Your Aging Vision
Dr. Jane Thrall
As with most things, age changes the way we see the world.
Eyes and the visual system are complicated and sensitive. Visual health is affected by
many life choices, including what we eat, how much exercise we get, and any bad habits
picked up along the way.
The most common eye conditions in older people are cataracts, glaucoma, and
age‐related macular degeneration (ARMD).
Cataracts
Cataracts are a clouding of
the lens inside the eye, a very
common condition in patients
over sixty years of age. When
the lens clouds, vision becomes
distorted and dull. The process
is usually so slow that it is barely
noticed until road signs are
difficult to read and night driving
becomes unnerving.
Cataract surgery is simple and
highly successful with minimal
risk. The most common thing I
would hear after a patient had
their first eye done was, “When
can I get the other one done?”
During a procedure called
phakoemulsification, the surgeon
makes a small incision in the eye
and inserts a device that breaks
up the lens and removes it in tiny
pieces. An intraocular lens of the
appropriate strength is inserted
to replace the natural lens, and
sight is restored. New glasses are
prescribed if needed, but often
patients only require reading
glasses.
Glaucoma
Glaucoma is an eye condition
that has few or no symptoms;
patients invariably present with
no concerns unless they’ve lost
nearly all their sight.
Historically it was thought that
glaucoma was a condition of high
pressure in the eye. While there is
a strong association between eye
pressure (intraocular pressure or
IOP) and glaucoma, it turns out
that’s not the whole story.
Fluid is always flowing into
and out of the eye. This aqueous
fluid keeps the eye healthy
and free from disease. When
something goes awry with this
process, pressure within the
eye builds up. This increased
pressure compresses tissue and
affects the flow of oxygen and
important nutrients to the optic
nerve tissue, which conveys sight
to the brain. The nerves affected
first are the ones associated with
peripheral vision, and the last to
go are the central nerves from the
macula.
Peripheral vision is lost one
cell at a time, but the pattern,
in most cases, is predictable.
Special screening tests have been
developed to flag those who may
be experiencing early changes to
their peripheral vision and more
in-depth tests can monitor the
vision changes.
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