Sight-threatening eye problems affect one in six adults aged 45 and older. And the risk for vision loss increases with age. In fact, a recent American Academy of Ophthalmology (AAO) report estimates that more than 43 million Americans will develop age-related eye diseases by the year 2020.
Tips for protecting your eyes
To protect your eyesight and keep your eyes healthy as you age, consider these simple guidelines:
- Be aware of your risk for eye diseases. Find out about your family's health history. Do you or any of your family suffer from diabetes or have high blood pressure? Are you over the age of 65? Are you an African-American over the age of 40? Any or all of these traits increase your risk for sight-threatening eye diseases. Regular eye exams can detect problems early and help preserve your eyesight.
- Have regular exams to check for diabetes and high blood pressure. If left untreated, these diseases can cause eye problems. In particular, diabetes and high blood pressure can lead to diabetic retinopathy, macular degeneration, glaucoma and ocular hypertension.
- Look for changes in your vision. If you start noticing changes in your vision, see your eye doctor immediately. Trouble signs include double vision, hazy vision and difficulty seeing in low light conditions. Other signs to look for are frequent flashes of light, floaters, and eye pain and swelling. All of these signs and symptoms can indicate a potential eye health problem that needs immediate attention.
- Exercise more frequently. According to the AAO, some studies suggest that regular exercise – such as walking – can reduce the risk of macular degeneration by up to 70%.
- Protect your eyes from the sun’s UV rays. You should always wear sunglasses with proper UV protection to shield your eyes from the sun's harmful rays. This may reduce your risk of cataracts and other eye damage.
- Eat a healthy and balanced diet. Numerous studies have shown that antioxidants can possibly reduce the risk of cataracts. These antioxidants are obtained from eating a diet containing plentiful amounts of fruits and colorful or dark green vegetables. Studies have also shown that eating fish rich in omega-3 fatty acids may also prevent macular degeneration.
- Get your eyes checked at least every two years. A thorough eye exam, including dilating your pupils, can detect major eye diseases such as diabetic retinopathy, which has no early warning signs or symptoms. A comprehensive eye exam also can ensure that your prescription for eyeglasses or contact lenses is accurate and up-to-date.
- Don't smoke. The many dangers of smoking have been well documented. When it comes to eye health, people who smoke are at greater risk of developing age-related macular degeneration and cataracts.
Following these steps is no guarantee of perfect vision throughout your lifetime. But maintaining a healthy lifestyle and having regular eye exams will certainly decrease your risk of sight-stealing eye problems and help you enjoy your precious gift of eyesight to the fullest.
Just as our physical strength decreases with age, our eyes also exhibit an age-related decline in performance – particularly as we reach our 60s and beyond.
Some age-related eye changes, such as presbyopia, are perfectly normal and don't signify any sort of disease process. While cataracts can be considered an age-related disease, they are extremely common among seniors and can be readily corrected with cataract surgery.
Some of us, however, will experience more serious age-related eye diseases that have greater potential for affecting our quality of life as we grow older. These conditions include glaucoma, macular degeneration and diabetic retinopathy.
When do age-related vision changes occur?
After you pass the milestone age of 40, you'll notice it's more difficult to focus on objects up close. This normal loss of focusing ability is called presbyopia, and is due to hardening of the lens inside your eye.
For a time, you can compensate for this decline in focusing ability by just holding reading material farther away from your eyes. But eventually, you’ll need reading glasses, multifocal contact lenses or multifocal eyeglasses. Some corrective surgery options for presbyopia also are available, such as monovision LASIK and conductive keratoplasty (CK).
Even though cataracts are considered an age-related eye disease, they are so common among seniors that they can also be classified as a normal aging change. According to Mayo Clinic, about half of all 65-year-old Americans have some degree of cataract formation in their eyes. As you enter your 70s, the percentage is even higher. It's estimated that by 2020 more than 30 million Americans will have cataracts.
Thankfully, modern cataract surgery is extremely safe and so effective that 100% of vision lost to cataract formation usually is restored. If you are noticing vision changes due to cataracts, don't hesitate to discuss symptoms with your eye doctor. It's often better to have cataracts removed before they advance too far. Also, multifocal lens implants are now available. These advanced intraocular lenses (IOLs) potentially can restore all ranges of vision, thus reducing your need for reading glasses as well as distance glasses after cataract surgery.
Major age-related eye diseases
Macular degeneration (also called age-related macular degeneration or AMD) is the leading cause of blindness among American seniors. According to the National Eye Institute (NEI), macular degeneration affects more than 1.75 million people in the United States. The U.S. population is aging rapidly, and this number is expected to increase to almost three million by 2020. Currently, there is no cure for AMD, but medical treatment may slow its progression or stabilize it.
Your risk of developing glaucoma increases with each decade after age 40 – from around 1% in your 40s to up to 12% in your 80s. The number of Americans with glaucoma is expected to increase by 50% (to 3.6 million) by the year 2020. If detected early enough, glaucoma can often be controlled with medical treatment or surgery and vision loss can be prevented.
According to the NEI, approximately 10.2 million Americans over age 40 are known to have diabetes. Many experts believe that up to 30% of people who have diabetes have not yet been diagnosed. Among known diabetics over age 40, NEI estimates that 40% have some degree of diabetic retinopathy, and one of every 12 people with diabetes in this age group has advanced, vision-threatening retinopathy. Controlling the underlying diabetic condition in its early stages is the key to preventing vision loss.
How aging affects other eye structures
While normally we think of aging as it relates to conditions such as presbyopia and cataracts, more subtle changes in our vision and eye structures also take place as we grow older. These changes include:
- Reduced pupil size.
As we age, muscles that control our pupil size and reaction to light lose some strength. This causes the pupil to become smaller and less responsive to changes in ambient lighting. Because of these changes, people in their 60s need three times more ambient light for comfortable reading than those in their 20s. Also, seniors are more likely to be dazzled by bright sunlight and glare when emerging from a dimly lit building such as a movie theater. Eyeglasses with photochromic lenses and anti-reflective coating can help reduce this problem.
- Dry eyes.
As we age, our bodies produce fewer tears. This is particularly true for women after menopause. If you begin to experience burning, stinging or other eye discomfort related to dry eyes, use artificial tears as needed throughout the day for comfort, or consult your eye doctor for other options such as prescription dry eye medications.
- Loss of peripheral vision.
Aging also causes a normal loss of peripheral vision, with the size of our visual field decreasing by approximately one to three degrees per decade of life. By the time you reach your 70s and 80s, you may have a peripheral visual field loss of 20 to 30 degrees.
Because the loss of visual field increases the risk for automobile accidents, make sure you are more cautious when driving. To increase your range of vision, turn your head and look both ways when approaching intersections.
- Decreased color vision.
Cells in the retina that are responsible for normal color vision decline in sensitivity as we age, causing colors to become less bright and the contrast between different colors to be less noticeable. In particular, blue colors may appear faded or "washed out." While there is no treatment for this normal, age-related loss of color perception, you should be aware of this loss if your profession (for example, artist, seamstress or electrician) requires fine color discrimination.
- Vitreous detachment.
As we age, the gel-like vitreous inside the eye begins to liquefy and pull away from the retina, causing "spots and floaters" and (sometimes) flashes of light. This condition, called vitreous detachment, is usually harmless. But floaters and flashes of light can also signal the beginning of a retinal detachment – a serious problem that can cause blindness if not treated immediately. If you experience flashes and floaters, see your eye doctor immediately to determine the cause.
What you can do about age-related vision changes
A healthy diet and wise lifestyle choices – including exercising regularly, maintaining a healthy weight, reducing stress and not smoking – are your best natural defenses against vision loss as you age. Also, have regular eye exams with a caring and knowledgeable optometrist or ophthalmologist.
Be sure to discuss with your eye doctor all concerns you have about your eyes and vision. Tell them about any history of eye problems in your family and any health problems you may have. Also, let your eye doctor know about any medications you take, including non-prescription vitamins, herbs and supplements.
Many normal, age-related problems affecting vision can be addressed with practical solutions, such as extra lighting for reading recipes or tinkering with garage projects.
In fact, after about age 60, you may find you need additional illumination for most tasks performed indoors or in darker conditions outdoors. This is because your eye's pupil no longer opens as widely as it once did to allow light to enter. Because less light is reaching your retina where vision processing occurs, images are no longer as sharp as they once were.
To help offset this problem, you might consider extra steps such as:
- Installing task lighting underneath kitchen cabinets or above stoves to help illuminate darker corners.
- Making sure you have enough lighting to brighten work surfaces in your garage, sewing room or other areas where you need to see fine details.
- Asking your employer to install additional lighting, if needed, at your work space.
Also, make sure you have regular eye exams that include critical tests for older eyes to rule out potentially serious age-related eye diseases that may affect vision quality. Your eye doctor also can advise you about the best vision correction options to reduce the effects of normal age-related declines in near vision, color vision and contrast sensitivity.
Cataracts, which are very common in the over-60 age group, also can cause cloudy or hazy vision. Cataracts usually are easily remedied with surgery that removes the eye's cloudy lens and replaces it with an artificial one.
What can you do about permanent vision loss?
Unfortunately, some serious vision losses are due to blind spots caused by age-related eye diseases including glaucoma, advanced macular degeneration and diabetic retinopathy.
Many low vision devices are available for people with permanent vision loss, to assist them with daily living tasks. These devices include:
- Strong magnifying lenses with extra illumination, for reading and other near vision work.
- Audio tapes, specially adapted computer or television screens, and telescopes.
- Lens filters and shields to reduce glare.
Vision loss and the elderly
One disturbing trend noted in recent years has been an increased tendency in our society to overlook or neglect the vision correction needs of elderly citizens, including those living in nursing homes.
As an example, researchers say almost one third of older Americans diagnosed with glaucoma receive no treatment for this potentially blinding eye disease.
Consequences of delaying vision correction or needed treatment, especially in elderly people, can be severe. Uncorrected vision problems can contribute to falls that seriously injure elderly people and greatly reduce their confidence in their ability to live independently.
If you have older relatives or friends living alone or in a nursing home, consider serving as their advocate to make sure they receive appropriate vision care and treatment of age-related eye diseases, to maximize their quality of life.
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