Worried About vision Loss with Aging? Ways to prevent it

Common eye problems seen in older people-

• Presbyopia - loss of ability to see near objects or difficulty while reading. Presbyopia is normal physiological process that develops slowly after the age of 40 years. Older people mostly adjust while reading or doing near work. Presbyopia can be corrected with reading glasses or multifocal lenses.
• Cataract : are cloudy areas that develop slowly in the lens which blocks light from passing to the retina, causing blurry vision. When it have a significant impact on vision, Cataract surgery is needed. Risk factors of developing early cataract are trauma, diabetes, medications like steroids and VR surgery etc. Surgery should be done after thorough fundus examination to rule out any other causes affecting vision.
• Glaucoma : is irreversible cause of vision loss mostly due to increased pressure inside the eye. In some cases of glaucoma eye pressure can be normal also (Normal Tension Glaucoma). It can lead to permanent vision loss and blindness, if not treated timely. It happens often without symptoms or pain in early stage. Risk factors for glaucoma include heredity, age, women, diabetes, myopia, ocular trauma and steroids etc. To rule out glaucoma various investigations like eye pressure, gonioscopy, visual fields, optic nerve head examination, pachymetry, optical coherence tomography are needed. Treatment may include topical eye drops, oral medications, laser treatment or surgery.
• Age Related Macular Degeneration : is characterized by the loss of cells in macular area causing blurred or distorted central vision. Early stages can benefit from nutritional supplements. People with ARMD will have low vision but will never go totally blind. Advanced AMD patients may need laser or intra-vitreal injection of Anti- VEGFs.
• Diabetic Retinopathy : Early stages of diabetic retinopathy, the blood vessels may leak fluid, causing blurred vision (due to Clinically Significant Macular Edema) or no symptoms at all. For CSME , intra-vitreal injection of Anti- VEGFs and laser may improve or preserve vision. As the disease advances, new blood vessels may grow and bleed into the center of the eye (Vitreous Hemorrhage), causing serious vision loss or blindness. In most advanced cases, laser treatment can prevent blindness. Vitreo-retinal surgery may be needed in these cases. Diabetic patients should routinely get their fundus examination to rule out diabetic retinopathy and should have good blood sugar control.
• Eye problems related to Hypertension : Can develop arterial or venous occlusions which can cause sudden loss of vision. So strict control of blood pressure is adviced to prevent these disorders.
• Retinal Detachment : Patient can have sudden appearance of floaters or flashes, sudden loss of vision or dark shadow in field of vision. Treatment is surgery or laser treatment.

Other rare disorders affecting vision- Uveitis, Posterior Vitreo-retinal Lymphoma

Other eye problems of Old age but do not affect vision

• Eyelid problems- Senile ptosis, Involutional entropion or ectropion, blepharitis, orbital fat displacement and blepharospasms. They can be treated medications or Surgery.
• Dry Eye
• Tearing
• Diplopia- doubling of vision occurs in cases of muscle palsy’s which happens in mostly uncontrolled diabetes and hypertension.

Eye problems become more prevalent with age. Measures to prevent or correct are always available

• Strict control of blood pressure and blood sugar or systemic disorders in collaboration with physician or endocrinologist.
• Complete eye examination after the age of 40 years and then routinely to detect eye diseases at early stage. As most eye diseases are treatable if detected at early stage.
• Visit your ophthalmologist or eye doctor if you feel sudden loss of vision or pain or any eye related symptom. Delaying the visit will aggravate the condition.