Dr. MJ Bazos MD, Patient Handout
Aging and Your Eyes

Did you know that many older people have good eyesight into their 80s and beyond? Growing older does not always mean you see poorly. But age brings changes that can weaken your eyes.

There are some easy things to try when these changes happen. You might add brighter lights in more places around the house—like at work counters, stairways, and favorite reading places. This may help you see better and can sometimes prevent accidents caused by weak eyesight.

While older people have more eye problems and eye diseases than younger people, you can prevent or correct many of them by:

•Seeing your doctor regularly to check for diseases like diabetes, which could cause eye problems if not treated.

•Having a complete eye exam with an eye specialist every 1 to 2 years. Most eye diseases can be treated when they are found early. The eye doctor should enlarge (dilate) your pupils by putting drops in your eyes. This is the only way to find some eye diseases that have no early signs or symptoms. The eye doctor should test your eyesight, your glasses, and your eye muscles. You should also have a test for glaucoma.

•Taking extra care if you have diabetes or a family history of eye disease. Have an eye exam through dilated pupils every year. See an eye doctor at once if you have any loss or dimness of eyesight, eye pain, fluids coming from the eye, double vision, redness, or swelling of your eye or eyelid.

Common Eye Complaints
Presbyopia is a slow loss of ability to see close objects or small print. It is a normal process that happens over a lifetime. You may not notice any change until after the age of 40. People with presbyopia often hold reading materials at arm's length. Some get headaches or "tired eyes" while reading or doing other close work. Presbyopia is often corrected with reading glasses.
Floaters are tiny spots or specks that float across the field of vision. Most people notice them in well-lit rooms or outdoors on a bright day. Floaters often are normal, but sometimes they warn of eye problems such as retinal detachment, especially if they happen with light flashes. If you notice a sudden change in the type or number of spots or flashes, see your eye doctor.
Dry eyes happen when tear glands don't make enough tears or make poor quality tears. Dry tears can be uncomfortable, causing itching, burning, or even some loss of vision. Your eye doctor may suggest using a humidifier in the home or special eye drops ("artificial tears"). Surgery may be needed for more serious cases of dry eyes.
Tearing, or having too many tears, can come from being sensitive to light, wind, or temperature changes. Protecting your eyes (by wearing sunglasses, for instance) sometimes solves the problem. Tearing may also mean that you have a more serious problem, such as an eye infection or a blocked tear duct. Your eye doctor can treat or correct both of these conditions.

Eye Diseases and Disorders Common in Older People

Cataracts are cloudy areas in part or all of the eye lens. The lens is usually clear and lets light through. Cataracts keep light from easily passing through the lens, and this causes loss of eyesight. Cataracts often form slowly and cause no pain, redness, or tearing in the eye. Some stay small and don't change eyesight very much. If a cataract becomes large or thick, it usually can be removed by surgery.

During surgery, the doctor takes off the clouded lens and, in most cases, puts in a clear, plastic lens. Cataract surgery is very safe. It is one of the most common surgeries done in the United States.

Glaucoma results from too much fluid pressure inside the eye. It can lead to vision loss and blindness. The cause of glaucoma is unknown. If treated early, glaucoma often can be controlled and blindness prevented. To find glaucoma, the eye doctor will look at your eyes through dilated pupils. Treatment may be prescription eye drops, oral medications, or surgery. Most people with glaucoma have no early symptoms or pain from increased pressure.

Retinal disorders are a leading cause of blindness in the United States. The retina is a thin lining on the back of the eye. It is made up of cells that get visual images and pass them on to the brain. Retinal disorders include age-related macular degeneration, diabetic retinopathy, and retinal detachment.

•Age-related macular degeneration. The macula is part of the eye with millions of cells that are sensitive to light. The macula makes vision possible from the center part of the eye. Over time, age-related macular degeneration can ruin sharp vision needed to see objects clearly and to do common tasks like driving and reading. In some cases, it can be treated with lasers.

•Diabetic retinopathy. This disorder can result from diabetes. It happens when small blood vessels stop feeding the retina properly. In the early stages, the blood vessels may leak fluid, which distorts sight. In the later stages, new vessels may grow and send blood into the center of the eye, causing serious vision loss. In most cases, laser treatment can prevent blindness. It is very important that people with diabetes have an eye exam through dilated pupils every year.

•Retinal detachment. This happens when the inner and outer layers of the retina become separated. With surgery or laser treatment, doctors often can reattach the retina and bring back all or part of your eyesight.

Conjunctivitis happens when the tissue that lines the eyelids and covers the cornea becomes inflamed. It can cause itching, burning, tearing, or a feeling of something in the eye. Conjunctivitis can be caused by infection or allergies.

Corneal diseases and conditions can cause redness, watery eyes, pain, reduced vision, or a halo effect. The cornea is the clear, dome-shaped "window" at the front of the eye. It helps to focus light that enters the eye. Disease, infection, injury, toxic agents, and other things can damage the cornea. Treatments include changing the eyeglass prescription, eye drops, or surgery.

Corneal transplantation is used to restore eyesight when the cornea has been hurt by injury or disease. An eye surgeon replaces the scarred cornea with a healthy cornea donated from another person. Corneal transplantation is a common treatment that is safe and successful. The doctor may prescribe eyeglasses or contact lenses after surgery.

Eyelid problems can come from different diseases or conditions. The eyelids protect the eye, distribute tears, and limit the amount of light entering the eye. Pain, itching, tearing and sensitivity to light are common eyelid symptoms. Other problems may include drooping eyelids (ptosis), blinking spasms (blepharospasm), or inflamed outer edges of the eyelids near the eyelashes (blepharitis). Eyelid problems often can be treated with medication or surgery.

Temporal arteritis causes the arteries in the temple area of the forehead to become swollen. It can begin with a severe headache, pain when chewing, and tenderness in the temple area. It may be followed in a few weeks by sudden vision loss. Other symptoms can include shaking, weight loss, and low-grade fever. Scientists don't know the cause of temporal arteritis, but they think it may be a disorder of the immune system. Early treatment with medication can help prevent vision loss in one or both eyes.

Low Vision Aids
Many people with eyesight problems find low vision aids helpful. These are special devices that are stronger than regular eyeglasses. Low vision aids include telescopic glasses, lenses that filter light, and magnifying glasses. Also, there are some useful electronic devices that you can either hold in your hand or put directly on your reading material. People with only partial sight often make surprising improvements using these aids.