Problem
Vision

While age brings with it susceptibility of certain conditions, good eye care can reduce the incident and early detection can reduce the effects. Early diagnosis may prevent the progressive loss of vision and eventual blindess that once marked these conditions.

Take care of your eyes

Follow these suggestions from the Mayo Clinic to prevent vision loss:

Get regular eye examinations--Have a complete examination every two to four years between ages 40 and 65 and every one to two years after age 65. If you have a family history of eye disease, such as glaucoma or macular degeneration, or a chronic condition that can affect your eyes, such as diabetes, you may need annual examinations. A complete eye examination typically includes a thorough history, eye function tests and an examination of the appearance of your eyes.

Control chronic health conditions--By treating chronic medical conditions such as diabetes or high blood pressure, you minimize the risk of developing associated vision problems.

Recognize symptoms--Get immediate care if you have these symptoms: sudden loss of vision in one eye, sudden hazy or blurred vision, flashes of light or black spots, halos or rainbows around lights. They may signal a serious medical problem such as acute glaucoma or a stroke.

Protect your eyes against sun damage--Wear sunglasses that block 90 to 100 percent of UVA and UVB light. When buying, read product information carefully to determine the amount of protection provided. For greater protection, choose a wrap-around style.

Dark glasses that don't block UV light may actually cause more damage than wearing no sunglasses; they dilate your pupil, allowing more light in without blocking the damaging rays.

In addition to sunglasses, wear a brimmed hat. Fifty percent of sunlight comes from directly overhead and can get by most sunglasses.

Eat a variety of foods--A deficiency of certain nutrients may increase your risk of some eye diseases. However, the American Academy of Ophthalmology recommends getting adequate nutrients by eating a variety of foods rather than by taking supplements.

Make the most of the vision you have-- Be sure to always use good lighting, such as a gooseneck lamp, that directs illumination onto your reading or work area. You need more light as you grow older whether you have vision problems or not.

If your vision becomes impaired, take advantage of the variety of low-vision aids available. Devices include everything from magnifiers to items such as large-size clocks and game boards (see HYPERLINK "/mayo/9310/htm/lowvisio.htm" Mayo Clinic Health Letter, October 1993 ). For information about vision aids, contact: The Lighthouse Inc., 36-02 Northern Blvd., Long Island City, NY 11101-1614, 800 829-0500.

Changes in your eyes are often more "visible" than changes elsewhere in your body. This visibility has enabled researchers and doctors to make great strides in detecting and treating vision disorders. A successful outcome is now the rule rather than the exception if you have cataracts or glaucoma--diseases that once meant certain vision loss or even blindness.

For eye disease, as with other disorders, succes sful treatment depends on early diagnosis. Schedule regular eye examinations according to your age and family history of eye disease. This preventive step is one of the best things you can do to safeguard your sight and independence.

Cataracts

The single largest risk factor for cataract development is age. Like gray hair, cataracts are included in the aging package everyone over age 65 naturally has some degree of lens clouding. That clouding may or may not lead to significant visual impairment that would be improved by removing the cataract.

The key to living with cataracts is knowing when it's time not to live with them anymore. Usually, this happens when your lifestyle becomes cramped because of your vision. Fortunately, advanced surgical methods make cataract surgery one of the most successful procedures done today.

Any of the following may also put you at increased risk for cataract development, possibly at an earlier-than-normal age:

  • Diabetes
  • A strong family history of cataracts
  • Previous eye injury
  • Taking certain medications (corticosteroids)
  • Excessive consumption of alcohol
  • Excessive sunlight exposure
  • Smoking

The Mayo Clinic web site has excellent information regarding cataracts and treatment decisions. Click HYPERLINK http://www.mayohealth.org/mayo/9810/htm/cataracts.htm http://www.mayohealth.org/mayo/9810/htm/cataracts.htm

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Glaucoma

About 2.5 million Americans older than age 40 have glaucoma. It's a leading cause of blindness among African Americans. In addition to race, risk factors include:

  • increasing age
  • family history
  • past eye injury
  • diabetes

Long-term use of corticosteroid drugs may foster development of glaucoma in susceptible people.

Fluid (aqueous humor) is produced continuously in your inner eye to nourish the lens and cornea. It then drains from your eye through a meshwork and canal of Schlemm located at the outside edge of your cornea.

Glaucoma occurs when fluid drainage becomes blocked. Excess fluid builds up within your inner eye and pressure increases. Elevated inner-eye pressure progressively damages the optic nerve, causing your side vision to slowly diminish. Central vision isn't affected in most people until later in the disease.

About 90 percent of glaucoma is chronic, in which pressure builds undetected over years. In addition to a pressure test, chronic glaucoma is diagnosed with a thorough eye evaluation.

If diagnosed and treated early, chronic glaucoma usually can be controlled with eyedrops or oral medications. They lower pressure by reducing fluid production or increasing fluid drainage. Regular use of glaucoma medications is needed to prevent intermittent increases in eye pressure and further vision loss.

If you need only a small reduction in pressure, your surgeon may use laser surgery to stimulate drainage without making an incision in your eye. Otherwise, a new drainage canal can be created surgically.

Compared to chronic glaucoma, acute glaucoma caused by a sudden increase in eye pressure is rare. It tends to be hereditary and to affect people who are farsighted. Symptoms such as a severe headache or pain in your eye or brow, nausea, blurred vision or rainbows around lights at night need immediate evaluation. Treatment may require emergency laser surgery.

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Macular degeneration

In this condition, tissue in the small central part of the retina (macula) deteriorates. Sometimes, abnormal blood vessels also develop. Blood vessels may leak and eventually cause scarring and loss of vision.

Macular degeneration affects as many as 15 million people older than age 50. It blurs central vision and reduces your ability to see fine detail, which can severely restrict reading and driving. It doesn't affect side vision and usually doesn't lead to total blindness.

Macular degeneration is diagnosed with a thorough eye evaluation. A simple vision test using an Amsler grid can detect early changes in your vision that may be difficult to notice.

Sometimes, fluorescein (flooh-RES-ene) angiography is used to detect leaky blood vessels under your retina. Fluorescent dye is injected into a vein in your arm. Then photographs are taken as the dye passes through blood vessels in the back of your eye.

The vision impairment caused by macular degeneration is irreversible. In some cases, however, laser treatment may help reduce or slow vision loss when macular degeneration is diagnosed early. The laser beam seals off the blood vessels, preventing further growth of vessels toward the macula.

There's no known way to prevent macular degeneration, but researchers are investigating a possible association with diet. Se the Mayo Clinic publication HYPERLINK "/mayo/9510/htm/sunli_sb.htm" "Sunlight, diet and eye disease" for the latest information.

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