Andrew Crawford Ophthalmologist Diamond Valley Eye Clinic

 “Check your macula”  “Take your vitamins”  “Don’t Smoke”  “Do / Don’t eat margarine”  “Do / Don’t drink red wine”  What does it all mean,  How can we all help?

 Wrong Glasses / No Glasses

 Cataract  Diabetic Eye Disease  Glaucoma  Macular Degeneration

 A Technological Success Story Artificial replacement of a worn-out lens  Surgery is suitable for all who have significant symptoms Waiting to be ready/ripe is historic  “If you’re fit for a haircut, you’re fit for a cataract operation”

 Diabetes is a huge and growing numerical problem  Uncontrolled diabetes damages blood vessels

 Diabetes is a huge and growing numerical problem  Uncontrolled diabetes damages blood vessels  Uncontrolled Sugar  Uncontrolled Blood Pressure  Uncontrolled Cholesterol

 A slow, insidious process Course is over many months – years  Generally few symptoms, unless/until macula is involved

 Primary Treatment Control Sugar, Blood Press, Cholest  Secondary Treatment Laser and/or Injections  Management Strategy Control Sugar, BP, Cholesterol 2-yearly checks for asymptomatic Disease Report central visual loss without delay

 A Constant Struggle Sugar, Blood Pressure, Cholesterol  Help is at hand, when needed Regular Checks to detect asymptomatic problems Report major change in vision

 Gradual thinning of the optic nerve  Precipitated, or worsened, by high pressure in the eye Treated by lifelong lowering of eye pressure  Eyedrops, laser and/or surgery  2% of population Family History is an important risk

 “The Sneak Thief of Sight”  Painless  Few Visual Symptoms until late stage

 Treatment Generally aimed at lowering eye pressure  Eyedrops Modern drops are very effective Treatment is lifelong  Laser  Surgery

 Management Strategy  Diagnosis If Family History, screen 10 yrs earlier Screen everyone 2-yrly after 60yo  Treatment Compliance Eyedrops regularly, for life

 Early ARMD Macular Wear & Tear, “The Old Bedsheet” Slow, gradual process  Dry ARMD Wear & Tear “runs into holes” Increased rate of deterioration  Wet ARMD New Blood Vessels sprout, leak, bleed Sudden and severe visual loss

 Injection Treatment Generally very effective Years of treatment, 1-2 monthly Over $2000/treatment, $20,000/year/eye Capacity and Funding are limited Financial, Political and Ethical dilemma

 90% of ARMD is Dry

 There is no highly effective treatment Diet may be a small help Supplements are smaller help if good diet  Experimental Laser in Melbourne

 Management Strategy  Reduce Risk Don’t Smoke Follow MD Diet – Green Leafy + Yellow Corn  Check for Early ARMD If present, be alert for sudden visual change and report this without delay

 “Check your macula”  “Take your vitamins”  “Don’t Smoke”  “Do / Don’t eat margarine”  “Do / Don’t drink red wine”  What does it all mean,  How can we all help?

 Cataract Check poor vision, surgery if disabling  Diabetes Encourage Sugar, BP, Cholesterol 2yr checks, Report major deteriorations  Glaucoma Check from 60yo Encourage and check eyedrop compliance  ARMD Don’t smoke, Good diet 2yr checks, Report major deteriorations

 Questions...