Our eyes, like the rest of us, inevitably change with time. And almost everyone is going to need some help seeing the computer screen or the morning paper as middle age rolls around.
Other problems can be prevented, stalled or fixed if you get the proper medical attention and take care of your vision, experts say.
Too many people wait until they fail the vision test when they go to renew their driver’s licenses before seeking help, said a professor of clinical optometry.
“People are living longer, so they need to use their eyes longer. If we look at World War II (population) statistics and project those onto baby boomers, we’re going to see a doubling in the rates of legal blindness,” .
“The sad thing is, it’s preventable. Don’t wait until your vision is blurry. Come on in.”
After age 65, people need a dilated eye exam once a year.
“There are changes that take place in the eyes and all of the tissues around the eyes that occur with aging,” said an ophthalmologist. “Eyelids become more puffy, more droopy, and they may not make good contact with the eye. Eyes become drier with time.”
On top of that, a muscle inside the eye that controls the focusing mechanism weakens over time (hence the reading glasses or bifocals), and the lens starts to turn cloudy, leading to cataracts.
“If you live a normal-length life, you will develop cataracts,”. Most people have cataract surgery around age 71.
Cataract surgery used to be much more complex, and patients were prone to infections and had to wear thick glasses after surgery. Now, most people do well with a quick operation in which their clouded lens is replaced with an artificial lens.
Common cataract symptoms include trouble seeing at night or while driving in the rain, seeing halos around lights and needing more light to read.
Annual eye exams are important for a number of reasons, particularly for screening for glaucoma, which does not have any symptoms. Those with glaucoma, cataracts or macular degeneration might need to be seen more frequently.
Besides scheduling an annual exam with an optometrist or ophthalmologist, people can help protect their vision by wearing sunglasses that guard against ultraviolet rays, avoiding cigarettes and living a generally healthy life.
“I tell patients: ‘Try to adhere to good general health practices. Control your blood sugar, control your blood pressure, control your cholesterol. Take a multivitamin usually. Do not smoke,’”.
Protection from the sun helps prevent and slow the development of cataracts and macular degeneration, a disease of the center of the retina that can lead to blindness.
Treatment for macular degeneration has come a long way. “There used to be very little we could do except diagnose it early.”
Now, eye doctors understand that nutritional supplements, including antioxidants and lutein, can slow the progression of dry macular degeneration, in which the retina wastes away.
In the rarer and more-severe form, which is called wet macular degeneration, new blood vessels form, impairing vision. Doctors can inject a cancer drug to stop the growth of blood vessels.
The procedure often has to be done repeatedly and is costly and burdensome, but “ the alternative is to go totally blind,”.
Other potentially blinding diseases that increase with age are diabetic retinopathy (caused by a thickening of the arteries and high blood pressure) and glaucoma, a condition in which fluid pressure inside the eye increases because of slowed drainage from the eye.
“Particularly with diabetes or glaucoma, the treatment goal is to keep it from getting worse, but you can’t get vision back once it’s gone,” .
Good control of diabetes is the key to preventing diabetic retinopathy, or stalling the disease once it has already shown up, he said.
Glaucoma can be found early only through pressure tests and by examining the optic nerve to see if there’s change over time. People with high blood pressure, heart disease or diabetes are at higher risk of developing the disease, as are African-Americans and Latinos.
Glaucoma can be treated with drops, but if they don’t control the pressure, a doctor might recommend a laser procedure or surgery.
A 66-year-old , was in for his annual eye exam a few years ago and learned that the pressure was up in both eyes. He went to an ophthalmologist and found out he had a precursor to glaucoma. Now, eyedrops are preserving his vision.
“I don’t know of any family history, so it caught me by surprise,”.
More primary-care physicians should do vision screening and talk about risks with patients. Even just reminding patients that they should go to an eye-care provider could help, he said.
“They could very well be wearing glasses they got 15 years ago.”
Age and eyes
Age-related macular degeneration damages sharp, central vision. It’s the leading cause of vision loss in older adults.
PARTS OF THE EYE
Cornea: clear, outer layer of the focusing system at the front of the eye
Iris: colored part of the eye that regulates amount of light that enters the eye
Pupil: opening at the center of the iris, which adjusts to control the amount of light that enters.
Lens: clear part behind the iris that helps to focus light and images on the retina
TYPES OF DEGENERATION
If you notice symptoms of age-related macular degeneration, contact an eye-care professional to schedule a dilated-eye exam.
WET
What it is: Abnormal blood vessels behind the retina grow under the macula and leak blood and fluid, which can displace and damage the macula.
What you see: Straight lines appear wavy.
Retina: light-sensitive tissue lining the back of the eye; converts light into electrical signals for the brain
Optic nerve: millions of bundled nerve fibers that transmit signals from the retina to the brain
Macula: sensitive area at the center of the retina that gives central vision
Fovea: macula’s center that gives the sharpest vision
DRY
What it is: Cells in the macula break down gradually, causing blurred central vision in the affected eye. Yellow spots under the retina, known as drusen, are detected; it occurs in stages.
What you see: As it progresses, a blurred spot might appear and grow in the center of vision; extra light might be needed to focus; faces can be difficult to recognize.
Sources: Columbus Dispatch Article 03/01/12
Sources: National Eye Institute; National Institutes of Health; American Academy of Opthalmology
