Aging and Your Eyes

Presbyopia, Cataracts, Age Related macular Degeneration & Glaucoma

As we age, there are a number of changes that may occur in our eyes. Some of these changes are minor and may simply require routine examinations, observation and perhaps the use of eyeglasses. Other age related eye changes might be a warning sign or even the result of certain eye conditions that are more common with age and may cause a loss of vision. In any event, each of us should take personal responsibility for the preservation and enhancement of sight, as we grow older. This means taking the time necessary to have regular eye examinations to facilitate the early detection of eye problems so that they can be addressed.

The most common eye conditions that are encounter with increasing age are Presbyopia, Cataracts, Age Related Macular Degeneration and Glaucoma.

Presbyopia

Presbyopia literally means “old eyes”. There are two main structures of the eye that must remain healthy and optically clear in order to have good vision. The first is the Cornea, which is the clear curved dome like structure on the front of the eye. Unless you have had infections or accidents with your eyes, your Cornea tends not to undergo much change with age and lasts a lifetime. The second structure is called the Crystalline Lens. Before we enter our 40’s the Crystalline Lens is optically clear, soft and flexible. This flexibility allows the Crystalline Lens to change its shape and alter its curvature in order to rapidly change focus from far, to near, to arms length and to near or far again much like the zoom mechanism of a camera.  As we approach our 40’s and up until about the age of 65, the Crystalline Lens begins to stiffen and lose its flexibility.

Presbyopia is the loss of flexibility of the Crystalline Lens resulting in difficulty in seeing near objects or things close up such as reading material. As patients begin to experience Presbyopia they often notice that their "arms are too short" requiring them to see up close by moving near objects and reading material farther away in order to bring them into focus and to see them clearly. It is important to know that Presbyopia affects everyone including those who have Cataracts. As Presbyopia begins, people who have never worn eyeglasses find that they need reading glasses or bifocals in order to read and see up close. People who already wear glasses may need bifocals or trifocals in order to see comfortably up close.

Cataracts

Cataracts occur when the Crystalline Lens not only loses it flexibility, but also loses its optical clarity. While Cataracts can occur as the result of an accident, infection or from another eye disease, the most common reason for cataracts to form is simply as the result of age. Cataracts occur with increasing frequency as we pass through the age of 55 and beyond. Patients with Cataracts might initially notice a blurring or shadowing of their vision and think that they need a change in their eyeglass prescription. They might experience difficulty with night driving, especially with glare from the headlights on cars. Colors may seem faded or washed out. The only way to correct Cataracts is through Cataract Surgery. Modern Cataract Surgery is performed on an outpatient basis with minimal downtime. It is one of the most common and most successful types of surgery you can have today with more than 2.5 million cataract surgery procedures being performed each year in the United States alone. Cataract Surgery is performed through a very tiny incision using only eye drops as anesthesia-no needles, patches or injections are even required. As part of the vast majority of cataract procedures, we are able to replace the cloudy Crystalline Lens with a perfectly clear permanent Lens Implant to correct vision. In fact, today we are able to use Lens Implants that correct your distance vision as well as your Presbyopia and near vision so that you can see well at a distance-for driving, and for seeing up close and arm’s length without having to wear eyeglasses, reading glasses or bifocals.

Age Related Macular Degeneration

Age Related Macular Degeneration affects more than 10 million Americans in some way. It is an incurable eye disease and is the leading cause of legal blindness for those aged 55 and older in the United States. Your chances of developing Age Related Macular Degeneration (ARMD) are directly related to your age. The older you are, the greater the chance that you will acquire Macular Degeneration. Macular Degeneration does NOT cause complete blindness but affects on the central or “straight ahead” vision. Unfortunately, good “straight ahead” vision is required for tasks such as recognizing faces, reading and driving a car-so the effects of Macular Degeneration can be significant on the ability to carry On the full range of daily activities.

There are two types of Age Related Macular Degeneration-“Dry Macular Degeneration” and “Wet Macular Degeneration”. Fortunately, Dry Macular Degeneration is by far the more common type as it has a slow onset and progresses fairly slowly, causing a gradual dimming of central vision. Dry Macular Degeneration accounts for approximately 85-90% of all cases of Macular Degeneration. Wet Macular Degeneration can be considerably more serious in that if it is not diagnosed and treated quite early in its course, it can result in bleeding and scarring in the central area of the Retina, called the Macula, which is almost always accompanied by a significant and irreversible loss of central vision. Today, with early diagnosis, we are very lucky to have some treatment options for Wet Macular Degeneration that can often help prevent the profound loss of vision. Based on new drug therapy that was originally used in cancer treatment, we are able to use an injection of a highly specialized drug into the back of the eye to deliver a treatment called “Vascular Endothelial Growth Factor Inhibition” which acts to halt the progress of the Wet Macular Degeneration process. If we are fortunate to make an early diagnosis, we can actually do this right in the office and offer treatment almost immediately. As with a number of other eye conditions, the key to preventing vision loss from Macular Degeneration is early diagnosis.

Glaucoma

Glaucoma is a collective term that describes a number of problems that damage the Optic Nerve and cause a loss of vision. Often it is associated with high pressure-called Intraocular Pressure-inside the eye. Glaucoma tends to become more common as we get older. The chances of developing Glaucoma increase, especially after the age of 40 and as we age further. In fact you are six times more likely to get Glaucoma if you are over 60 years of age-even if you have no other family or medical history that is significant-and your risk is greater if you have any family history of Glaucoma or other systemic or eye disease that compromises your circulation such as diabetes.

Most serious eye problems usually produce some symptoms that make patients uncomfortable or disturb their vision. Unfortunately, Glaucoma can begin without any symptoms or obvious loss of vision. In this way it is insidious in onset and, if not diagnosed and treated early in its course, will lead to progressive, permanent, and unnoticed vision loss. It is essential to diagnose and treat Glaucoma as early in its course as possible through regular eye examinations.

The effects of aging on our eyes are inevitable. However, vision problems such as Presbyopia are readily manageable-and with early diagnosis and treatment vision loss from the age related eye conditions of Cataracts, Macular Degeneration and Glaucoma are preventable. Regular eye examinations are the key to early diagnosis and treatment of aging eye problems.