Seeing Well A Vision Overview

As you grow older, your body changes. Your eyes change along with the rest of you.

Some people believe that growing older means losing their sight. They don't get medical care for eye problems because they think nothing can be done. This is not true.

Many eye diseases and disorders are more common as we age. But advances in ophthalmology allow most people to maintain good vision as they grow older. Many eye problems can be prevented or corrected if detected in their early stages.

Regular medical eye examinations by an ophthalmologist are the best way to detect eye conditions early, while they can be treated. An ophthalmologist is a medical doctor (M.D. or osteopath) with special training and skill to diagnose and treat all diseases of the eye.

The following eye problems are common among older people.

Presbyopia

When you are young, the lens in your eye is soft and flexible. It changes shape easily, allowing you to focus on objects both close and far away.

As you grow older, your lens becomes rigid, or "sets." By age 40, the lens can't change shape as easily as it once did and it is more difficult to read at close range. This perfectly normal condition is called presbyopia.

No exercise or medication can reverse presbyopia. You will need reading glasses or bifocals to help your eyes focus. The lens continues to harden, so you will need to change prescriptions as you grow older.

Floaters

You may sometimes see small specks or clouds moving in your field of vision. They are called floaters. You can often see them when looking at a plain background, like a blank wall or blue sky.

Floaters are actually tiny clumps of gel or cells inside the vitreous, the clear jelly-like fluid that fills the inside of the eye.

What you see are the shadows they cast on the retina, the nerve layer at the back of the eye that senses light and helps send images to the brain.

You should see an ophthalmologist right away if you suddenly develop any new floaters, especially if you are over 45 years of age.

Cataract

A cataract is a clouding of the eye's lens, like a window that is "fogged" with steam. When the lens becomes cloudy, light rays cannot pass through it easily and vision becomes blurry.

All of us would get cataracts if we lived long enough. Protecting your eyes from strong sunlight may slow the growth of a cataract. There are no medications, eye drops, exercises or glasses that will cause cataracts to disappear once they have formed.

Common symptoms of cataract include:

· Painless blurring of vision;

· Frequent eyeglass prescription changes;

· Glare and haloes;

· Colors look dulled and brownish;

· Poor night vision.

It is up to you to decide when to have the cataract removed. When you are not able to see well enough to do the things you like to do, you should consider cataract surgery.

Surgery is the only way to remove a cataract. Cataracts cannot be removed with a laser. Cataract surgery improves vision in over 90% of cases. Cataract surgery is usually done on an outpatient basis, which means you can go home the same day.

A plastic intraocular lens (IOL) is usually placed inside the eye during cataract surgery to replace the cloudy lens that was removed.

Glaucoma

Glaucoma is one of the leading causes of blindness in the United States. The older we get, the more likely we are to develop glaucoma.

You are at risk for glaucoma if:

· Someone in your family has glaucoma;

· You are of African ancestry and over age 40;

· You are nearsighted;

· You have had a serious eye injury;

· You have hardening of the arteries;

· You are taking steroid medications.

Many people think of glaucoma as a problem with pressure inside the eye, but glaucoma is really a disease of the optic nerve. The optic nerve carries the images we see from the retina at the back of the eye to the brain.

Because you don't notice symptoms of glaucoma until much damage has already occurred, early diagnosis and treatment are the key to preventing blindness.

Your ophthalmologist can determine if you have glaucoma after examining:

· The pressure in your eye;

· Your optic nerve;

· Your side vision.

Glaucoma is usually controlled with eye drops, or sometimes with pills and drops together. Laser surgery or operative surgery may be done if the drops do not control the disease.

These treatments only stop further damage; they cannot reverse any damage or loss of sight that has already occurred. That's why early detection and taking the eye drops as prescribed are so important to prevent blindness from glaucoma.

Macular degeneration

Macular degeneration is damage or breakdown of the macula of the eye. The macula is a small, central area at the back of the eye that allows us to see fine details clearly.

When the macula doesn't function correctly, you experience blurriness or distortion in the center of your vision.

Macular degeneration makes close work -like reading or threading a needle- difficult or impossible.

Although macular degeneration reduces vision in the central part of the retina, it does not affect the eye's side, or peripheral, vision. For example, you could see a clock but not be able to tell what time it is.

Macular degeneration alone does not result in total blindness.

Most degeneration is caused by aging and thinning of the tissues of the macula. Vision loss is usually gradual.

Sometimes abnormal blood vessels develop and leak fluid or blood under the macula. Vision loss may be rapid.

If you experience one or more of the following symptoms, have your eyes examined promptly:

· Words on a page look blurred in the center;

· Straight lines look distorted, especially towards the center of vision;

· A dark or empty area appears in the center of vision;

· Colors look dim.

There is no cure for the condition. In some cases of leaking blood vessels, laser surgery may slow vision loss.

Various low-vision optical devices can help people continue with many of their normal activities. They include:

· Magnifying devices;

· Closed-circuit television;

· Large-print reading materials;

· Talking or computerized devices.

Your ophthalmologist can prescribe optical devices or refer you to a low vision specialist or center. Because side vision is usually not affected, a person's remaining sight can be very useful.

A wide range of support services, rehabilitation programs and devices are available to help people with macular degeneration maintain a satisfying lifestyle.

Diabetic eye problems

Many older adults have diabetes, a disease in which the body does not use and store sugar properly.

Diabetes can cause changes in the blood vessels, the veins and arteries that carry blood throughout your body.

Diabetes can affect your vision by causing cataracts, glaucoma and, most importantly, damage to blood vessels inside the eye.

When blood vessels in the retina are damaged, they may leak fluid or blood, and grow fragile brush-like branches and scar tissue. This can blur or distort the images that the retina sends to the brain and is called diabetic retinopathy.

You can have serious, sight-threatening retinopathy without any symptoms. People with diabetes should have medical eye examinations at least once a year.

Laser surgery is the most common treatment for diabetic retinopathy. It often does not return vision to normal, but is very helpful in preventing continued loss of vision.

The best protection against loss of vision from diabetic retinopathy is to have regular medical eye examinations by your ophthalmologist.

Most older people have good vision. If you do develop a vision problem, early diagnosis and treatment by an ophthalmologist can help to preserve useful vision.