Ageing Eyes | A Comprehensive Guide to Eye Problems in the Elderly

As the curtains fall on World Glaucoma Week, which was commemorated from March 12th to March 18th, we received many inquiries about eye ailments affecting the elderly. So, we thought we’d give you a rundown of the most common eye afflictions among our esteemed seniors.

As we age, our eyes undergo a series of changes that can lead to a variety of eye problems. These problems can cause discomfort, reduced vision, and even blindness. It’s important for seniors to be aware of these eye problems, their symptoms, causes, and treatments.

   

1.     Presbyopia

Presbyopia is the gradual loss of your eyes’ ability to focus on nearby objects. It’s a natural, often annoying part of ageing. It usually becomes noticeable in your early to mid-40s and continues to worsen until around age 65.

Symptoms:

} A tendency to hold reading material farther away to make the letters clearer

} Blurred vision at normal reading distance

} Eyestrain or headaches after reading or doing close-up work

Risk factors:

} Age. Age is the greatest risk factor for presbyopia. Almost everyone experiences some degree of presbyopia after age 40.

} Other medical conditions such as diabetes, multiple sclerosis or cardiovascular diseases — can increase your risk of premature presbyopia, which is presbyopia in people younger than 40.

} Certain drugs are associated with premature presbyopia symptoms, including antidepressants, antihistamines and diuretics.

Causes: Age-related changes in the lens and surrounding muscles.

Treatment: Reading glasses, bifocals, or progressive lenses can help correct presbyopia.

2.     Cataracts

Cataracts are a common eye problem in seniors. They occur when the lens of the eye becomes cloudy, leading to decreased vision.

Symptoms: Blurred vision, increased glare from lights, difficulty seeing at night.

Causes: Age-related changes in the lens. Cataracts can also be caused by certain medical conditions like diabetes. Long-term use of steroid medications, too, can cause cataracts to develop.

Risk Factors:

} Increasing age

} Diabetes

} Excessive exposure to sunlight

} Smoking

} Obesity

} High blood pressure

} Previous eye injury or inflammation

} Previous eye surgery

} Prolonged use of corticosteroid medications

} Drinking alcohol

Treatment: Cataract surgery is the most effective and successful treatment. During surgery, the cloudy lens is removed and replaced with an artificial lens.

3.     Age-related macular degeneration (AMD)

AMD is a common eye problem that affects seniors. It occurs when the macula, the part of the eye that allows us to see fine details, deteriorates.

Symptoms:

} Visual distortions, such as straight lines seeming bent.

} Reduced central vision in one or both eyes.

} The need for brighter light when reading or doing close-up work.

} Increased blurriness of printed words.

} Difficulty recognizing faces.

} A well-defined blurry spot or blind spot in the field of vision.

Causes: Age-related changes in the macula.

Risk factors

} Age. This disease is most common in people over 60.

} Family history and genetics. This disease has a hereditary component. Researchers have identified several genes linked to the condition.

} Race. Macular degeneration is more common in white people.

} Smoking

} Obesity. Research indicates that being obese may increase your chance that early or intermediate macular degeneration will progress to the more severe form of the disease.

} Cardiovascular disease. If you have heart or blood vessel disease, you may be at higher risk of macular degeneration.

Treatment: While there is no cure for AMD, treatments such as injections and laser therapy can help slow the progression of the disease.

4.     Glaucoma

Glaucoma is a condition that causes damage to the optic nerve, which can lead to vision loss. It is more common in seniors.

Symptoms: There are often no early symptoms of glaucoma, but as the disease progresses, peripheral vision can be affected.

Causes: Increased pressure in the eye.

Risk factors

} High internal eye pressure, also known as intraocular pressure

} Age over 55

} Family history of glaucoma

} Certain medical conditions, such as diabetes, migraines, high blood pressure and sickle cell anaemia

} Extreme nearsightedness or farsightedness

} Eye injury or certain types of eye surgery

Treatment: Eye drops, laser therapy, and surgery can all be used to treat glaucoma.

5.     Dry eye syndrome

Dry eye syndrome occurs when the eyes don’t produce enough tears, leading to discomfort and vision problems.

Symptoms: Dryness, burning, and itching of the eyes, blurred vision, and sensitivity to light and eye fatigue

Causes: Age-related changes in tear production.

Risk factors:

} Being older than 50.

} Being a woman.

} Eating a diet that is low in vitamin A, which is found in liver, carrots and broccoli, or low in omega-3 fatty acids, which are found in fish, walnuts and vegetable oils.

} Wearing contact lenses or having a history of refractive surgery.

Treatment: Eye drops, warm compresses, and lifestyle changes can help manage dry eye syndrome.

6.     Diabetic retinopathy:

Diabetic retinopathy is a complication of diabetes, especially untreated or undertreated diabetes. It can cause damage to the blood vessels in the retina, leading to vision loss or blindness if left untreated.

Symptoms can include blurred vision, floaters, and difficulty seeing at night.

Treatment may involve laser surgery to seal leaking blood vessels or injections of medication into the eye. Complications can include permanent vision loss.

7.     Retinal Vein Occlusion (RVO)

When a retinal vein is blocked by a blood clot, it cannot drain blood from the retina. This leads to haemorrhages (bleeding) and leakage of fluid from the blocked blood vessels in the eye.This condition is called retinal vein occlusion (RVO). It can be Central retinal vein occlusion (CRVO) or Branch retinal vein occlusion (BRVO).

Symptoms:

There is painless blurring or loss of vision. It almost always happens in just one eye. At first, the blurring or loss of vision might be slight, but it gets worse over the next few hours or days. Sometimes there is a complete loss of vision almost immediately.

Risk factors:

It is more likely to occur in people with diabetes, and possibly high blood pressure, high cholesterol levels, or other health problems that affect blood flow. Mental stress and emotional distress is an important risk factor.

Treatment:

There is no way actually to unblock retinal veins. However, the eye specialist can treat by giving certain injections to prevent further loss of vision and other complications.

Important tips for the elderly for eye health

} Yearly Eye Examination by Eye Specialist. This can help detect cataracts and other eye problems at their earliest stages.

} Quit smoking and Alcohol

} Choose a healthy diet that includes plenty of fruits and vegetables. Adding a variety of colorful fruits and vegetables to your diet ensures that you’re getting many vitamins and nutrients. Fruits and vegetables have many antioxidants, which help maintain the health of your eyes.

} Wear sunglasses. Ultraviolet light from the sun may contribute to the development of cataracts. Wear sunglasses that block ultraviolet B (UVB) rays when you’re outdoors.

} Manage all medical conditions. For example, if you have cardiovascular disease or high blood pressure, take your medicine and follow your doctor’s instructions for controlling the condition.

} Maintain a healthy weight and exercise regularly. If you need to lose weight, reduce the number of calories you eat and increase the amount of exercise you get each day.

} Include fish in your diet. Omega-3 fatty acids, which are found in fish, may reduce the risk of macular degeneration. Nuts such as walnuts also contain omega-3 fatty acids.

} Know your family’s eye health history. Glaucoma tends to run in families. If you’re at increased risk, you may need more frequent screening.

Mental stress and emotional distress in the elderly is one of the most important modifiable risk factors contributing significantly in accelerating the process of ageing in all organs and the worst outcome of different diseases.

In elderly individuals, stress and anxiety have been associated with a higher risk of developing certain eye diseases, such as age-related macular degeneration (AMD) and glaucoma.

Dr. Zubair Saleem is a Senior Geriatric Consultant and a Gerontologist

Disclaimer: The views and opinions expressed in this article are the personal opinions of the author.

The facts, analysis, assumptions and perspective appearing in the article do not reflect the views of GK 

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