Is Advancing Age Clouding Your Vision?

Over the past few years, have you noticed that it's harder to see things close up? Has reading become more difficult? Do you sometimes have trouble distinguishing colors, such as blue from black? Does it take you longer to adjust to changing levels of light when you enter or exit a dimly lit room? Does the glare from oncoming headlights seem to bother you more than it used to?

These are all very common vision issues that strike a majority of us as we age. In fact, by age 45, most of us will start to experience symptoms of presbyopia – more commonly known as farsightedness. If you find yourself holding books or newspapers at arm's length in order to read, you're probably ready to join the majority of US adults who need reading glasses to be able to perform close-up tasks such as needlepoint, crafts, and of course reading. Most cases of presbyopia can be easily corrected with glasses or contact lenses. Other common eye problems include:

• Floaters. These tiny spots that float across your field of vision – especially in well-light rooms or on bright sunny days – are often normal. If you experience them only on occasion, it's probably nothing to worry about. But, more frequent or persistent floaters, especially when accompanied by light flashes, could be a sign of a retinal detachment. If you notice a sudden change in the type or number of floaters, see your doctor as soon as possible.
• Dry eyes. Dry eye (or keratoconjunctivitis) is common, and can be incredibly uncomfortable. It occurs when your tear glands don’t make enough tears to keep your eyes lubricated. The result is itchy, burning eyes, and sometimes even loss of vision. Talk to your doctor about treatment options, which range from a humidifier to keep the air in your home moist, prescription eye drops, or even surgery for severe cases.
• Watery eyes. Constant tearing, whether from wind, temperature changes, or increased sensitivity to light can be extremely bothersome. Protecting your eyes with sunglasses may help, but if the problem continues, consult your doctor. It could be a sign of an eye infection or blocked tear duct.

But there are many other vision changes that aren't so simple and shouldn't be ignored. Many of these issues can result in vision loss or even blindness in older adults. Often there are few or no early symptoms, so having a regular eye exam is even more critical for anyone over the age of 45. Regular screening can help identify eye diseases and conditions such as:

• Cataracts. Cataracts cause cloudy areas in the eye's lens, which results in blurred or hazy vision. Most people will develop cataracts at some point, but not all require treatment. If cataracts are small and don't affect your eyesight much, you and your doctor may opt to wait and watch for changes. But, large cataracts can significantly reduce your vision, and require surgery to remove. Fortunately, cataract surgery is very common, safe, and effective.
• Glaucoma. Too much fluid pressure inside the eye can cause glaucoma, but there are often no early symptoms so it goes undiagnosed. And, untreated glaucoma can to vision loss or even blindness. That's why it's critical to get a complete, dilated eye exam every year, especially if you are age 65 or older.
• Age-related macular degeneration (AMD). The macula is a small central portion of the retina responsible for detailed vision. When cells are lost in this area, it can cause blurry or distorted central vision – even impacting facial recognition. In the early stages, AMD may benefit from nutritional supplements. More advanced cases may be helped with laser treatment or injected medication, but there is no cure, so early intervention is critical.
• Diabetic retinopathy. As the number of Americans with diabetes skyrockets, so does the concern over diabetes-related eye problems. In fact, vision disturbances are one of the early signs of diabetes. If you have (or are at risk for) diabetes, an annual eye exam is an absolute must. Diabetic retinopathy is of particular concern, since it develops slowly and often doesn't show any symptoms. As the disease advances, increased floaters, blind spots, or cloudy vision may result. New blood vessels may also grow and bleed into the center of the eye, resulting in vision loss or blindness. Keeping your blood sugar, blood pressure, and cholesterol under control can all help prevent diabetic retinopathy. Drug injections and laser treatment may improve the condition and help preserve vision.
• Corneal conditions. Corneal abrasions – superficial scratches on the clear, protective window (cornea) at the front of the eye – are frequently caused by contact lenses, dust, dirt or other foreign body in the eye. These abrasions cause pain, redness, tearing, sensitivity to light, blurry vision, and even headaches. They are generally not serious, and heal within a few days – but should still be treated by an eye doctor to prevent further damage or infection. Disease, infections, and injuries can seriously damage the cornea and may require surgery.
• Low vision. Low vision can be corrected with contact lenses, glasses, or surgery. It is a permanent condition that affects some people as they age.
  Symptoms of low vision include:
  • Not seeing well enough to read, cook, carry out hobbies or everyday tasks.
  • Having difficulty recognizing the faces of friends and family.
  • Not being able to read street signs, or see lane markings clearly.
  • Perceiving a room is too dim, even when it’s brightly lit.

Special aids such as magnifying glasses, brighter light bulbs, and motion-detectors that light up a room before you enter can help you manage with low vision. Driving with low vision is dangerous, so be sure to ask your doctor if it’s still safe for you to drive.

Preserving eyesight as we age is critical to staying active, engaged and fulfilled in life. That's why an annual eye exam should be a part of your regular healthcare routine. If you don't have an ophthalmologist, El Camino Health can help. Click here for help finding a qualified ophthalmologist that's right for you.

This article first appeared in the March 2023 edition of the HealthPerks newsletter.