As we grow older, it’s not uncommon to experience various aches and pains as our bodies age. That applies to our eyes as well. Eye health also suffers the effects of getting older. We find it harder to read things up close, our vision starts to cloud and our eyes start to dry out more now than ever before. These all are indicators of age-related eye problems that become more common after the age of 40. A family history of eye disease and a past need for glasses play a vital role in prescribed eye exam frequency to screen for these everyday issues, but thankfully, in most cases, easy-to-implement treatments are available.
In simple terms, refractive error means the shape of your eye doesn’t bend light correctly, resulting in nearsightedness and farsightedness. For most people, this starts before 40, but can worsen with age. As a result, people would need reading or regular glasses or contacts.
A cataract occurs when the natural lens of the eye becomes cloudy over time. “Cataracts can cause people to have more trouble reading the restaurant menu because there is not enough light,” says T. Chris McCurry, MD, refractive specialist at Woodhams Eye Clinic. “It can also cause driving at night to be very difficult because of glare from the car lights and street lights.”
Although it cannot be prevented, wearing sunglasses to reduce ultraviolet exposure can help slow down development as can controlling blood sugar and not smoking. Currently, surgery is the most common treatment to remove cataracts. “It has been done with ultrasound energy traditionally, but laser technology has become a part of the picture,” says Andrew Feinberg, MD, partner at Georgia Eye Partners and medical director at Eye Surgery Center of Georgia. “It’s thought to be gentler to the eye, and we can do specific things like correct astigmatism.”
Simply put, glaucoma is the increased pressure within the eyeball, usually from fluid, that can reduce or eliminate sight. Common treatments for glaucoma are topical medications in the form of eye drops, laser surgery or incisional surgery.
DRY EYE DISEASE
As the name implies, dry eyes result when the eyes do not stay lubricated. This issue can be caused by not producing enough tears but, more commonly, happens because the body does not produce good quality tears, especially as we age. “It can manifest as burning, irritation, foreign body sensation (like something is in the eye), intermittent blurry vision and even tearing,” McCurry says.
Certain steps can help prevent dry eyes. “Symptoms can be prevented by controlling environmental conditions such as drafts, smoke, low humidity and allergen exposures, avoiding prolonged uninterrupted computer or screen sessions, consuming foods rich in omega-3 fatty acids, and by engaging in regular exercise to optimize cardiovascular health and improve blood flow,” says Anisa B. Threlkeld, MD, physician/owner of North Atlanta Eye Care.
Treatments range from over-the-counter drops, gels, and ointments, to prescription drops, and sometimes to minor procedures depending on the cause, says Jonathan Woolfson, MD, president and founder of Woolfson Eye Institute.
Age-related macular degeneration (AMD) is a condition that damages the macula, which is the center of the retina and is responsible for detail vision. This damage can cause distorted, blurred, or severe loss of vision in the central visual field. Those who smoke, are over the age of 60, and have a family history of AMD are at risk.
The condition occurs in two basic forms, dry and wet, explains Paul Kaufman, MD, and Jessica McCluskey, MD, of Thomas Eye Group. Dry AMD results in bare patches of vision because the macula is no longer getting the proper nourishment and support it needs. Whereas wet AMD may create rapid central vision loss caused by bleeding or leaking abnormal blood vessels that grow under the macula.
Recently, medications have been developed that can be injected into the eye of someone with active wet AMD, often resulting in the shrinking of the abnormal vessels. With adequate treatment, most patients will experience stability or improvement in their vision. So far, treatment to reverse dry AMD has been unsuccessful, although much research is being performed in this area. Early detection through exams at least once a year can increase the chances of treating AMD successfully.
Presbyopia is the natural aging process of the eye. “The natural lens becomes less flexible, making it harder to perform near tasks,” Threlkeld says. “If uncorrected, it can lead to fatigue or headaches.” Unfortunately, there’s nothing to be done to prevent it.
For most patients, glasses or contacts are required to counteract the effects of presbyopia. Laser refractive surgery, commonly known by brand names like LASIK, PRK and SMILE, is another treatment option.
Another, newer option is PreLex™ surgery. “PreLex™ works by removing your natural lens with any degree of hardening and/or cloudiness, and replacing it with special lenses that give you a range of vision without glasses,” McCurry says.
As with all medical research, treatments for these and other eye ailments continue to change and evolve, leading to more effective treatments in the future. One such treatment involves stem cell therapy, but experts caution against using these treatments this early in the process.
Currently, there has been a lot of discussion about it, which leads to a lot of hope for the future, Woolfson says. However, at the moment, there are no proven treatments. “We’ve been very careful to stay with treatments with proven science behind them,” he says. “[Stem cell therapy] makes a lot of sense, but we don’t know how long it will take until it’s proven and effective.”
For now, the best step those age 40 and older can take to keep their eyes healthy is to have regular eye screenings to monitor for early signs of these ailments. “Those with diabetes or other similar systemic medical conditions, or a family history of such conditions may need more frequent screenings,” Feinberg says.