Sight loss can be traumatic at any stage of life, and as UK demographics shift the prevalence of it is growing.
The most common reason is macular degeneration; a condition that is generally associated with ageing and genetics, and as the elderly population increases so does the disease.
There are currently 600,000 people in the UK who have lost sight as a result of macular degeneration, and that number is expected to rise considerably over the next few decades if current demographic trends continue.
However, despite the considerable impact and cost of the condition, the level of public awareness is still relatively poor.
This is why the Macular Society has launched Macular Week, to draw attention to the impact and scale of the issue, and offer advice and support to sufferers and those at risk.
The charity’s Chief Executive, Cathy Yelf, explains why the campaign is so important.
She says: “The reason for our awareness week is that even though this is the biggest cause of sight loss, even though the NHS spends more on this treatment than almost any other drug it buys, hardly anyone knows what macular disease is. So, we need to raise awareness, we need to help people to understand how to look after their eyes better and we need to raise the profile of this amongst policy makers and decision makers, because this is a very big problem that is only going to get worse in the foreseeable future because of the ageing population.
“If we don’t do something about this – in terms of putting more funding into research to find some answers - then we will have, as one consultant described it, a ‘tsunami of elderly sight loss’ in the next few years. We have a huge problem now, but in the next ten to twenty years it will be vast. We need something like the Prime Minister’s dementia challenge, but for macular degeneration. It is the same magnitude of problem, and society can’t afford to treat all these people.
“The Macular Society is here to support people with macular degeneration and we want people to know what services we can offer and make use of us. So, for example, we have a network of around 300 support groups around the country, which are free. All our services are free and they are available to anybody who wants them, you don’t have to be a member. So, knowing what’s available is really a vital part of this week.”
Ms Yelf is particularly keen to draw attention to measures that can be taken to prevent or lessen the effects of the disease, with quitting smoking top of the list.
According to her: “Of the things that you can change, the most important single modifiable risk factor is smoking. Smoking causes sight loss. It interferes with the oxygen supply to the back of the eye and contains toxins which kill the delicate cells of the eye. It damages the tiny blood vessels that supply oxygen and nutrients and inflames the back of the eye. So, there are very many reasons why smoking is incredibly bad for your sight. If you smoke you are three to four times more likely to get AMD than if you don’t smoke. And if you have certain genes then you are almost certain to get AMD if you smoke.”
Informing people of the link between smoking and blindness is a key part of the Macular Society’s campaign, given the impact it has on people’s behaviour.
Ms Yelf describes it as “as frightening to children and young people as things like cancer and heart disease. They fear losing their sight and actually it is quite a good motivator. Currently there are not enough public health warnings talking about sight loss as a preventable problem. I think a lot of people think: ‘I have got to die of something,’ but you have got to live with sight loss - that’s what strikes people.
“Awareness week this year is really playing on that smoking message. If you get the condition and you smoke you will get it more severely. If you have the wet form of macular disease, which is the only form that can be treated, your treatment will be less successful if you smoke. So, in all circumstances giving up smoking is a very good to do for your eyes.”
Alongside this there are other factors which are thought to increase the risk of sight loss, which Ms Yelf outlines, saying “there is a little bit of evidence that people who have low levels of antioxidants in their diets are more likely to get macular degeneration.
“So, if you eat a healthy diet with lots of green, leafy vegetables, fish oil and fruit you may reduce your chances of getting it. There is a little bit of evidence as well that people who are exposed to very high levels of ultra-violet light may be more at risk, so protecting your eyes from ultra violet light by wearing good quality sunglasses is important; as is having regular sight tests. Nowadays it is much easier to pick up the early signs of macular degeneration. Lots of people have them, with possibly half the population over sixty showing early signs. Not all of them will go on to develop sight loss, but those people who are at risk need to know, so that they can stop smoking, eat more healthily and generally look after their eyes.”
Beyond the immediate treatments the Macular Society is also optimistic that there will be a cure in the future, but only if the area receives adequate funding.
Given the significant financial and social burdens the disease currently imposes Ms Yelf hopes research funding will be forthcoming.
“The costs of this are gigantic and growing very fast,” she says.
“So, this is a very pressing political, social and personal burden. The NHS is struggling to cope – our clinics are absolutely full to bursting and it is having a knock on effect on other areas of ophthalmology as well. Many people in this country don’t get treated as quickly as they should and so even though we are spending vast amounts of money on this, the outcomes are not as good as they should be because the clinics are overwhelmed with demand.
“There are lots of potential avenues to explore here, but they cost money and there needs to be a concerted effort to find the answers. There is a lot of exciting work. There is some very early stem cell work that is going on. There are also some very small safety studies that have started in humans. There is a big project in the UK called the ‘London Project to Cure Blindness’ which we have partly funded and there is some very exciting work going on there.
“There is some very interesting work to try to understand the ageing process, which has a lot in common with some of the other ageing diseases, like Alzheimer’s for example. A lot of this research is in its early stages and unless we put our foot on the gas over this a bit, it is going to be many years before we find the solutions. So, there needs to be some significant investment now to solve some of these puzzles about ageing and macular degeneration.”
As Macular Week commences the Macular Society will seek to grab the attention of policy makers and shed further light on this devastating condition.