The ability to see is something the majority of people take for granted, without ever really wondering about how the process works. Yet the human eye is a remarkably complex system, with many different component parts working together to provide sight. However unsurprisingly, such a complex system has many factors which can become impaired, especially with advancing years. The medical technology industry has been helping to deal with such problems for many years. Indeed, spectacles and lenses are one of the earliest examples of medical technology being deployed, dating back to ancient Rome; the Emperor Nero was reputed to use an emerald as a corrective lens when watching gladiatorial contests, and spectacles were being used in China as early as the 13th century.
In fact, most people will experience deterioration in their ability to see clearly and sharply at some point in their lives as the majority of sight problems are age-related. As Europe’s population ages, such problems will affect a larger proportion of the population. There are a number of eye conditions which become particularly prevalent as we grow older. Myopia, or short-sightedness, occurs in around 25% of the population, and sufferers have difficulties in focusing on distant objects. It is caused by the eyeball being elongated or the curve of the cornea being too steep. Hypermetropia, also known as long-sightedness, is caused by the eyeball being too short or a cornea that cannot curve steeply enough. Sufferers have difficulty focusing on close objects. Other conditions include astigmatism, where the cornea is elliptical; this can cause blurring of both near and close objects. Presbyopia is when the eye finds it more difficult to focus on close-up objects. This is a natural and unavoidable effect of ageing, usually beginning around the age of 40 and will affect most people as some point in their lives.
Most of these conditions can be dealt with by wearing spectacles or contact lenses. Improvements in lens manufacturing technology now allow spectacles to offer bifocal or varifocal lenses; essentially two or more lenses in one. Meanwhile contact lenses have become much more effective and easier to wear for longer periods.
However, more serious degenerative conditions are also increasingly commonplace. Age-related macular degeneration (ARMD) affects the centre of the field of vision, leading to numerous difficulties. Recent advances in laser surgery can assist in management of this disease, but it remains a difficult challenge. Glaucoma, meanwhile, is a degeneration of the optic nerve, caused by an increase in pressure inside the eyeball. Although it can be managed, there is no definitive cure.
Cataracts are another extremely common problem of degenerative eye conditions, affecting up to 50% of European citizens over the age of 75. Cataracts are a gradual clouding of the lens, and until recently were considered difficult to treat effectively. Indeed, as recently as 20 years ago, cataract surgery was considered a very high-risk procedure. It had to be performed under general anaesthetic and followed by a substantial hospital stay; furthermore there was a real risk that the eye could suffer permanent damage from the large incisions required.
Today, with the advances made in eye surgery, cataract-affected lenses can be removed and replaced with a new artificial one. The procedure need only take around 15 minutes in a day-care unit, with no need for a general anaesthetic nor an in-patient stay. Patients are often able to drive again after 24 hours.
However it is important that patients in Europe who undergo cataract surgery should be made aware that there is a choice of treatment options. There are two types of lenses; monofocal intraocular lenses (for standard cataract removal) and advanced technology intraocular lenses (to correct presbyopia and astigmatism while treating cataract at the same time). Advances in ophthalmology will continue, addressing challenges like those posed by ARMD and glaucoma. As we live longer, and seek to work and contribute to society for longer, we will increasingly need to access the best possible eye care.