By age 65, one in three Americans has some form of vision-impairing eye condition. Glaucoma, cataracts, macular degeneration and diabetic retinopathy are the major eye diseases that affect us as we age. Since there is a great deal of information available on cataracts, the focus of this article is on the other less frequently discussed diseases.
Age-related macular degeneration is a leading cause of vision loss among people age 50 and older. It causes damage to the macula, which is responsible for the central visual acuity necessary for reading and distinguishing facial features. Caucasians have a higher risk in developing the disease, but it affects all races. The cause is unclear, but it is likely due to an interplay between genetic and environmental factors. A number of high risk genes have been identified, and environmental factors such as smoking also increases the risk. There are two types of macular degeneration: the dry form and the wet form. Dry macular degeneration tends to advance slowly, which is why self-monitoring with the AMSLER grid is helpful in detecting changes that may otherwise be ignored. No effective treatment exists to undo the damage caused by dry macular degeneration. However, patients who take eye vitamins with AREDS 2 (age-related eye disease study) formulations decrease their risk of progression. Some patients with dry macular degeneration may convert to the wet type and may experience sudden painless change of vision. They should contact their eye doctor immediately. Eye injections with a medicine called anti-vascular endothelial growing factor have been life changing and help stop further decrease in vision and may improve vision.
Diabetes can accelerate cataract development, cause glaucoma, and affect the retina. The blood vessels in the retina can bleed, grow abnormal connections, leak lipids, and cause swelling of the macula. Treatments include laser, injections of steroid, or anti-vascular growth factor. Blood sugar control is of crucial importance. In patients with diabetes, an annual dilated eye exam is recommended. If diabetic retinopathy is present, a patient may need to be seen by a doctor more frequently.
Glaucoma is a group of diseases that can damage the eye’s optic nerve and result in vision loss and blindness. The prevalence of glaucoma increases with age. According to the National Eye Institute, African-Americans age 40 and older are at the highest risk of developing glaucoma compared with people of other races. Many patients with early to moderate glaucoma have peripheral vision loss, although central vision could be affected. Because our two eyes compensate for each other, often, patients do not notice any vision loss until much later when a great amount of visual field has already been damaged. Treatment involves eye drops, laser therapy, and surgery, and these can help slow the progression, but vision loss is irreversible. An ophthalmologist can detect early signs of glaucoma, such as elevated eye pressure, damaged fluid drainage pathway (angles of the eye), and suspicious appearing optic nerve in a routine exam.
Play an active role in caring for your eyes. See an ophthalmologist annually for a comprehensive dilated eye exam. Many common eye diseases often have no warning signs. A dilated eye exam is the only way to detect these diseases in their early stages.