High Risk Patients – Eye Diseases

  1. Many patients are genuinely surprised when they find out they have a serious eye disease.
  2. Often vision loss goes largely unnoticed by patients (e.g. Diabetic Retinopathy / Glaucoma).
  3. Most in the general public do not have regular eye examinations even though they are free.
  4. The uptake of the latest Diagnostic equipment is slow & is charged out at high rates.
  5. Children don’t understand that what they see isn’t what everyone else sees.

1. Children 5-15:

  • Sixty per cent of children identified as ‘problem learners’ are challenged by ‘poor vision’. (Vision Australia).
  • World Health Organisation (WHO) states that: “The prevalence of Myopia and High Myopia is increasing globally at an alarming rate.”
  • Published evidence supports the hypothesis that excessive near work (which includes the use of things like mobile devices) increases the risk of Myopia.
  • Evidence supports the use of spectacle lenses, Orthokeratology, specially designed Contact Lenses and Low dose atropine to slow the progress of Myopia.
  • Current evidence suggests the mode of action is a reduction in peripheral Hypermetropia.
    (The Impact of Myopia & High Myopia – University NSW 2015)

Many schools now run classes described as ‘Device Only.’ Exposure to prolonged near vision tasks and ‘Blue Light’ from mobile devices is inevitable for most Australian Children.

2. High Range Myopes
(short Sighted) -5.0 D and greater:

  • Have an increased rate of Glaucoma, Retinal Detachment  & Cataract.
  • Increased risk of developing Myopic Macular Degeneration (which includes choroidal neovascularization).

(The Impact of Myopia & High Myopia – University NSW 2015)

LASIK patients should be considered as ‘High Range’ as many were and the operation does nothing to treat the underlying condition.

3. Those over 50 years of age:

Move into the higher risk category for:

  • Glaucoma.
  • Age Related Macular Degeneration.
  • Cataract.
  • Dry Eye – particular severe in menopausal women.
  • Diabetic related conditions.


4. Those over 65:

  • All of the risk categories that are prevalent in the over 50’s escalate in the over 65’s.
  • Medicare now provides for an ANNUAL eye examination for the Over 65’s.

5. Diabetics

  • There are currently around 72,000 people in Australia with diabetic retinopathy, with approximately 3 in 5 experiencing poor sight.
  • Diabetes is the leading cause of preventable blindness in Australia.
  • The total indirect cost of vision loss associated with diabetic macular oedema in Australia is estimated to be $2.07 billion per annum.
  • Diabetic retinopathy occurs in over 15 per cent of Australians with diabetes.
  • The longer the duration of the disease the higher the risk of developing further complications.
  • Cataract & Glaucoma are more prevalent.
    (Diabetes Australia)

6. Glaucoma:

  • Early detection and adherence to treatment can halt or significantly slow progression.
  • 2 in 100 Australians will develop Glaucoma in their lifetime.
  • 1 in 8 Australians aged over 80 years will develop glaucoma.
  • First degree relatives of people with glaucoma have an up to 10-fold increased risk of developing the disease.
  • Currently, about 50% of people with glaucoma remain undetected.

Although anyone can get glaucoma, some people have a higher risk – they are those with:

  • A family history of glaucoma;
  • Aged over 50;
  • African or Asian descended ethnicity;
  • Diabetes;
  • Short or long sightedness;
  • A previous history of eye injury;
  • Past or present prolonged use of cortisone drugs (steroids);
  • Migraine;
  • High or low blood pressure
    (Abridged: NHMRC Guidelines, 2010)

7. Concussion

  • Are widely unreported.
  • Patients do not generally link visual symptoms to the initial injury.
  • The onset of symptoms may is not immediate.
  • Peripheral retinal tears.
  • Visual symptoms including headaches & diplopia can last for up to 12 months.