm compresses at home to help unclog these glands and ease symptoms. This can help, but some people benefit from a more targeted, effective approach.
In-Office Treatment: Blephasteam
At our practice, we offer treatment for dry eye and Meibomian Gland Dysfunction using Blephasteam Heat Goggles in combination with Meibomian gland expression.
Blephasteam is a gentle, heat-based therapy designed to warm the eyelids and help unblock the Meibomian glands.
The treatment involves wearing a pair of specially designed heated goggles, similar in appearance to swimming goggles, but with a built-in warming system. Before the session, soft, disposable paper rings soaked in water are placed inside the goggles. Once on your eyes, the gentle heat converts this moisture into warm steam, bringing the eyelid temperature to just above 40°C allowing optimal heat for melting the thick, waxy oils blocking the glands.
After the warming phase (approximately 10 minutes), we perform Meibomian gland expression to help release the melted oils and clear the gland openings. This allows the glands to begin producing healthy oils again, helping restore your natural tear film and significantly reducing dry eye symptoms.
If at-home treatments haven’t provided lasting relief, consider booking in for Dry Eye treatment. Talk to us today to find out if Blephasteam could help you.
Many areas of medicine adopt proactive ways to manage disease, aiming to mitigate against progression of a condition through positive lifestyle choices. We have some strategies to share which are appropriate if you are being monitored for signs of glaucoma developing, and if you already have been diagnosed with glaucoma.
This proactive, preventive model for glaucoma care focuses on five key lifestyle, non-pharmacological pillars.
Pillar 1: Physical Activity
A link between physical activity and eye health
Physical activity is well recognised for its systemic health benefits. There is emerging evidence of an association between physical activity and eye health in glaucoma.
With the exception of one type of glaucoma (pigment dispersion) aerobic exercise has consistently been associated with temporarily lowering eye pressure. Eye pressure reduction occurs within minutes of walking, jogging, or cycling, and may be sustainable for up to 30 minutes.
There may also be a further benefit through exercise, attributed to blood flow to the nerve in the eye.
However there are also a few cautions associated with exercise and glaucoma. It is recommended to exhale when doing strength training, to use large goggles when swimming, and avoid head down positions in Yoga.
Pillar 2: Stress Management
Psychological stress is increasingly recognised as an influential factor in eye pressure control. So any eye-pressure-lowering strategy should include stress management as part of a holistic approach.
Mindfulness meditation was first reported to reduce IOP in 2018 including a technique called 365 breathing – deep breathing with six breaths per minute for five minutes, three times a day.
Managing stress through mindfulness meditation or 365 breathing is safe, non-invasive, easy to implement, and effective. These techniques empower people with a natural way to help lower eye pressure as well as reducing the effects of stress on overall health.
Pillar 3: Sleep Right
Quality sleep is crucial for restoring bodily function, and eye health is no exception. Snoring, daytime sleepiness, sleep apnoea, insomnia, long sleep duration (over nine hours) and short sleep duration (under seven hours) are all associated with more progression in glaucoma.
With sleep, the position also matters, and can influence eye pressure. Night time eye pressure tends to go down for sleeping positions which lift the eye and head above the rest of the body. Side-lying positions can result in a higher eye pressure in the lower eye.
Pillar 4: Diet and Nutrition
A healthy diet can maintain eye health
Diet and nutrition are key factors in maintaining eye health for people at risk of glaucoma. Specific nutrients have been linked to a reduced risk of glaucoma onset and progression, while a diet high in antioxidants and low in processed foods may help protect the optic nerve. Incoporating a variety of colourful fruits and vegetables into your daily diet which include essential vitamins – A, B, C, and E - is recommended. Fatty fish including salmon, mackerel, sardines, and anchovies are excellent sources of omega-3 fatty acids, which has also been associated in reducing the odds of glaucoma. (On the other hand, ultra-processed foods high in refined sugar, salt, and saturated fats may increase the risk of glaucoma.)
Multiple beverages have been studied in relation to glaucoma. Drinking hot tea daily was associated with lower odds of having glaucoma. Coffee, on the other hand, may increase eye pressure and glaucoma risk, especially in those who are genetically predisposed.
Alcohol consumption was found to be consistently and adversely associated with glaucoma, even at intake levels below the recommended guideline.
Pillar 5: Neuroprotection – Reinforcing the Optic Nerve
There are several nutraceuticals - products made from food or natural ingredients that offer extra health benefits beyond basic nutrition - which show promise in slowing glaucoma progression. These effects are on eye pressure and also mechanisms which contribute directly to optic nerve health.
Preliminary trials have reported that nutraceuticals such as saffron, blackcurrant, a combination of bilberry and maritime pine bark, and palmitoylethanolamide lead to modest eye pressure lowering effects.
Closely interrelated with IOP is external psychological stress. Psychological stress contributes not only to elevated IOP, as noted earlier, but also to increased blood pressure and a heightened risk of cardiovascular issues. In addition to mindfulness meditation and 365 breathing, nutraceutical supplements have been shown to help alleviate psychological stress and support the body’s stress response. Key examples include saffron, lutein, and zeaxanthin.
As for vascular factors, active folate and vitamin B12 can improve blood flow to the optic nerve while nutraceuticals such as ginkgo biloba, bilberry, and French maritime pine bark have shown benefits for ocular blood flow.
A randomised controlled trial demonstrated that nicotinamide (vitamin B3) helps stabilise mitochondrial function, and improve the resilience and performance of retinal cells in glaucoma patients.
Botanical extracts such as saffron, bilberry, ginkgo biloba, and grape seed exhibit potent antioxidant and anti-inflammatory properties, helping to mitigate against oxidative stress and chronic inflammation.
Science and research continues to investigate ways to slow glaucoma, the results here empower us with steps we can take to help maintain healthy vision.
Relief from dry eye while you sleep
Optometrist Emily Kamimura has been working with us since the start of the year, and will be a familar face to many of you. Her tips are all about helping you see and feel your best.
This Month's Pick: Night-time Lubricating Eye Ointments
Do you wake up with dry, gritty, or uncomfortable eyes? You're not alone, many people experience this, especially if they sleep with a fan or aircon on, or suffer from dry eye.
My recommendation is to try a night-time lubricating eye ointment or gel. These thicker formulas provide long-lasting moisture while you sleep, helping your eyes feel refreshed and comfortable by morning. They’re especially great for people with moderate to severe dry eye or those who find the relief from regular drops wears off too quickly.
There are several options so ask us for a recommendation - we’re always here to help!
Emily, Optometrist
Regular cleaning of the eye lid margins is useful for Meibomian gland dysfunction, MGD, and anterior blepharitis where scaly material accumulates at the base of the eye lashes.
Using a warm flannel or cloth can be a start, but there are product formulations which work more effectively. We recommend foam cleaners (Sterilid or Blephadex), or wipes (Systane Lid Wipes or Lid ‘n Lash). Using the cleaner or wipes at least 3-4 times per week will get the best results.
Previously people were advised to use diluted baby shampoo. This is no longer recommended as this can exacerbate inflammation.
Using the correct product can help relieve blepheritis.
