As people age, they notice many differences in the ways every part of the body works, and the eyes are no exception. The Vision Council of America reports that approximately 75% of adults use some sort of vision correction, which means that people of all ages have become resigned to the use of corrective glasses or contacts. But as humans age, vision issues become more complicated to identify and to treat.
While some of the population experiences vision issues early on, many people have relatively healthy eyes throughout their 20’s, 30’s, 40’s, and beyond. But as the eyes age, they also undergo some changes. Lenses slowly harden. The vitreous shrinks and pulls away from the retina. Eye muscles weaken, and pupils become less responsive to light. As everyone ages, they experience all of these changes to some degree. For some, the resulting issues are mild and manageable, while for others, the condition are more severe and require medical attention.
For most people, the transformation of the eyes occurs slowly over time. For some, reading glasses or magnifying lenses are needed to see details up close. For others, it results in more difficulty adjusting to changes in distance or brightness. Still others find it harder to distinguish colors as they age, putting on black shoes instead of navy, or mistaking a brown scarf for a black one.
While these changes can be frustrating, they are normal. Between the ages of 40 and 60, the number of people with age-related eye problems rises dramatically. While some ocular conditions can be slowed, corrected, or even prevented, others are harder to predict or defend against.
In the January 2011 edition of NIH News in Health, Dr. Cynthia Owsley, an eye researcher at the University of Alabama at Birmingham, noted,
Many people know that extended exposure to direct sunlight can result in eye damage. That’s because ultraviolet rays from the sun can accelerate age-related eye diseases. According to the Cleveland Clinic,
This video from The American Academy of Ophthalmology explains the process:
This is why presbyopia results in the gradual loss of the ability to see things clearly up close. Many people begin to notice the effects of presbyopia around the age of 40, though some experience this in their 30s, while don’t notice it until their 50’s or beyond.
Men and women with presbyopia will find it difficult to read up close. To compensate, some people begin to increase the size of the text on their phones or computers. Others find reading glasses help with close-up tasks like reading, sewing, or grooming.
For certain people, purchasing non-prescription magnification glasses is a sufficient, short-term solution. As presbyopia advances, bifocal or trifocal prescriptions may be necessary.
Refractive surgery is a way to reverse the effects of presbyopia. Using a laser, an ophthalmologist works to allow one eye to have clear far vision, while allowing the other eye to have clear close-up vision. An eye specialist may recommend trying monovision lenses before deciding upon surgery, to ensure that a monovision correction is a comfortable, long-term option.
Corneal inlays are tiny devices that help correct presbyopia. They are implanted in the corner, at the front of the eye to correct close-up vision. Not everyone is an ideal candidate for a corneal inlay, but the staff at Lavenburg Medical Group can assess its suitability on a case-by-case basis.
While there are no sure-fire preventative measures for presbyopia, people who avoid smoking, stay at a healthy weight, and enjoy a healthy diet with omega-3 fatty acids, lutein, zinc, and vitamins C and E may be able to maintain flexible lenses longer. This means they may experience presbyopia later in life, or to a lesser degree. But, ultimately, most people will deal with this issue at some point in their lifetime.
The eyes’ lenses are naturally clear. They are made to bend or refract light onto the retina in ways that help people see clearly. Flexible, clear lenses result in good eyesight.
However, as one gets older, normal proteins in the lens break down. As these proteins break down, they begin to interfere with vision. People may report that their vision has become cloudy, brown, sepia-toned, faded, foggy, dusty, or like looking through a dirty car windshield. Others experience double-vision, severe issues with night vision, or sensitivity to light.
This video from The American Academy of Ophthalmology explains how cataracts form.
Many people will get cataracts to some degree in later life. It's normal for patients over the age of 60 to report minor issues with clouding vision. However, significant vision problems may not present themselves until years later, if at all.
Certain populations are at higher risk of cataracts. People with diabetes are more likely to have cataract issues. Individuals who have had detached retinas, eye surgery, or radiation treatment in the upper body are more likely to develop cataracts. Extended time in the sun without UVA/UVB protection can accelerate the formation of cataracts. The use of certain medications, especially corticosteroids, can increase the likelihood of the condition. And finally, cataracts are a hereditary condition. People who have parents or siblings with cataracts are more likely to have them at some point in their lives.
While cataracts are often an issue with older people, doctors can't accurately predict how quickly cataracts will develop, or how severe they will become. Younger people and patients with diabetes may have cataracts that remain minor for years, even decades. Or they may have cataracts that accelerate quickly. Close medical supervision and regular eye exams are usually the prescribed method of tracking a cataract's progression.
To diagnose cataracts, a specialist will conduct a comprehensive eye exam, which will include dilating the pupils using eye drops. Once the eyes are fully dilated, the eye professional will use a slit-lamp to examine the cornea, iris, and lens. They will also look for signs of glaucoma and inspect the retina and eye nerve. They will conduct a refraction and visual acuity test, usually using an eye chart, to evaluate the clarity and sharpness of the patient's vision.
Surgery may be necessary for advanced cases of cataracts. However, for people who diagnosed when the cataracts are in the early stages, presenting few or no significant vision issues, the recommendation may be as simple as continued observation.
As part of that continued observation, a comprehensive eye exam should be scheduled every two years. This exam should be annual for those age 65 or older, or if their doctor recommends more frequent examinations.
People trying to prevent the development of cataracts, or who want to slow down the progression of cataracts, have several ways to extend the health of their eyes.
You need to be vigilant about protecting their eyes from sun damage. Doctors recommend sunglasses that block UVA and UVB light and suggest patients choose the highest level UVA/UVB protection available. Brown or amber lenses are preferred since they enhance contrast, which can help the wearer see better. Hats that provide shade over the eyes offer additional protection.
Smokers are more likely to form cataracts. Once cataracts are diagnosed, continued smoking tends to accelerate the formation of cataracts.
People with minor cataracts can improve their vision using the same techniques used for many other types of vision problems. Brighter lights are helpful for reading and other tasks. A magnifying glass or magnifying reading glasses can help with reading or close tasks.
Those with early-stage cataracts must be careful when driving after dark or avoid night driving altogether. Night vision, halos, and glare can make it difficult or impossible to drive safely at night.
Some population-based studies have found antioxidant vitamins to be potentially preventative. Avoidance of certain medications is also thought to limit the likelihood of cataract development.
Advanced cataracts can be treated with surgery. During cataract surgery, the eye surgeon will remove the cloudy lens and replace it with an artificial lens, called an intraocular lens, or IOL. The eyes' capsule holds the IOL in place. Sometimes the capsule will become hazy again, often years later. If this happens, an ophthalmologist may recommend a capsulotomy, in which a laser is used to clear the cloudiness and restore clear vision.
Eyelids are made up of two folds, made up of the thinnest skin on the body. Although eyelids are light and relatively delicate, they also protect the eyes from debris, dust, and strain. The upper eyelid connects with surrounding muscles to keep it taut. These muscles allow the lid to move it up and down, shut, and blink. This same network of muscles helps the body use your eyebrows to raise eyelids.
As the body ages, eye muscles may weaken or even become damaged, resulting in drooping or sagging eyelids that work less effectively to protect the eyes. Some people, especially older people, may notice that their eyelids have started to sag or droop. When prominent, sagging eyelids can decrease peripheral vision, cause ocular fatigue, and result in general eye irritation.
While eyelids sag naturally as people grow older, factors in some populations may accelerate or worsen the drooping. People who have experienced the incorrect Botox injections may experience paralysis of the muscles in the eyebrow or lid. Glaucoma patients may use eye drops which cause fat loss in the eye area, affected the eyelid’s ability to function properly.
Some medical conditions may cause eyelids to droop or sag. Third nerve palsy is a condition in which a nerve involved in the movement of the eye is damaged. Diabetes and autoimmune diseases can lead to sagging eyelids. People with myasthenia gravis may experience a loss of muscle control in the eyelids. People who have suffered a stroke may also be left with sagging or drooping eyelids in one or both eyes.
Treatment for sagging eyelids focuses on the particular anatomical change that is causing the drooping.
When the conditions is advanced, sagging eyelids can decrease peripheral vision, cause ocular fatigue, and result in general eye irritation. By working with an ophthalmologist at Lavenburg Medical Group, patients can get information and advice to help them evaluate the benefits of surgery and non-invasive collagen tightening.
The body produces tears to keep the eyes moist, healthy, and comfortable. When the body stops producing enough tears, the condition is diagnosed as dry eye. This is also the term used for eyes that don’t create the right type of tears.
Healthy, young eyes continually produce tears to keep the eye moist. When eyes are irritated, the eye produced an abundance of moisture, resulting in tears. When eyes stop functioning in this way, patients can see redness or feel stinging, burning, grittiness, and experience general irritation. Eyes can become more sensitive to irritants like wind or smoke. In severe cases, people may experience blurred vision or discover strings of mucus in an around the eye. Dry eyes can also produce an excess of tears as the human body struggles to compensate for dry eyes.
As all people age, their body tends to produce fewer tears. While both men and women can get dry eye, it is especially common in post-menopausal women. Some diseases or conditions can trigger dry eye, including lupus, thyroid issues, rheumatoid arthritis, Sjögren’s syndrome, and blepharitis.
Extended exposure to certain environmental conditions can also result in dry eye, including desert climates, high winds, prolonged exposure to computer screens, and reading.
Dry eye can be a side effect of refractive eye surgery, such as LASIK. It may also manifest as a side-effect of certain medications, including diuretics prescribed for high blood pressure, beta-blockers, antihistamines, antidepressants, heartburn medicines, and sleeping pills.
Some research shows that diets high in omega-3 such as those found in oily fish like salmon and tuna, and omega-6 fatty acids, such as those found in soybeans, seeds, and nuts, can help reduce the likelihood of dry eye.
Rarely, permanent vision loss can result from severe dry eye. If you are experiencing dry eye, talk to the doctors at Lavenburg Medical Group to discuss whether new therapies to stimulate tear production and maintain tear volume are right for your condition.
The macula is a small area in the center of the retina. It plays a vital role in facilitating the ability to see details of objects, including text, clearly.
Age-related macular degeneration (AMD) is the leading cause of vision loss for people over the age of 50. It occurs when the macula is damaged, resulting in a loss of central vision. People suffering from age-related macular degeneration can’t see fine details close up or at a distance, even though peripheral vision remains intact.
There are two forms of AMD: dry and wet. About 80% of people diagnosed with AMD have the dry form. In this scenario, parts of the macula get thinner as they age, and tiny clumps of protein grow, obscuring vision. Vision loss occurs slowly, over time, as the proteins progress and obscure vision. There is currently no effective treatment of this type of AMD, but some patients have benefited from taking combinations of nutritional supplements. An ophthalmologist can help a patient determine if supplements will help them treat dry AMD.
Wet AMD occurs in 20% of diagnosed cases and is more dangerous. It occurs when abnormal blood vessels grow under the retina and leak blood or other fluids, scarring the macula. Vision loss may result in substantial blurriness and can progress quickly. This type of macular degeneration may be treated with an injection or series of injections that help reduce the number of abnormal blood vessels in the retina. This type of injection may also slow any leaking from blood vessels. In some cases, laser surgery can be used to reduce the number of blood vessels and slow leaking blood.
This video from The American Academy of Ophthalmology explains the condition in more detail.
The use of ultraviolet light and blue light filtering glasses may protect against macular degeneration. Studies show that people who are overweight, smoke, or eat a diet high in saturated fats are more likely to suffer from age-related macular degeneration. People with high blood pressure, heart disease, or a family history of AMD are also more likely to develop the condition.
Early detection of this disease is essential since it can be difficult or even impossible to reverse existing damage. Treatment currently focuses on preventing further damage. Everyone over age 40 should schedule a comprehensive dilated eye exam at least every two years. People over the age of 40, people in high-risk categories including smokers, people with diabetes, high blood pressure, or heart disease, and families with a history of AMD should schedule an annual dilated eye exam to check for early warning signs.
Eye floaters are spots in your vision. While they can occur at any age, they are more common in older populations. Many eye floaters are minor occurrences that appear and disappear without consequence. Floaters may appear as black or gray specks, strings, or cobwebs that drift through your eyesight, or that seem to dart away when you try to look at them.
Floaters happen when a jelly-like substance inside your eyes, called vitreous, thins and becomes more liquid. Inside the vitreous, tiny fibers can clump, creating shadows on your retina. Eye floaters are actually the shadows caused by clumps inside your eye.
As you age, the vitreous partially liquefies and shrinks a bit. As it shrinks, it also clumps and gets stringy, which results in floaters becoming more frequent and numerous.
This video from The American Academy of Ophthalmology explains floaters.
Floaters are more common for people who are over age 50 or nearsighted. The number of floaters may increase after eye trauma, cataract surgery, or for people with diabetic retinopathy.
When eye floaters suddenly increase in number, size, or intensity, patients should contact an eye specialist immediately, especially if the change in floaters is accompanied by flashes of light or loss of peripheral vision. These may be signs of a significant sight-threatening condition that requires immediate attention.
A change or increase in floaters may indicate a torn retina. If left untreated, a retinal tear can lead to retinal detachment and eventual vision loss. Untreated retinal detachments can cause permanent vision loss. People with any symptoms of a torn retina, including an increase in floaters, should treat it as an emergency and see an eye specialist immediately.
A sudden increase in floaters can be the result of bleeding in the eye caused by diabetes, hypertension, blocked blood vessels, or injury. Again, people who notice a sudden increase in floaters, especially if they have been diagnosed with diabetes or hypertension, should treat it as an emergency and see an eye specialist immediately.
A sudden increase in floaters may also be a symptom of posterior uveitis, an inflammation within the eye. This condition should also be treated promptly.
In conclusion, as we age, our bodies change due to the wear and tear and diminishing returns that inexorably comes from the passage of time. Such change affects our quality of vision and the health of our visual organs: our eyes. Some changes are mild and manageable differences, while others could be serious conditions that require ongoing care and medical treatment.
If you’re reaching the age of 50 or greater, please seek out regular checkups with your local optometrist or ophthalmologist to ensure that any potential vision problems and eye conditions are identified as early as possible.
For those living in and around the Elkton Maryland, Newark Delaware, and Wilmington Delaware areas, please feel free to contact us to schedule an appointment. From all of us at Lavenburg Medical Group, we hope this eye care information is useful and we wish you good health!
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