A Ripple Autumn 2022 article
Many eye diseases have no early symptoms. They may develop painlessly, and you may not notice the changes to your vision until the condition is quite advanced. Wise lifestyle choices, regular eye exams and early detection of disease can significantly improve your chances of maintaining good eye health and vision as you age.
You may not realise that health problems affecting other parts of your body can affect your vision as well. People with diabetes or hypertension (high blood pressure), or who are taking medications that have eye-related side effects, are at greatest risk for developing vision problems.
Therefore, regular eye exams are even more important as you age, in fact an annual eye examination for everyone over age 60 is recommended. However, see your ophthalmologist immediately if you notice any changes in your vision. Let’s look at some of the changes we see in our eyes as we grow older:
Presbyopia
Your eyes start having trouble focusing on objects nearby, a process that almost always starts in your 40s.
Symptoms include:
- Trouble reading small print
- Headaches
- Eye strain
What causes presbyopia? Over time, the lens of the eye hardens. Muscles around the lens also change with age. These changes make it harder for the lens to work.
An eye doctor can diagnose presbyopia and correct it with eyeglasses or contact lenses. Bifocals are glasses with the higher focusing power in the lower part of the lens. If you do not need glasses for distance, you may need only reading glasses.
Cataracts
Cataracts cloud vision. They are often associated with aging and a large proportion of people develop cataracts by the time they reach 80.
Symptoms include:
- Blurry, cloudy, or dim vision
- Double vision with one eye
- Trouble seeing at night or in dim light
- Halos around lights
- Sensitivity to light and glare
- Faded or yellow colours, or trouble telling the difference between blues and greens
- Trouble seeing an object against a background of the same colour
At earlier stages, simply changing your eyeglass or contact lens prescription is all you need. Using brighter lights for reading or a magnifying glass may also help. If halos or glare are a problem, night driving may be difficult. Sunglasses and tinted lenses can improve driving comfort during the day. See your ophthalmologist for any concerns you have.
If a cataract begins to interfere with your day-to-day life, an ophthalmologist specialising in cataract surgery can remove the cloudy lens and replace it with a clear lens implant.
Floaters
These are usually a harmless, natural part of aging. They are shadows of vitreous, which is the gel-like substance that makes the eye round, cast on the retina.
Floaters can appear as spots, threadlike strands, or squiggly lines that drift around, even when your eye stops moving. They are most obvious when you look at something bright, like a blue sky. They are more common in people who are very near-sighted or who have had cataract surgery.
If you suddenly notice many floaters, it may mean a part of the vitreous has pulled away from the retina all at once, sometimes with a tear in the retina. If you also have a loss of side vision, and light flashes, the retina may be lifting from its normal position. This is a retinal detachment. It can cause permanent vision loss, even blindness, if not treated. Seek immediate medical attention by seeing your eye doctor. If surgery is necessary, an ophthalmologist or a “retina specialist” may be called upon.
Dry Eyes
Tears moisten your eyes, lessen the risk of infection, and keep the eye surface (cornea) smooth and clear.
Sometimes your eyes don’t make enough good-quality tears. This makes it hard for the eyes to stay healthy. Dry eyes can happen at any age but are more common in people older than 65. Hormonal changes at menopause can also raise the risk of dry eyes in women. Other factors that may contribute are medications, contact lenses, and certain medical or environmental conditions, such as a dry climate.
Symptoms include:
- Burning
- Scratchy, gritty, or irritated feeling
- Extra watering
- Blurred vision
If dry eyes become too severe, the cornea can become damaged, impairing vision.
For mild dry eye, over-the-counter artificial tears may do the trick, along with self-care, such as increasing humidity.
Prescription eye drops or other types of treatment may be best for more severe cases of dry eye. You should see your eye doctor if non-prescription drops don’t relieve your dry-eye symptoms, since dry eyes can be a symptom of other eye problems.
Other eye changes as you age
- Pupils become smaller and don’t open as well as they used to.
- Eyelids droop or become inflamed. This sometimes affects vision.
You can make some adjustments to deal with these changes, such as:
- Use extra lighting and put shades on lightbulbs.
- Choose “high colour” fluorescent bulbs with a colour-rendering index of 80 or above.
- Wear glasses with anti-reflective coating.
- Get rid of distractions when driving.
- Get an eye exam at least once a year.
- Exercise regularly, don’t smoke, and protect your eyes from ultraviolet rays and injury.
What is low vision?
Low vision means you cannot fix your eyesight with glasses, contact lenses, medication, or surgery. Low vision affects some people as they age.
You may have low vision if you:
- Can’t see well enough to do everyday tasks like reading or cooking
- Have difficulty recognising the faces of your friends or family
- Have trouble reading street signs
- Find that lights don’t seem as bright
If you have any of these problems, ask your eye care professional to test you for low vision.
Vision rehabilitation programs and special aids, such as a magnifying device, can help you adapt to vision loss and make the most of your remaining sight. Remember to ask your eye doctor if it is safe for you to drive with your vision. If you must stop driving, organisations in your area may be able to arrange rides for you, or public transportation may be available.
Other tips that may help:
- Brighten the lighting in your room.
- Write with bold, black felt-tip markers.
- Use paper with bold lines to help you write in a straight line.
- Put coloured tape on the edge of any stairs in your home to help you see them and prevent you from falling.
- Install dark-coloured light switches and electrical outlets so that you can see them easily against light-coloured walls.
- Use motion lights that turn on when you enter a room. These may help you avoid accidents caused by poor lighting.
- Use clocks with large numbers and phones with large screens; put large-print labels on the microwave and stove.
Always tell your ophthalmologist about your health conditions and what medications and nutritional supplements you take. They will also want to know about your eating, sleeping, exercise and other lifestyle choices. Remember: you and your ophthalmologist are partners in caring for your vision.
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