Vision and the aging eye

Courtesy of ORBIS US on Flickr

Courtesy of ORBIS US on Flickr

Many patients reach a certain life stage and realize they need to start thinking more about their vision and preventing eye problems.  This usually happens in their early to mid-forties when people notice reading is a lot easier when there’s plenty of light and the print is held further away.  Those who have seen an eye care provider for this problem should have already discovered that this is a normal aging process.  But how does one know when vision changes are normal or should be concerning?

Eye conditions that impact vision:

  • Presbyopia is the medical term for when the focusing muscles in the eye are not as flexible, causing poor focusing ability for objects nearby.  This typically occurs in the late thirties/early forties and is easily corrected with reading glasses or bifocal or progressive lenses.
  • Cataracts begin to develop in our forties and progress over time.  There is a natural clear crystalline lens in our eye which focuses light onto our retina.  With ultraviolet ray exposure, this lens can become more opaque and yellow over time, causing a dimming of vision and glare and haloes around lights.  The best way to prevent cataracts from progressing quickly is to protect the eyes with UV-blocking sunglasses anytime you are outdoors.  The good news about cataracts is that they can be easily removed and replaced with an artificial lens implant.  With the latest technology of intraocular lens implants such as muiltifocal lenses, patients are now able to see clearly at all distances without the use of glasses or reading glasses.
  • Glaucoma is a symptomless eye disease of the optic nerve head where the nerve slowly deteriorates over time.  Most patients who develop glaucoma will not have any symptoms until the late stages of the disease, when peripheral vision deteriorates and patients are left with tunnel vision.  There is no cure or preventative measure for glaucoma, however, it is easily treated with eyedrops.  The only way to determine if you have glaucoma is to have annual comprehensive eye examinations.

    Courtesy of Nargopolis on Flickr

    Courtesy of Nargopolis on Flickr

  • Macular Degeneration is another common eye disease that can cause debilitating vision loss.  This occurs when the macular region of the retina loses its integrity causing poor central vision with distortion or gray spots.  It is often detected upon routine examination, especially when photos of the retina are compared over time.  Fortunately, there have been extensive studies on macular degeneration and the field has changed dramatically over the last several years.  An important test in recent years is genetic testing to determine one’s risk factor for vision loss as a result of macular degeneration, as well as antioxidants that may be useful in reducing this risk.  Clear risk factors include a history of smoking, exposure to ultraviolet radiation, increased cholesterol levels and Caucasian women with lighter eyes and fairer complexions.
  • Retinal Detachment tends to occur more often in those who are older than 65.  The retina is a thin and fragile tissue that lines the back wall of the eye and sends visual information to the brain.  This tissue becomes more fragile over time and can easily develop a hole or tear leading to a retinal detachment.  If you experience flashes of light, new floaters, or a change in your vision, you need to be seen right away by your eyecare provider.

There are a myriad of eye conditions that can develop as one ages.  The most important and useful method of preventing vision loss is to stay healthy.  See your primary care physician regularly to evaluate and treat high blood pressure, high cholesterol, diabetes and other health conditions.  If you have uncontrolled health conditions, you can easily lose your vision to diabetic retinopathy, hypertensive retinopathy, or a stroke in the eye.

So, as I tell all my patients, see your physician regularly, eat green leafy vegetables, take your medications, and monitor your own blood pressure or blood sugar.  And of course, wear sunglasses outdoors and see your optometrist annually.

~Cindy P. Wang, OD, FAAO
California Optometric Association
http://www.coavision.org

Eyecare Myths Debunked, Getting the Facts Straight

As an optometrist, there are several questions I hear pretty often. Questions that some may consider myths, while others deem them as fact. Today, I’m going to set the record straight. I’ve narrowed down the questions to the top five based on how often the question is asked or because some people are too embarrassed to ask.

  1. Wearing glasses will make your eyes weaker. I’m asked this question almost daily, mostly by patients over 40, wondering whether their reading glasses are making their vision worse. The simple answer to this question is no, glasses do not ruin your vision. People often forget that every day you get a little older, and as your eyes get older it becomes harder to get by without a proper prescription.
  2. Smoking marijuana is good for glaucoma. Yes, marijuana can lower the intraocular pressures of the eyes, which is helpful in decreasing the progression of an eye disease called glaucoma. However, the amount needed would essentially make you non-functional since you would have to smoke constantly throughout the day. Your optometrist can prescribe once daily eye drops that are more effective at lowering the pressures in the eye without the added risk of smoking at all.
  3. Contact lenses can roll behind the eye into the brain and get stuck. This question will inevitably come up while I’m bending at odd angles trying to find a “lost” contact lens in a patient’s eye. No, the contact lens has nowhere to go and will not roll into the brain. There’s a thin tissue covering the front of the eyeball and the inner eyelid that keeps the lens in front of the eye. Sometimes, contacts can slide off to the side of the eye but this tissue prevents it from going any further back.

    Picture courtesy of I.gence on Flickr

    Picture courtesy of I.gence on Flickr

  4. Eating certain foods will improve my vision. Contrary to popular belief, carrots are not the best food for your eyes (spinach is more like it). Eating a variety of antioxidant-rich foods can protect your eyes from various eye diseases, thereby preserving one’s vision at its current state. I could write a full article on this topic but to put it simply, just add some fish, nuts, whole grains and colorful fruits and vegetables to your diet for the health of your eyes and your body.
  5. Reading in the dark and watching TV or video games too long can make your vision worse. None of these have been proven to cause poor vision, however they can all cause eyestrain and/or dryness of the eyes. Eyestrain can occur if you aren’t reading or watching television under ideal circumstances or for very long periods of time, but that should not cause your vision to decrease. Proper ergonomics such as bright illumination, a working distance of approximately 16 inches, proper head and neck positioning and taking breaks to allow your eyes relax can help keep eyestrain to a minimum.

I’ve only addressed five common eyecare myths today, although there are plenty more. If you would like the answers to more in a future article, please comment below.

~Cindy P. Wang, O.D., F.A.A.O.

California Optometric Association, Communications Chair

South Pasadena Optometric Group