Diabetes and Your Sight

Who can develop diabetic eye disease?

Anyone with diabetes can develop diabetic eye disease, but your risk is greater if you have high blood pressure or high blood glucose that is left untreated over a long period. You are also increasing your risk if you have high blood cholesterol and/or are a smoker.

How does diabetes affect my eyes?

Diabetes affects your eyes when your blood glucose is too high. This is because the retina needs a constant supply of blood, which it receives through a network of tiny blood vessels and over time, a persistently high blood sugar level can damage these blood vessels and even cause blindness.

What types of eye problems are caused by diabetes?

There are four main problems:

Diabetic retinopathy

Diabetic retinopathy is the most common cause of vision loss in people with diabetes and up to a third of diabetics over the age of 40 show some signs of the disease.

In early diabetic retinopathy, blood vessels can weaken, bulge, or leak into the retina. This stage is called non-proliferative diabetic retinopathy.

If the disease gets worse, some blood vessels close off, which causes new, weaker blood vessels to grow on the surface of the retina, which can cause serious vision problems. This stage is called proliferative diabetic retinopathy.

Fortunately, finding and treating diabetic retinopathy early can reduce the risk of blindness by up to 95 percent.

Diabetic macular oedema

Diabetic macular oedema is a swelling in the macula – the functional centre of the retina and the part that gives us the ability to see fine detail and provides the best colour vision. Over time, this disease can destroy the sharp vision in this part of the eye, leading to partial vision loss or blindness. Macular oedema usually develops in people who already have other signs of diabetic retinopathy.

Glaucoma

If you have diabetes you are at twice the risk of developing glaucoma. Ask at your next appointment in branch for more information on glaucoma.

Cataracts

Cataracts occur when the lens in your eye develops cloudy patches which cause blurry, misty vision and, if left untreated, blindness

People with diabetes are more likely to develop cataracts and to do so at an earlier age:  It is believed that high glucose levels cause deposits to build up in the eye’s lens.

I have diabetes – should I be worried?

Diabetes is one of the leading causes of blindness in adults in the UK. However, if you are keeping your blood sugar levels under control then there is no real need to be any more concerned than usual about your eyesight. You should always visit your optician regularly, though, as in the majority of cases problems picked up early can be stopped from progressing and sight can be saved.

How do we check for any problems?

Anyone who is diabetic should have regular diabetic eye screening, typically once a year as well as their normal eye examination. A screening appointment is a specific check to examine the health of the blood vessels and structures in the retina. It involves using drops to dilate the pupils to give the widest field of view of the back of the eye. We also take images and 3D scans of the retinas in order to accurately compare them to the last screening, that way we can pick up more subtle changes earlier than would otherwise be possible. We also send reports to your GP to keep them updated, and a copy for yourself.

If you feel concerned about your eye health please contact your local Patrick and Menzies branch.


Important Notice

 

Because of the current health emergency, from Monday 23rd, temporarily, we are restricting our service to telephone and email contact only. This is to protect our team and the wider public. We hope this period doesn’t last too long while we work out a system to deal with any emergency you might have.

Our team are currently working extremely hard contacting everyone who has an appointment booked and those who are imminently due, arranging deliveries of glasses and contact lenses and generally being fantastic. If you do need to contact us, we are here but please do but bear with us as this is a fast-moving situation and we are quite busy.

If, however you are having problems with your vision, have lost your glasses, or any other situation where you need our help, then we will do everything possible to ensure we can take care of you.

Braintree: 01376 320419
Brightlingsea: 01206 302249
West Mersea: 01206 383455

Or email enquiries@patrickandmenzies.co.uk

While we await guidance on what, emergency/essential cover we may be able to provide, please go to 111.nhs.uk first or call 111 if you feel you really do have an emergency.

Please take care of each other and stay safe.

The Patrick & Menzies Team


Brand Spotlight | Flexon

In 1961 US Naval scientists discovered that the metal alloy they were creating for missile heat shields automatically returned to its original shape, even after being hit with a hammer! This advanced memory material became the unique selling point of Flexon, which, since its launch in the US in 1988, has changed the world of eyewear with its unique attributes, building on the memory metal and further utilizing Japanese materials and technology.

Many brands have tried to imitate Flexon’s incredible success, but none have done so. That’s because Flexon frames feature technologically advanced memory metal in the bridge and/or temples allowing them to be flexed, bent or twisted and yet return to their original shape. Flexon frames require a minimal amount of adjustment but the nose pads and end pieces can be fine-tuned for a more custom fit.

Over the years Flexon eyewear has consolidated its design and manufacturing experience to create a varied collection filled with colour and comfort. Memory metal is combined with rubber, TR90 and stainless steel to make lightweight yet durable frames which allow the user to confidently go into any situation their busy lifestyle demands.

In 1997 Flexon Juniors launched: We all know how hard children can be on their glasses, so the Zeus and Aphrodite frames, among others, offer mature yet fun looks in durable, sit-on-able, chuck-in-your-school-bag-able memory metal.

in 2003 the Flexon 600 series quickly became the industry benchmark and in 2014, the modern, practical Evolution collection debuted. From these ranges, the temple of the Nathaniel model has been enhanced with an embossed, rectangular-brick pattern in contrasting shiny and matte finishes; the Julian has bowed temples to accommodate a wide fit; the Gloria is enhanced with a laser etched pattern design with crystal detailing and the best-selling Mariene has two-tone interwoven stainless steel temples.

In 2016 the Sun Collection launched in a rage of classic styles with polarized lenses and backside anti-reflective coatings, and in 2019 the new premium collection, Flexon Black: Sunglasses come in classic aviator and flat metal shapes and Flexon Black offers innovation with screwless spring hinges and tailored temples padded with rubberized detailing.

Flexon spectacles are an ideal choice if you play sport in your glasses or just tend to put your glasses through a lot, but a word of caution: Although Flexon frames are durable, they are not indestructible! Flexon frames should not be twisted more than 90° and Flexon temples should not be twisted more than once around the finger!

Having said that, it’s a stylish, lightweight range well worth considering, so pop in to any of our branches when you’re next in town to see which models we have in stock and how amazing the memory metal really is!


Everything You Ever Wanted to Know About Varifocals!

Why Varifocals?

Varifocals, or progressive lenses, have been around for longer than you might think. First introduced in the late 1950s, the ‘Varilux’ lens was developed by the French company Essel. These varifocals were created to combine a person’s distance and near prescriptions, without the need for a dividing line between the two. Unlike bifocals, with that visible line, varifocals have an ‘intermediate’ area on the lens which enables the wearer to focus on objects in the middle ground like a computer screen. Traditional bifocal lenses often can’t match this.

How do Varifocals Work?

Simple lenses work because their surfaces are curved, and because the material they are made from is denser than air. The more curved and denser they are, the more powerful they will be. Let’s consider the curvature: The weaker the lens is, the flatter it will be. A single vision lens (one that just corrects say, distance vision) has more or less the same curvature all over its surface because its power needs to be consistent. So, if you have a lens that has two different powers to it, like a bifocal, it will have two different curves. The dividing line on a bifocal, which you can often see and feel, is where these two curvatures meet on the lens surface.

In a progressive lens, there is no line and no jump between the two curves – instead there is a gradual change in power from the distance zone in the top of the lens, to the near vision zone in the bottom. The way the lens manufacturers achieve this is to gradually increase the curvature of the lens surface from top to bottom. You can’t ‘see’ this on the lens, but it does create some problems that the manufacturers are finding ever more technological ways of dealing with.

How are the Manufacturing Difficulties Overcome?

As the surface progresses downward and the curvature changes, some distortion is created in the outer, lower edges of the lens.  Effectively the prescription is wrong in these areas of the lens. It’s important to understand that the vision doesn’t suddenly become terribly blurry and distorted as soon as you stray outside the central zone, it starts gradually and gets worse the further out you go. The amount of error that is created is governed by several things, but mostly by how different the near vision prescription is compared to the distance.

Manufacturers have developed ways of minimising this, so it impacts on how the lens feels as little as possible. The amount of error is calculable (by complicated computer algorithms) so 20 or so years ago manufacturing techniques altered to control the curvature of the lens surface much more accurately in the periphery. In the better varifocal lenses then, the surface error is more accurately calculated and more points on the surface are corrected for the error. This gives a wider field of vision, less distortion, more natural feeling vision, smoother transition from near to far and quicker adaptation on the part of the wearer. Basically, a better lens all round.

Which Varifocal Lens Should I Choose?

As with many things in life, the better the lens, the more you tend to pay – and in the case of varifocals, you really do get what you pay for. There are literally hundreds of varifocal lenses available on the market so as a result opticians tend to like to find a manufacturer that makes really great lenses that work for everyone: We choose Nikon Optical for our preferred lens supplier, as we have consistently found that even their entry level varifocal lens are brilliant quality and totally reliable. Their top-of-the-range lenses are really exceptional and can be tailored very specifically to your visual preferences – something we’ll expand on in a future blog.

 

In the meantime, feel free to pop in to any of our branches to discuss how varifocals may work for you.


Migraines, Headaches and Eye Health

Migraines? Aren’t they just bad headaches? Well, not really. Migraines are defined as a headache that lasts from 4 hours up to several days and affects one or both sides of your head. It can feel as though your head is throbbing or being constricted and can be extremely painful. Often but not always, the pain is accompanied by nausea, dizziness, sensitivity to light and sound and can feel worse if you move around. Some GP’s define a migraine as a headache bad enough for to stop you going about your normal day.

What’s that got to do with my eyes?

Migraines are headaches linked with a sensory imbalance, and as vision is a key part of your perception it is integrally linked to your nervous system: If your eyes are constantly straining, it can sometimes trigger a migraine.

What causes eye strain?

Asthenopia, the medical term for eyestrain, occurs when your eye muscles are over tired. If you can’t see clearly, you may squint often or hold items up close or far away from your face. This will tire the muscles more, meaning your eyesight deteriorates further – creating a vicious circle. Poor lighting can also strain your eyes, but any activity that demands intense use of your eyes for long periods can be linked to problems.

If you’re concentrating hard on something, be it staring at a screen, studying or driving, you tend to blink less, this can make the eyes feel very uncomfortable as they dry out. Working in low lighting creates a poor-quality image on the back of your eye, meaning your eyes work harder to keep focus. If you do any of this for several hours at a time, then the problem is just compounded. It’s important to make it a rule to give your eyes a break every twenty minutes by looking away and purposely focusing on something distant for a while. This increases the blink rate for and relaxes the focussing muscles.

The effort that the eye muscles exert is no different from any other muscle in the body. They get tired if you ask them to do too much. If you focus up close for a long time, it’s effectively the same as carrying heavy shopping back from the shop, your arms would ache, so your eyes will ache too. Having the right glasses will help, if you need a prescription for this, but no glasses will make you superhuman, if you do it for too long it will ache!

I’ve heard about migraines causing blindness – is that true?

Ocular migraines, if you’re unlucky enough to have them, can give many kinds of unusual symptoms. They are more common than you might imagine and are caused by spasms in the blood vessels near the visual pathway (the route from the eyes to the brain). Most commonly people report shimmery, kaleidoscope-type effects in their vision, often arc-shaped, lasting around 20 minutes and still visible when the eyes are closed. They can happen on their own, without the headache. In rarer, more severe cases, the vision can be interrupted more completely. In these cases, there are often other symptoms as well that can appear similar to a stroke. It all depends on where and how severe the spasms in the vessels are. Statistically you may be at a higher risk for permanent vision loss, it is rare though and often linked with other associated medical conditions. Barring an emergency, any concerning symptoms should be investigated by your GP, but it would be advisable to come and talk to us about your symptoms, too.

Sometimes my glasses give me a headache – what can I do?

Headaches caused by wearing spectacles can occur for a number of reasons. Reducing them depends on what you think is causing the headache. For example, if you get headaches mostly when you’ve been on your computer then it may be your prescription needs updating or you need a different type of lens for that task. It may be that you are suffering from glare problems. Or it may even be that it isn’t your specs, you may need to take better breaks from the screen as previously mentioned, as screen glare can cause strain.

Sometimes you can get headaches when you’ve had a change in prescription, particularly if it’s a big change. This happens is because your focusing muscles are used to working with your last prescription and now have to readjust. In order to help this process, it’s best to wear your new prescription as much as possible in order to shorten the time it takes your muscles to adjust.

Headaches can also be caused by a badly fitting pair of specs. If they are too tight, the pressure can get to a point where it causes an ache. If they are loose or wonky, the lenses can be misaligned, causing eyestrain. If you find the fit of your frames needs tweaking, or you need new frames altogether that are measured and fitted properly so that you can wear them with comfort we’ll be happy to help, of course.

Conclusions?

The causes of headaches and migraines are complex and often difficult to pin down. Your eyes can be the cause, but they aren’t always the whole story. If any of the points raised in this article are causing you concern, then don’t hesitate to come and see us at any of our branches or contact your GP.


Brand Spotlight | Tiffany Frames

 

Perhaps the world’s most loved and recognisable jeweller, Tiffany & Co. launched its own brand of frames, exclusively designed for women, and its one of our most popular ranges.

History
In the 1830s Charles Lewis Tiffany and John Young had a dream of opening a jewellery store that everyone knew and admired. From small beginnings as a ‘stationery and fancy goods store’ the company became popular with fashionable ladies and first won international recognition at the 1867 Paris World Fair. Tiffany’s introduced the engagement ring as we know it in 1878 and in the same year produced the first catalogue, with a cover in the iconic Tiffany Blue. The brand we all know today has over 200 stores worldwide, known still for its exquisite jewellery and dazzling accessories. Kate Winslet, Anne Hathaway, Natalie Portman and Lady Gaga are just some of the celebrities who are often seen wearing Tiffany jewellery.

“As a luxury fashion accessory, eyewear seems like a natural addition for us” said Michael J. Kowalski, the Chairman and CEO of Tiffany’s, upon the launch of their optical collection: As you may expect from a jeweller, many of the styles are adorned with gemstone embellishments. As you would certainly expect from Tiffany, their signature blue also features heavily!

Style

The frames are romantic and glamorous – dainty charm symbols such as the lock, key and heart appear frequently and the materials used to decorate the frames include gold, silver, diamonds and other precious gems. There are styles with delicate knotworks in silver running along the arms, little clusters of gems which catch the light, or chunkier styles with a tiny Tiffany & Co. plaque! The frames themselves are mainly made from acetate, which is strong, flexible and hypoallergenic.

With a legacy spanning over 160 years, Tiffany glasses are timeless but never old-fashioned. The bold colours and thoughtful details mark these frames out as something quite special and there’s lots of unusual shapes and colours you won’t find anywhere else – from cats’ eyes to rectangular; from an elegant smoky grey to a feminine and flattering blush pink.

Pop in and browse this most luxurious of collections. We feel sure you’ll be as impressed as we are with the detailing, and of course, any of them can be fitted with exactly the right lens for your needs. We look forward to seeing you.


Everything You Ever Wanted to Know About Dry Eyes

 

By Dan Edwards, FBDO
Partner/Dispensing Optician at Patrick & Menzies Brightlingsea branch
___________________________________________________________

The subject of dry eyes and the associated symptoms is so vast whole books have been written about it, but today we’ll try to tackle the basics of an increasingly common problem for all ages.

What do tears do and why are they important?

The tear layer sits on the front of your eye, over the cornea and the white of your eye. It’s there to do several jobs – it lubricates the eyelids as you blink (if you had no tears it would be like blinking with two bits of sandpaper! Ouch!), it protects the eye from dust and particles to minimise irritation. It is also the first thing that starts the process of refraction to produce a clear image, because the light hits the tear layer before anything else. In addition, the tear layer allows the cornea to absorb oxygen.

Diagram showing layers of the eye | Causes of dry eye and running eyes
Diagram showing layers of the eye

The cornea (the clear bit over your iris and pupil) has no blood vessels in it, but its cells still need oxygen to stay healthy, so the eye diffuses it from the air, into the tears, then into the cells. (Aha! I hear you ask, what about when you’re asleep?! Well, at night it’s the same process but the oxygen diffuses through the thin vessels on the inside of your eyelids. At much lower levels but just enough to sustain the system while you’re asleep). So, you see, tears are essential for healthy, comfortable eyes, and good vision.

What are tears made of?

Tears are actually quite a delicate balance of three different types of fluid: The bulk of tears are made of water, but equally important are the mucous layer and the lipid (fatty) layer. The mucous layer sticks the tears to the front of the eye and stops them falling off and running down your cheeks. The lipid layer helps prevent the tears from evaporating too quickly, so both are essential to maintain a good quality tear film. An imbalance in these different layers is what gives rise to the many different types of problems associated with dry eyes.

What type of problems do dry eyes cause?

One of the most common problems we see are people complaining of their eyes ‘watering’, especially if it’s windy outside. It seems counter-intuitive to say this is a dry eye problem but technically that’s what it is. If your eye is missing the mucous layer then the cornea is exposed – the wind irritates the eye, so it responds by watering (as it thinks it has a foreign body in it), that water won’t stick, so the tears run off, and the problem spirals.

We often see people with intermittent blurry vision and uncomfortable eyes which can stem from the lipid layer being missing or inadequate. The watery layer evaporates, leaving the mucous layer, which as the name perhaps indicates, gives rise to smeary vision, varying with the blink (a bit like putting petroleum jelly on a camera lens).

People often complain of sore eyes, poor vision and eyelids being stuck together when they wake up in the morning. Assuming infection has been ruled out, this is again happening because the tears are inadequate. If you go to sleep with little or no tear film, what you have got evaporates overnight, and as you don’t produce tears while you’re asleep, you’re left with a mucous residue that stick the lids together and sore eyes as the eyelids haven’t been able to absorb much oxygen.

People with allergies, particularly hay fever, can have dry eye issues as they tend to over-produce the watery part of the tears which washes out the other layers, making the tears badly balanced and unstable.

All of these issues can cause uncomfortable eyes which can look red and sore depending on the severity of the problem. Blinking with reduced tears is a really big irritant and in very severe cases it can actually damage the cornea leading to potentially sight-threatening infection. Thankfully this is rare and the vast majority of people come and see us or their GP before things got to that stage.

What causes dry eyes?

It’s true that dry eyes are more of a problem in older people. This is because as you age you tend to produce a reduced volume of tears and lose elasticity in the eyelids: Droopy lower eyelids expose more of the part of the eye below the iris which not only increases irritation but more importantly, if the lid is falling forward the mechanical support for tear volume is lost and tears run off the eye.

Some medical conditions such as Sjogrens syndrome and other auto-immune diseases in the spectrum of arthritis can reduce the amount of tears we produce. Some medications, including some cancer treatments, also reduce tear production.

Most commonly though lid hygiene is a big factor: the fatty and mucous layers of the tears are produced by tiny glands on the inside of the eyelids just behind the line of the lashes. These ducts are very fine and are easily blocked, so if make up isn’t removed very well, or the lids aren’t cleaned very well, over time the ducts can get blocked with dead skin cells, make-up, dried tear residue etc. This obviously results in inadequate tear production and an unstable tear layer.

The lids can also be affected by something called Blepharitis, an inflammation of the edges of the eyelid which is again more prevalent in older people and leads to a dandruff-like appearance which blocks the ducts and affects tear production.

Environmental factors also play a part. With increasing use of screens, both desktop and handheld, people find themselves staring at these for most of the working day. Each time you blink, you refresh your tears, but when you stare at a screen your blink rate goes down, increasing the amount that the tears evaporate. But it’s not just air-conditioned offices – people on long drives often complain of dry, uncomfortable eyes after staring down the motorway for hours (although this can also be because they need specs!) We also see a spike in dry eye problems when the weather gets cold and everyone cranks the central heating up.

Finally, we have to mention Demodex. Demodex is a tiny mite which we all have on our skin, it lives in harmony with us and is harmless. However, it does like to hide in hair follicles, particularly eyelash follicles, causing inflammation and clogging up the lid margins. Don’t be horrified – we do all have them, and mostly they don’t cause a problem, but if there are too many present they can be the cause of a stubborn dry eye problem that keeps recurring as the mites multiply.

What can be done to resolve dry eye issues?

The best way to tackle dry eyes is to try and find out what’s causing it in the first place, which is sometimes very hard to pin down. An appointment with one of our opticians gives us an opportunity to really have a look at your tear layer and lids and see what the issue is. We can measure your tear break-up time (how fast it evaporates), the tear volume (how much there is and if it’s too thin) and see why it is the way it is: Most of the time there is no one clear answer or treatment, and in some cases, while the problem cannot be ‘cured’, it can often be very well managed.

Options include hot compresses to clear blocked eye ducts, eyelid wipes to remove blockages and kill any mites that are present, drops to re-balance the tears, lifestyle and health advice. There is some evidence to suggest some vitamin supplements can increase tear production, and for some chronically blocked ducts, steam treatments are sometimes used. Sometimes just understanding why something is happening can make one feel better and remove some of the frustration felt.

If you have any of the issues detailed above dont hesitate to come and see us at any of our branches. We have specific dry eye consultation appointments available where your optician will focus on dry eye issues and help you find ways to improve the symptoms. Pop in or give us a call.


What is a PD Measurement and Why is it Important?

 

What is PD?

Pupillary Distance, or PD, is the distance between the pupils of your eyes. When it comes to spectacles, PD is specifically the distance between the pupils when focused at distance and the eyes are in the primary position –so, imagine when you are behind the wheel of your car, staring down the motorway into the far distance.The near PD is when the eyes are focused on something closer, for example, when you’re reading. In this situation the eyes will typically converge so the PD will be smaller.

Why does my optician need to know my PD?

Because of how lenses in spectacles work, your PD measurement is a critical piece of information needed to produce your glasses correctly: Every lens, be it in a camera, microscope, magnifying glass or spectacles, has an optical centre (OC). The OC is actually the only point on the lens where its strength is absolutely true. At every other point the power differs from what was originally ordered. This is due to the physics of how light travels through lenses and is therefore to be expected. However, the further away from the OC (and this is especially so for stronger prescriptions) the more the power differs and the more error you will note towards the periphery of your lens.

So, when we put together an order for your glasses we carefully measure your PD so that we can make sure the OC coincides exactly with your pupil centres, to give you the most accurate and comfortable spectacles.Incorrectly centred lenses can lead to blurry, uncomfortable vision or even double vision. The alignment of the centres is always important but, again, gets increasingly so the stronger the lens is or if you need a multifocal.

Once the lens is glazed to the frame the OC becomes a fixed point, but obviously our eyes are constantly moving so while it’s not the case that we are always looking through the OC, it is crucially important that the alignment is correct for things like driving or watching TV. If you are a glasses wearer, you may recognise that strange feeling when you first got glasses or had your prescription changed –when things just suddenly looked and felt a bit odd? This is due to your brain becoming accustomed to and tuning out the error from the periphery of the lenses as your eyes move around. (How our brains process our vision is a subject all of its own – we’ll expand on that in a later blog!)

Can you give me my PD so I can order glasses online?

We often get asked why we don’t note your PD on the copy of the prescription that we provide after an eye examination. This is partly because it isn’t a legally required part of a prescription but also because it is information which should only be measured by the supplier making your spectacles: Obviously it’s impossible for an online glasses supplier to measure your PD and doing it yourself is tricky and unreliable.

So, at Patrick & Menzies our policy is not to provide a PD measurement on request: Your PD will vary depending on the fit of the frames you choose and if we provide a PD measurement which is then used to buy glasses online, some of the responsibility of whether those glasses are correct or not, falls to us. However, if we have had no opportunity to assess the fit and suitability of the frame, or your lenses, let alone be able to check them upon manufacture, then we’re sure you will understand that we wouldn’t feel comfortable taking that responsibility on.


New Nikon Lenses

 

Following our succesful switch from Rodenstock spectacles lenses to Nikon towards the end of last year. The Nikon lens portfolio goes from strength to strength.

Designed using the very latest technolgy and research in Japan, made in the UK, Nikon have developed the Ultimate varifocal.

Seemax Ultimate represents a real breakthrough in how your lenses are tailored to your vision and visual preferences. Each of us sees things in our own unique way and has our own demands on how we view the world. With the new Ultimate technology, available in thin lens forms, Transitions and polarised, your lens design can be tailored like never before.


Our new Website is here!

To coincide with our birthday year, we have updated our website to make it fresh, engaging and provide you with lots of information about us and what we do. It’s taken a few months to get things right and we’ll still be polishing things and updating the site over the next few weeks as we add more content; but we hope you’ll agree it looks lovely! It’s designed to give you a feel for our practices and how we like to look after people. There are links to book appointments online, get to know who we are and who you might see. Have a nose around and let us know what you think!