By Dr. Mark Shust

As we age, it is expected that we will notice certain changes throughout our bodies. Our eyes are no exception, and older adults experience changes in their vision over time. Many of these changes are completely normal, but others can indicate the presence of more serious conditions that require professional attention. The following is a summary of some eye conditions that occur more frequently in older individuals.

CATARACTS

There is a lens inside of the eye that focuses images onto the retina, allowing us to see clearly. As we age, this lens gradually loses its clarity and becomes cloudy. This clouding or opacification of the lens is referred to as a cataract. When a cataract develops it may reduce the amount of light that passes into the eye, causing the vision to become blurry or hazy. Sometimes cataracts can progress to the point where they cause significant impairment of vision. In such cases, surgery can be done to remove the cataract and restore clear vision. The surgery involves removing the cloudy natural lens and replacing it with a clear artificial lens, known as an implant. Cataract surgery is one of the most commonly performed and most successful surgical procedures in this country.

GLAUCOMA

Glaucoma occurs when the fluid pressure inside of the eye becomes elevated, causing gradual damage to the optic nerve. In the most common type of glaucoma, called open angle glaucoma, there in no pain or discomfort and the vision usually remains normal during the early stages. As the damage to the optic nerve progresses, however, permanent loss of vision can occur. A less common form of glaucoma, known as angle closure glaucoma, can cause pain in the eye as the fluid pressure rises. Glaucoma is usually treated with eye drops that reduce the fluid pressure inside the eye, preventing further damage to the optic nerve. In some cases, surgery may be necessary. It is very important to detect and treat glaucoma at an early stage, before permanent vision loss occurs.

MACULAR DEGENERATION

The retinal is a layer of nerve tissue which lines the inside surface of the back of the eye. The center portion of the retina, called the macula, is responsible for the sharp vision in the center of your field of view. The macula is also prone to degenerative changes in some older adults. Dry macular degeneration is the milder form of this condition in which the degenerative process occurs slowly and visual impairment is less severe. In wet macular degeneration, however, bleeding and swelling occurs in the retina which can result in greater vision loss. Treatments are available for some types of macular degeneration that may help to improve vision or prevent further loss of vision. Early diagnosis is important in maximizing the effectiveness of treatment. Some doctors recommend the use of multivitamins and antioxidants to slow the progression of macular degeneration, although you should consult your doctor before taking any supplements.

FLOATERS

The eye contains a thick fluid, known as the vitreous, which can sometimes degenerate with age. As this degeneration occurs, small particles may begin to form within the vitreous. This may cause individuals to see spots that seem to float around in their vision. In most cases, these so called "floaters" are harmless and disappear with time. Sometimes, however, floaters can be a sign of more serious retinal disorders, such as retinal tears or detachments, which require immediate treatment.

PRESBYOPIA

Presbyopia refers to a normal weakening of the focusing muscles in the eye that typically occurs at age 40 - 45. When presbyopia occurs, individuals will notice a gradual and progressive decrease in the clarity of their vision with near tasks, such as when reading. The blurred vision is usually corrected by prescribing single vision or bifocal glasses, or in some cases with contact lenses.

RECOMMENDATIONS

Many age-related visual changes are normal, but some can be caused by more serious problems within the eye. The best way to prevent or detect sight-threatening problems is with regular periodic eye health evaluations. This is especially true in patients with chronic conditions, such as diabetes or hypertension. Remember that some serious eye diseases, such as glaucoma, may not cause any symptoms in the early stages. It is also important to notify you doctor immediately of any sudden changes in your vision. Finally, keep in mind that older individuals may need to use brighter lights when reading or doing other near work. Peripheral vision and reaction time may also decrease with age, so use extra caution when driving. It is best to limit your night driving to well-lighted roads in familiar area.