What You Need To Know About Your Eye Health


We chat to Leoni Joubert, lead optometrist at Joubert Tilly Optometrist, a specialist in Paediatric and Binocular Vision and the Founder of the Paediatric Training Academy, to discuss what you need to know about your eye health. Here is what she had to say.

How do I know when it is time to visit an optometrist?
One should visit your optometrist annually, as there are many ocular conditions that can be present and would not necessarily cause visual problems initially (such as glaucoma, which is a condition due to raised intra-ocular pressure that could be completely painless but only causes visual problems once it is already too late and damage to the optic nerve has already occurred). Having said that, any condition which causes blurry vision, pain, double vision, redness, discharge, headaches, eye strain, difficulty changing focus, tearing, pupil abnormalities, bright flashes of light (an ocular emergency which could indicate a retinal detachment) or other ocular discomfort should be investigated.

How often should I visit my optometrist?
Annually or as above. If you are diabetic, you need a dilated fundus exam every six months. This is very important as small changes like bleeding occur in the retina (nerve layer at the back of the eye) and could permanently affect vision. Also, changes seen in the retina often mirror events happening elsewhere, such as kidney damage and peripheral neuropathy.

When is the best time to start taking children to an optometrist and how often should they visit?
The American Optometric Association as well as the British College of Optometrists recommends that if there is no noticeable visual defect, a child should be taken for their first visual exam at the age of six months. Then at three years of age, then at six years (just before entering formal schooling) and then annually thereafter. Be aware that not all optometrists are trained, comfortable or skilled in seeing young children or babies, so make sure to check before you schedule an appointment. If there is a visual problem or you notice something untoward, it is imperative to seek professional help immediately.

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How do I go about finding a good and qualified optometrist that I can trust?
Word of mouth is usually the best option. Cheaper isn’t always better! Watch out for misleading advertising like “two for one deals”, as there are often other hidden costs. Look at the person’s qualifications. You can contact the South African Optometric Association for information (although not ALL optometrists are a member of the SAOA). It is important to develop a good relationship with your eye care practitioner. If you are not on medical aid, there are other options. Most practitioners are willing to help, so discuss your concerns, ask questions.

What can I expect during my eye test?
Fun! Visual exams are generally painless and easy. The optometrists will discuss your general and ocular health and associated medical history with you. They will ask about the reason for the visit and what your visual requirements are, measure your visual acuity, do a refraction to determine your prescription and refractive error. They will also check your eye health by measuring the intra-ocular pressure, checking the internal and external health of your eyes, possibly also take photographs of the inside of your eye, check eye movements and other visual skills and then make recommendations as to what the best solution would be to meet your visual needs.

What do I need to know when I go for an eye test? 
Please don’t take your shoes or clothes off during your visual examination! We are here to examine your eyes only. We get really close during the visual examination when we’re doing ophthalmoscopy. This is normal. Please don’t think we are trying to get to know you better. Please do not bring your children in when they are sick! Make sure to bring your old spectacles with for all consultations. Be honest! We are not here to judge you. It is important to tell us your full medical history. Know what medications you’re on and what conditions they are for.

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What are the most common eye ailments?
Refractive errors like myopia (short-sightedness), Hyperopia (far-sightedness), Astigmatism (irregular shape of the cornea) and presbyopia (difficulty reading as we age due to hardening of the lens) are the most common ailments. Obviously, eye infections like pink eye are also pretty common (especially in children) and dry eye is often found in older patients.

What symptoms of eye problems should I be looking out for?
Any blurry vision, eye strain or visual discomfort needs to be investigated. If you see bright flashes of light (almost like a camera flash going off) and dark floaters it is an ocular emergency and you need to see an eye care practitioner urgently. The same goes for any sudden loss of vision or double vision.

What are the most common ways people damage their eyesight?
Well, the most common ways depend a lot on what people are doing and what time of year it is. New Year almost always leads to vision loss due to injury from fireworks. They are ridiculously dangerous! The amount of ocular injury on Valentine’s Day due to champagne corks is always common. But by far, the most common damage to eyesight is from trauma due to either accidents like vehicle accidents or from violence and fighting. People also weld without proper protection and get “arc eyes”. Or they get injured in the workplace due to grinding accidents. Scratches to the eye from fingers or mascara brushes can also be a problem. Pellet or BB guns cause damage to vision in children. You cannot damage your eyesight by reading in dim illumination (it might cause eye strain though).

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What is meant by 20/20 vision? Is this perfect vision? 
Visual resolution, which is generally written as 20/20 or 6/6 (metric), means you can resolve a letter or figure which subtends 5 minutes of arc at 6 metres (or is 0.87cm in height). That is considered to be relatively good eyesight but there is much more to vision than that. Having 20/20 (6/6) vision does not necessarily mean you have perfect vision. 20/20 vision only indicates the sharpness or clarity of vision at a distance. Other important vision skills include peripheral awareness or side vision, eye coordination, good ocular movements, depth perception, focusing ability and colour vision. These all contribute to your overall visual ability.

How will I know if I need glasses?
Your optometrist will investigate your visual functioning and make a recommendation but should you experience blurry vision at distance, near or both, have difficulty maintaining clear vision at any time, get headaches or eyestrain (especially with computer or electronic screen use), please see an optometrist.

What is the better choice between glasses and contact lenses?
It depends on what you need to do. For example, contact lenses are great for sport or leisure activities and when cosmesis and convenience is an issue. But they would be impractical for a child/baby or for someone who works in a very dusty environment or under other non-sterile conditions. Also some people cannot tolerate contact lenses, have very dry eyes or cannot handle them properly in terms of being able to place them in their eyes or remove them. Spectacles are usually less expensive than contact lenses and most people can wear them. They can be purpose specific (for example for driving or computer work) or they can be multi-task type lenses that can be used for more than one activity. Fashion conscious people also often like the look that spectacles give.

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What should I know when I am purchasing sunglasses?
Avoid “side of the road” sunglasses as they are often of inferior quality, do not offer proper UV protection, have poor optical quality lenses and can cause eyestrain and not provide adequate protection. Always make sure there is a good quality UV filter and that the lenses are free of distortions. Make sure to buy sunglasses from a reputable source to ensure good UV protection. The frame should fit you well and provide good coverage of your eyes. Stickers on sunglasses can be misleading as bad quality ones just put random UV stickers on them. In the electromagnetic spectrum UV light has a range of 100-400nm. The atmosphere and eyes cut out most levels of UVC. UVA and UVB reach us through the atmosphere. Sunglass lenses should block out all UV. So they often have a sticker that says UV400 which means they block out all UV up to 400nm. Even clear plastic lenses will cut out some UV but not all whereas glass allows more UV through.

Is there anything I can do to protect and preserve my eyesight?
Yes! Have annual check ups with your optometrist to ensure you do not have any underlying condition, make sure you wear sunglasses when outdoors with a good UV protection factor, always wear protective goggles when welding or grinding and get a good blue control filter on your spectacles if you spend a lot of time looking at electronic screens.

Is there anything I can eat or any exercise I can do to preserve/ improve my eyesight?
It is said eating carrots is good for eyesight and to an extent this is true, as it contains elements that help our eyes when adapting for vision in low light conditions. Carrots contain beta-carotene, which is a component of Vitamin A, which is necessary to change from light (photopic) to dark (scotopic) viewing conditions. But they won’t improve eyesight due to any refractive error. All foods or supplements that contain anti-oxidants (Vit A, C, E, Magnesium and Selenium) have a protective effect for the retina. Eye exercises are beneficial if there is a problem like convergence insufficiency, accommodative inflexibility or weakness of eye muscles. Eye exercises cannot help for refractive errors like being short-sighted, far-sighted, presbyopic or astigmatic. Sometimes they can help for a squint but it depends on the deviation and cause

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For more information about Joubert Tilly Optometrists, click here.

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