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All About Aging Eyes

Do you know the difference between normal changes in vision that occur with age and abnormal changes caused by age-related eye disease? Here's a look at some common eye problems associated with getting older.

Presbyopia

This is the slow loss of ability to see close objects or small print. It happens gradually after age 40 and is considered a normal consequence of aging. The lens of the eye slowly stiffens with age, and the muscles that control the curvature of the lens become unable to focus the lens properly. Reading glasses or bi- or trifocals can often help with this problem.

Cataracts

The lens of the eye becomes cloudy, blocking light from passing through and eventually causing a loss of vision, according to the National Institute on Aging (NIA). Cataracts develop slowly and have no symptoms until they become large enough or thick enough to affect vision. Cataracts may be corrected through surgery.

Dry eyes

This is caused when the tear glands stop working well, the NIA says. Dry eye can cause itching, burning and even some vision loss. A humidifier in your home or artificial tears may help ease dry eye.

Glaucoma

Glaucoma is a condition in which the optic nerve is damaged, resulting in vision loss. It is caused by a number of poorly understood diseases. These diseases usually, but not always, cause an abnormal increase in fluid pressure inside the eye. Glaucoma has no early symptoms. The best prevention is to have a regular eye exam in which your eyes are dilated. Treatment may be eye drops, oral medication or surgery.

Age-related macular degeneration (AMD)

This disorder, which occurs as a wet form or a dry form, affects the part of the retina called the macula. The macula gives you your central vision used for reading, driving and seeing fine detail. A person with AMD eventually develops a blind spot in the center of the visual field and is not able to see objects clearly. It does not affect peripheral (side) vision. Wet AMD can be treated with laser therapy or with medication. New drugs have been developed that slow or block the growth of new blood vessels and decrease the leakage of blood from existing blood vessels, thus preserving sight. These medications are injected into the eye. Pegaptanib (Macugen), a drug that is injected every six weeks, was approved in 2004; ranibizumab (Lucentis), which is injected monthly, was approved in 2006 and may be able to reverse some of the effects of macular degeneration. There is no cure for dry AMD, but vitamin supplements and lutein can slow the progress.

Retinal detachment

This occurs when the inner and outer layers of the retina become separated, the NIA says. The retina is the light-sensitive tissue at the back of the eyeball. Symptoms of retinal detachment include an increase in the number of floaters (small spots or strings that appear in your field of vision), a shadow seems to block part of your visual field, light flashes or a sudden blurring of vision. If you have these symptoms, see your eye doctor immediately; you may not have a retinal detachment, but only your eye doctor can tell you for certain. Surgery or laser treatment may be able to reattach the retina.

Eye exams

Adults 60 or older should have an eye exam at least once a year to determine if they have any vision changes that could be corrected with a new eyeglass prescription or better lighting, or if they have a serious vision problem that needs medical attention.

An eye exam includes adding eye drops to dilate your eyes. This is the only way to find some eye diseases, such as glaucoma, that have no early signs or symptoms, the NIA says. Your eye doctor should check your eyesight, your glasses and your eye muscles.

You also should see your primary care doctor regularly to check for diabetes and other diseases that can cause eye problems if not treated.

Steps to take

These are reasons to see your eye doctor:

  • You have a need for more light and a gradual, spotty loss of detail vision or a sudden and severe loss of central vision. These may be warning signs of wet or dry AMD, the most common eye disorder in older people. AMD occurs when the retina degenerates over time. There's no treatment for the dry form, but studies have found antioxidants and lutein may slow progression.

  • Your vision seems hazy, you're having trouble distinguishing colors, have an increased sensitivity to glare, and/or light scatters and appears like a "halo." These may be the warning signs of cataracts, cloudy areas in part or all of the eye lens. Some cataracts remain small and don't affect eyesight too much. But those that become large or thick can keep light from easily passing through the lens, which can cause loss of eyesight. They can be successfully removed surgically 90 percent of the time.

  • You experience a subtle loss of contrast, difficulty driving at night and/or loss of peripheral vision. These may be the warning signs of glaucoma, a condition that results from too much fluid pressure inside the eye that can lead to vision loss. Treatment options include prescription eye drops, oral medications and surgery.

  • You have diabetes. Depending on how long you have had it and your current eye health, your eye doctor will want to see you every six months to a year.

  • You experience sudden onset of pain in an eye.

For people with AMD, it is important to check vision in each eye every day to monitor for changes in central vision.

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