Age-related vision problems and treatment

Decreased eyesight is a common problem that occurs with age. Although often unavoidable, routine eye checks are crucial. An ophthalmologist from Baylor College of Medicine describes different age-related vision problems and how to manage them.

Cataracts

It is one of the most common age-related vision problems. A cataract occurs when the natural clear lens we are born with becomes cloudy. This affects concentration and can cause symptoms such as blurred vision despite wearing glasses or problems driving at night.

“Everyone develops a cataract over time. Some people develop them earlier in life, while most develop age-related cataracts,” said Dr Sumitra Khandelwal, associate professor of ophthalmology at Baylor. “You start seeing signs of cataracts in your late 50s and 60s and they continue to grow over the decades.”

Surgery is the best option once the cataract begins to affect vision. It involves removing the cloudy lens and implanting a clear, artificial lens. Unlike most aging eye conditions that require management, surgery removes cataracts and cures vision problems.

Presbyopia

Similar to cataracts, presbyopia (or loss of near vision) also occurs in most aging adults and cannot be prevented. At a younger age, the lens of the eye is able to adapt or shift to see near or far, allowing people to do activities without glasses or with only one pair of glasses. As you get older, usually at 45 or older, you start to need more lighting or a prescription reading glasses to see up close. It continues to get worse with age.

Treatment options for managing presbyopia include:

  • Eyeglasses
  • Special contact lenses
  • Laser vision correction
  • Prescription eye drops that shrink the pupil to help you see up close for six to eight hours

Macular degeneration

A less common problem that affects the older population is age-related macular degeneration, an aging process where the retina develops areas of thinning. The dry form is the most common and can slowly affect central vision. About 20% of these patients will progress to the wet form, which may require injections into the eye. Your eye care professional would be able to determine the type of macular degeneration.

Khandelwal recommends taking eye vitamins that help with vision loss and lifestyle changes to prevent it from worsening, such as eating leafy green vegetables and avoiding smoking. She urges seeing an eye care provider annually if you have macular degeneration.

“You can develop early signs of macular degeneration and not know it,” Khandelwal said. “If you have a family history of it, that may be a reason to see your eye doctor earlier in life.”

Glaucoma

Glaucoma occurs when high pressure in the eye damages the nerve in the eye. The role of the nerve is crucial as it sends messages from the eye to the brain.

“One of the most important parts of our ability to see is the optic nerve because it allows what we see to register in the brain,” she said.

Glaucoma can also run in the family, or you may have a genetic predisposition even if a family member does not have it. Most types of glaucoma do not cause pain, so there are no indicators of development until you see an eye care provider. As you get older or if you have a family history of glaucoma, your healthcare professional will check your blood pressure and detect signs of early glaucoma before it begins to affect vision. Similar to macular degeneration, glaucoma cannot be prevented. Treatment involves taking certain pressure-control eye drops that help prevent deterioration of vision.

dry eye

Everyone suffers from age-related dry eye. As your skin becomes drier with age, so do your eyes. Treat dry eyes using artificial tears.

“If your skin is dry and you wait until it’s very papery to put lotion on, it won’t help as much as if you put lotion on your skin every day to prevent dryness – he the same goes for your eyes. As you age, you notice dryness and irritation. That’s when you should start using artificial tears,” Khandelwal said.

Treatment options include over-the-counter eye drops, over-the-counter eye ointments, and prescription eye drops. Eye care professionals can prescribe medications that reduce eye inflammation and increase tear production. Make sure you catch it early, otherwise your dry eye can get so advanced that treatment might not be an option.

“Don’t blame vision problems on aging eyes alone. Get your eyes checked as it can be a more serious issue that can be treated,” Khandelwal said. “If you wait too long, you may not be able to treat it.”

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