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Sight and hearing are so integral to our lives that it is easy to take them for granted. Here, the experts share advice on how best to protect them, and we hear from some people who know all too well just how precious these senses are

It is an eye-opening statistic that 100 people in the UK start to lose their sight every day. More alarming still is the fact that in at least half of all cases, sight loss is avoidable. “For example,” says Matthew Athey, eye health information service manager at the charity RNIB, “many older people are needlessly living with sight loss due to refractive error and cataracts. Both of these can be diagnosed by a simple eye test and, in most cases, the person’s sight could be improved by wearing prescribed glasses or undergoing cataract surgery.”

The RNIB recommends that most people have an eye test with an optometrist at least once every two years. “It’s important because there are several eye conditions, such as glaucoma and diabetic retinopathy, which do not cause people to experience any symptoms until it’s too late,” explains Matthew. “Early detection means that an individual can receive treatment to prevent sight loss.”

“If glaucoma is not detected early enough, it can lead to permanent sight loss,” says Dr Susan Blakeney, clinical advisor to the College of Optometrists. “People are more likely to go blind from glaucoma if they have not been to their optometrist for several years.”

Optometrists are also able to pick up on other eye conditions, such as age-related macular degeneration (AMD), and they may also spot other health issues, such as high cholesterol or high blood pressure, she adds.

A “shocking” diagnosis

Glaucoma is usually caused by a build up of pressure in the eye that causes damage to the optic nerve. It’s thought that about half a million people in England and Wales have glaucoma – although many more may have it without knowing. In its most common form, it is the peripheral, outer vision that is lost first.

Arnold, who is 80, has glaucoma, and was diagnosed during a routine sight check at the age of 31. “Up until that moment, I had never heard of glaucoma,” he says. “Four days later, I was in the operating theatre. Luckily, the operation was very successful.”

Initially, Arnold says, the diagnosis was “devastating”. He earned his living running a transport business and driving lorries, but because he had already lost a great deal of his peripheral vision, the consultant said he was no longer able to drive. Arnold says: “It was a total shock to me, but I told myself that, come what may, I could see well enough to run the business even if I couldn’t drive anymore.

“From that point, up until about 10 years ago, life was more or less the same,” he continues. “I would have regular eye checks and the glaucoma was said to be under control. Now it’s changing, because of age I suppose. But I really want people to understand that life doesn’t end with a diagnosis of glaucoma.”

Arnold says he often wonders why he hadn’t picked up on the glaucoma himself and noticed the impairment in his vision. “I think the brain must slowly adapt to the vision it has,” he says. “Looking back, I think I must have had it for five or six years. The reason I think that is because I had a series of minor motoring accidents and, with hindsight, I now believe they were caused by the fact that I had glaucoma – that I must have missed something in my field of vision.”

His own story is not the only reason why Arnold believes that everyone should have regular sight tests. His youngest son was diagnosed with glaucoma at the age of 27. “His glaucoma was nowhere near as far down the line when he was operated on as mine had been and he still has enough vision for him to be able to drive,” says Albert.

Being aware of glaucoma – and being pro-active about eye checks – is the best defence. But recent research carried out by the College of Optometrists found that a third of people wait more than a month before seeking help after noticing a deterioration in their eyesight – and that one in 10 people have never had their eyes tested.

“The main risk factors for developing glaucoma are those that you cannot change,” says Dr Blakeney. “These include being over 40, of African or Caribbean origin, closely related to someone with glaucoma or being very short sighted. There is nothing you can do to reduce your risk of developing glaucoma, so it is important to ensure that you have regular eye examinations so that your optometrist will spot it early to reduce the chance of avoidable sight loss.”

By 2030, more than 14.5 million people in the UK will suffer from hearing loss

Insight into AMD

AMD is a painless condition where central vision becomes increasingly blurry. It is the most common cause of sight loss in the developed world and there is, as yet, no cure for it. “Wet AMD is caused when new, abnormal blood vessels grow in the retina,” explains Dr Blakeney.

Wet AMD can be treated with anti-VEGF therapy. “VEGF stands for ‘vascular endothelial growth factor’ – one of the chemicals responsible for the growth of these blood vessels,” says Dr Blakeney. “Anti-VEGF therapy works by blocking this chemical, to reduce the growth of these blood vessels. It is injected into the back of the eye with a very fine needle. This may halt the progression of the disease and in some cases it may even reverse it.”

John, who lives in West Yorkshire, had been retired for 10 years when he first noticed that there might be a problem with his vision, back in 2004.

“I suddenly found that I had to get very close to the TV to read Teletext,” he says. Even though he had had a sight test just six months earlier, he booked himself in for another check-up.

“The optometrist checked my eyes and then disappeared for a moment,” he recalls. “When she got back, she told me that she had made an emergency appointment for me for the next day. That was when I was told I had AMD.”

He was told there was no treatment available to him on the NHS unless he wanted to spend thousands of pounds of his own money, but with no guarantee of success. So, for three to four years he had no treatment at all while his sight got gradually worse. In about 2008, drug treatment on the NHS became available to John. “By that time, sight in my left eye – which had been my better eye – had practically gone, so they couldn’t do anything with that eye, but they started to inject my right eye every month and that held my eyesight as it was,” he says. For just over a year, John has been having a different drug, injected every three months.

John is determinedly positive about his life and his sight. “I like to think that I am perfectly sighted, although I am not,” he says. “For instance, I fell over a litter bin while running to catch a bus and broke a bone in my shoulder. That taught me that I shouldn’t run for buses. I can’t manage everything I would like to. I have to use a strong magnifying glass for reading and I use a monocular to help me see numbers of buses or to see the screen at my local history meetings. I sometimes use a white stick for crossing the road.”

John believes that the biggest challenge for those suffering with losing their sight is psychological. “I want to have a positive attitude,” he says. “It does hit you hard when you are diagnosed. But although I can’t see a lot, there’s still a lot I can do.”

The exact cause of AMD is not known. “However, some things are thought to increase a person’s chances of developing AMD,” explains Matthew. These include age – the older a person gets, the more likely they are to get some degree of AMD. Genes may also be a factor. “Some genes have been identified which seem to be linked to the development of AMD in some people,” says Matthew.

“Smokers are up to four times more likely as non-smokers to develop AMD and tend to develop it earlier than nonsmokers,” adds Dr Blakeney. “Obesity and exposure to UV light may also increase people’s risk of developing AMD. Having a diet that is rich in coloured fruit and vegetables – for example kale, broccoli or mangoes – may help to reduce the risk.”

 

Loud and clear

About 10 million people in the UK have a degree of hearing loss, and the ageing population means this number looks set to rise in the next few decades. “The World Health Organization (WHO) estimates that by 2030, more than 14.5 million people in the UK will suffer from hearing loss,” says Gemma Twitchen, senior audiologist at the charity Action on Hearing Loss.

We could all help protect our hearing by being more aware that exposure to loud noise is, according to the WHO, the single biggest cause of preventable hearing loss in the world.

“Prolonged and repeated exposure to loud noise above 85 decibels can cause permanent hearing damage,” says Gemma. “Loud noise can cause both hearing loss and tinnitus and there is currently no cure.” It’s thought that loud noise can destroy the tiny sensory hair cells in the ear that are vital for hearing. Once lost, these hair cells can’t be replaced.

So how can we know when noise is too loud? As a helpful gauge, the sound of a quiet room is about 20 decibels (dB), ordinary conversation 60dB, a city street 70dB and a pneumatic drill – or the maximum volume on some mp3 players – 100dB. “As a rule of thumb,” says Gemma, “if you have to raise your voice to speak to someone two metres away, the noise is loud enough to damage your hearing.”

Tinnitus is a ringing in the ears or head in the absence of an external sound. An estimated six million people in the UK have tinnitus – and about 600,000 people are thought to have it to the extent that it affects their quality of life.

Marc, 34, is a DJ and property developer who has had tinnitus for six years. He started playing the drums aged 11 and, in his teens, started clubbing and dj-ing.

“I was around loud music a lot of the time and I thought nothing of it,” he says. “But six years ago, I was practising for a gig and I started to get a ringing in my ears. I would often get ringing in my ears after a gig and would regard it as a sign of a good night out. This seemed different though, and it didn’t go away. After four weeks, I went to see an audiologist and was diagnosed with chronic tinnitus.”

Although there are various theories as to what causes tinnitus, Marc is sure about what caused his. “I have put two and two together and come to the conclusion that all that exposure to loud music over the years has affected my ears.”

He manages the tinnitus by trying to keep his stress levels as low as possible, so is careful about diet, exercise and sleep. “There is a theory that cortisol levels in the blood can aggravate tinnitus further and, in my experience, keeping stress levels low makes a difference,” he says.

When he was first diagnosed, Marc says he was very upset. “Eventually, I came to terms with it. I started using professional ear plugs when I went out and I got to a level of acceptance with the tinnitus. But then, all of a sudden, at the beginning of this year, after a series of stressful events and then going out not using my ear plugs, it set off again and I was back to square one. When it is bad, it is pretty unpleasant and frustrating. The worst scenario for me is to be in a quiet room.”

He is passionate about spreading the word that it’s essential to look after your hearing. “When you’re 18, you think you’re invincible, but when you get to your 30s, you realise that there’s another chapter of your life where you might have to suffer with ailments because of decisions you made when you were younger, whether because of a sport you used to do or because of listening to a lot of loud music. My message is, have fun, by all means, but look after yourself, as in later life you will be grateful for this.”

For more information:

• The College of Optometrists
• RNIB