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 Table of Contents    
Year : 2022  |  Volume : 15  |  Issue : 2  |  Page : 125-127  

Ignorance is not bliss when it comes to eye health: Lifestyle diseases in a neuro-ophthalmology practice

Department of Ophthalmology, Neuro-Ophthalmology Unit, Al Nahdha Hospital, Ministry of Health of Oman; Undergraduate Program, College of Medicine and Health Sciences, Sultan Qaboos University; Ophthalmology Residency Program, Oman Medical Specialty Board, Muscat, Oman

Date of Submission21-May-2022
Date of Acceptance23-May-2022
Date of Web Publication29-Jun-2022

Correspondence Address:
Dr. Farida Al Belushi
P.O. Box 857, PC 121 Seeb, Muscat
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ojo.ojo_150_22

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How to cite this article:
Al Belushi F. Ignorance is not bliss when it comes to eye health: Lifestyle diseases in a neuro-ophthalmology practice. Oman J Ophthalmol 2022;15:125-7

How to cite this URL:
Al Belushi F. Ignorance is not bliss when it comes to eye health: Lifestyle diseases in a neuro-ophthalmology practice. Oman J Ophthalmol [serial online] 2022 [cited 2022 Dec 8];15:125-7. Available from: https://www.ojoonline.org/text.asp?2022/15/2/125/348970

Lifestyle diseases are illnesses associated with the way one lives. These are internationally known as noncommunicable diseases (NCDs), and are caused by lack of physical activity, unhealthy diet, alcohol, substance abuse, and smoking tobacco. These diseases are obesity, Type II diabetes, metabolic syndrome, heart disease, stroke, and lung cancer. Today, NCDs are a significant public health problem worldwide, including the Gulf Cooperation Council (GCC) countries, of which Oman is a member nation. NCDs were responsible for 61% of all death in 2005, as estimated by the WHO. NCDs kill around 40 million people each year, which is approximately 70% of all deaths globally. Among all NCDs, cardiovascular diseases, cancer, respiratory diseases, and diabetes are the most common cause of death, with diabetes alone causing an annual morbidity rate of 1.6 million.[1],[2]

The majority of the neuro-ophthalmology practice in Al-Nahdha Hospital comprises eye disorders related to lifestyle diseases and includes the following: ischemic optic neuropathy (i.e., nonarteritic anterior ischemic optic neuropathy, [NAION]), diabetic retinopathy with papillopathy, and microvascular cranial neuropathies (oculomotor, trochlear, and abducens). Unlike in the Western population, Omani patients with lifestyle diseases are younger. However, they present late with advanced stage with ocular and nonocular complications of the disease. The prevalence of Type 2 diabetes is exceptionally high among these patients presenting to our neuro-ophthalmology clinic. A nationwide NCD risk factor survey study conducted in 2017 to determine the prevalence of diabetes mellitus (DM) among the adult population of Oman reported an overall prevalence of DM of 15.7%. One-third of patients were under the age of 50. Moreover, 56% of uncontrolled cases, comprising two-thirds of the cases with raised blood glucose, were not taking any medication to control their blood glucose. Diabetes is currently ranked the sixth-leading cause of premature mortality in Oman and the fifth prominent cause of disability-adjusted life years lost in the country.[3] Published results of two previous cross-sectional surveys in 2004 in Oman showed a prevalence of obesity of 16.7% in men and 23.8% in women, with an unsurprising increase in these statistics presently. Furthermore, a cross-sectional study done on Sultan Qaboos University College students found that the knowledge related to nutrition was generally feeble (below 60%). Among the studied population, the rate of physical activity score and number of hours of exercising per week was higher only in overweight and obese individuals.[3],[4],[5],[6] Obesity in Oman and other GCC countries is a by-product of an increase in wealth and subsequent development, leading to a change in lifestyle to a sedentary one.

Patients presenting to our neuro-ophthalmology clinic with a sudden loss of vision due to NAION or acute diplopia due to cranial neuropathies are often unaware of the association of neuro-ophthalmic complications of DM. Our clinical experience leads us to believe that there is an underestimation of the impact of lifestyle factors, such as diet and physical activity, on health in general and eye health in particular among patients.

Another prevalent neuro-ophthalmic disease in Oman with increasing prevalence worldwide is idiopathic intracranial hypertension. The disease mainly affects overweight or obese women of childbearing age. There is a remarkable improvement in the disease status achieved with weight reduction. Although most of these young patients have a more benign course, a few have a fulminant type, which results in permanent total vision loss in one or both eyes.[7]

Due to the growing concern about the burden of NCDs worldwide, a global strategy on diet, physical activity, and health was endorsed by the World Health Organization in 2004. Among the lifestyle factors, diet and physical activity have a crucial effect on one's health including eye health. This subject is commonly discussed with every patient presenting to us with a neuro-ophthalmic complication of a lifestyle disease.

Population-based interventions are required to tackle these issues to save millions of lives without overlooking, at the same time, the responsibility of the individuals toward their health. Behavior, which is often closely linked to biological, environmental, and social factors, is a crucial risk factor for all NCDs. Hence, providing a more supportive environment and the right incentives are likely to motivate individuals to change their behavior and care for their health. The following measures could help in the prevention and control of lifestyle diseases:

   Public Education on Health and Diet Top

Lifestyle is generally considered a personal issue, and many are unaware that a lifestyle change is an important factor in the emergence, control, or prevention of NCDs. Thus, teaching nutrition and lifestyle habits should be an essential part of formal education in schools, primarily since the roots of the habits often originate during the early stages of childhood. It is vital to start teaching important lessons concerning healthy living, early in life.

   The Notion of Movement should be Widespread in the Community Top

Promoting physical activity is as much the responsibility of governments as individuals. However, an individual's commitment to physical activity is influenced by the environment and availability of sports and recreational facilities. Providing a suitable environment requires coordination among many sectors, such as health, sports, education and culture policy, media and information, transport, urban planning, local governments, and financial and economic planning. Examples of some effective measures include building more parks to increase access to green spaces, using beaches for sports and activities, providing easy access to bicycles to the public, and supporting and organizing sports events as much as possible.

   Mass Health Communication Top

Health communication efforts should educate the public about the importance of diet and exercise and motivate them to eat healthier and engage in more physical activity. It should also motivate the concerned authorities to create policies and environments that support healthy eating and increased physical activity to change social norms related to eating and activity. Specific campaigns could be organized that intend to make the public aware of health risks and complications related to a specific organ or system like the eye. Moreover, health-care programs in the community should provide effective preventive services to the public to control the prevalence of NCDs.

   Ban or Limit Tobacco Use Top

A comprehensive public health approach is needed to control tobacco use and promote its cessation through measures, such as tax and price policy, restrictions on tobacco advertising, promotion and sponsorship, educational campaigns, restrictions on smoking in public places, and cessation support services. The most significant impact will only be achieved by sustained political will and engagement and, above all, practical and well-enforced legislation.

   Epidemiologic Surveillance and Research Top

Given the gravity of the health-related risks associated with lifestyle factors and the lack of research underpinning solutions, large-scale epidemiological surveillance of a population's dietary practices and physical activity levels is necessary to quantify and understand the scope of these problems. Data surveillance will help identify trends, target subgroups for intervention, guide state planning, evaluate the impact of interventions, inform the public, and influence public policy.

Lifestyle factors matter and strategies aimed to increase awareness, provide guiding policy and action plans, and monitor underlying factors to reduce the risk of NCDs that stem from unhealthy lifestyle factors can make a remarkable difference in patients' eye health and visual prognosis.

   References Top

Al-Maskari F. LIFESTYLE DISEASES: An Economic Burden on the Health. Available from: https://www.un.org'chronicle'article'lifestyle-disease [Last accessed on 2022 May 10].  Back to cited text no. 1
Tabish SA. Lifestyle diseases: Consequences, characteristics, causes and control. J Cardiol Curr Res 2017;9:00326.  Back to cited text no. 2
Al-Mawali A, Al-Harrasi A, Jayapal SK, Morsi M, Pinto AD, Al-Shekaili W, et al. Prevalence and risk factors of diabetes in a large community-based study in the Sultanate of Oman: STEPS survey 2017. BMC Endocr Disord 2021;21:42.  Back to cited text no. 3
ALNohair S. Obesity in gulf countries. Int J Health Sci (Qassim) 2014;8:79-83.  Back to cited text no. 4
Al-Lawati JA, Jousilahti PJ. Prevalence and 10-year secular trend of obesity in Oman. Saudi Med J 2004;25:346-51.  Back to cited text no. 5
Al-Kilani H, Waly M, Yousef R. Trends of Obesity and Overweight among College Students in Oman: A cross sectional study. Sultan Qaboos Univ Med J 2012;12:69-76.  Back to cited text no. 6
Subramaniam S, Fletcher WA. Obesity and weight loss in idiopathic intracranial hypertension: A narrative review. J Neuroophthalmol 2017;37:197-205.  Back to cited text no. 7


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