Taking a Good Look at Age-Related Vision Problems

December 27, 2021

Susan was a happily retired 80-year-old, actively volunteering her time and talents in myriad ways. She was a trusted, supportive friend to many, often chauffeuring those younger than she here and there.

Until the day her doctor told her she could no longer drive due to macular degeneration, one of several common age-related vision disorders.

“That was the hardest day of my life,” she confessed.

Susan is not alone in her decreased ability to see as well as she once did. In fact, one in three seniors develops some form of vision-reducing eye disease by the time they reach 65.

Common Age-Related Eye Diseases

There are several age-related eye disorders, but themajor ones are cataracts, glaucoma, macular degeneration, and diabetic retinopathy. We will look at each of these individually.

Cataracts

…are cloudy or opaque areas on the lens in the front of the eye. They develop slowly and usually cause no pain. Cataracts prevent light from passing through to the back of the eye (the retina), causing blurred vision. If they grow and significantly obscure vision, cataracts can be easily removed with surgery. Cataract surgery is largely safe and one of the most common operations performed across the globe.

Glaucoma

…is caused by increased pressure inside the eye, leading to permanent vision loss or total blindness, if not treated. Risk factors include heredity, age, race, diabetes and some medications; symptoms can include blurred or distorted vision. Sudden eye pain and/or visual disturbances (a medical emergency) can also be indicative of glaucoma. However, there are often no symptoms, making subjective diagnosis difficult. Glaucoma is detected by examining the optic nerve and measuring eye pressure. Treatment can include oral medications, eye drops, laser treatment or surgery.

Macular degeneration

…is the loss of cells in the macula, the central part of the retina, causing blurred or distorted central vision. There are two types of macular degeneration: dry and wet. Eighty percent of people affected have the dry form, in which parts of the macula slowly become thinner and develop protein growth. Much less common (but far more serious) is the wet form, in which new blood vessels form in the retina, leaking blood and other fluids that can cause scarring of the macula. While there is no cure for advanced cases of macular degeneration, those in early stages can benefit from certain foods or nutritional supplements as well as medication injections.

Diabetic retinopathy

…is a complication of Type 1 and Type 2 diabetes whereby small blood vessels leak fluid, causing blurred vision, floaters, blind spots and clouded vision. If new blood vessels bleed into the center of the eye, serious vision loss or blindness may result.  Drug injections may alleviate swelling of the retina associated with diabetic retinopathy, and in advanced cases, laser treatment can prevent blindness. Regular appointments with an eye doctor are important for all seniors, but especially so for those with diabetes.

Other age-related eye conditions

• Presbyopia, or difficulty seeing small print or close objects, occurs in most adults around the age of 40-50. Because this is such a common condition, “cheater” reading glasses are readily available in drug stores, supermarkets, and dollar stores. Even high-end department stores feature cheater glasses, usually of a more stylish variety.
• Floaters are tiny spots or specks that float across one’s field of vision. Some say they look like cells under a microscope. Floaters are usually harmless, unless they are accompanied by light flashes, which could indicate retinal detachment.
• Dry eyes (or keratoconjunctivitis sicca) occurs when tear glands underproduce tears, another common condition among older adults. Prescription or over-the-counter artificial tears may help as well as a humidifier or even surgery, in more severe cases.
• Retinal detachment is the separation of the inner and outer layers of the retina. Symptoms include the sudden appearance of spots or flashes of light, wavy vision as if under water, and dark shadows in the field of vision. Surgery and laser treatment can successfully restore some or all vision.
• Additional age-related eye conditions include various corneal diseases, problems with the eyelids, watery eyes (epiphora), and temporal arteritis.

Preventing or Managing Age-Related Vision Loss

Indeed, “the eyes have it” when it comes to multiple age-related complications. But, while vision loss can be physically debilitating and emotionally devastating, it does not have to mean the end of a vibrant, fulfilling life for older adults. Some eye diseases can be prevented, or at least forestalled, and even if vision loss cannot be avoided, there are ways to manage and adjust to it.

• First and most important of all are regular eye exams with a qualified eye professional, preferably an ophthalmologist, a medical doctor providing the broadest range of eye care (including surgery). Yearly or even biannual exams can screen for various age-related eye diseases, facilitating preventive measures and appropriate treatment when necessary. Those with diabetes are strongly encouraged to have a comprehensive eye exam at least once a year, along with pupil dilation.
• A variety of devices can aid vision loss, including magnifying glasses, telescopic glasses, electronic magnification systems, light-filtering lenses, print and e-books with large print, oversized calculators, and more.
• Good lighting without glare is key. Whether for yourself or a loved one, purchase lamps and bulbs that reduce glare and increase contrast as well as those that provide direct task lighting. Large areas can benefit from under-counter lighting for overall illumination. Though it may seem counterintuitive, keeping lights on during the day will equalize lighting from both indoor and outdoor sources.
• Seniors with decreased vision are particularly vulnerable to falling. Reduce the risk of falls by installing nightlights in bedrooms, hallways and bathrooms. Eliminate tripping hazards such as rugs, cords and low-lying, difficult-to-see furnishings. It may even be beneficial to reposition some furnishings to make the home easier to navigate. Take care to familiarize yourself or your senior with the new lay of the land, as new arrangements can be disorienting, especially at night or for those with cognitive decline.
• Contrasting colors are a senior’s friend. Similar tones make it difficult for someone with low vision to distinguish one object from the next. This applies to doorways, furniture and stairs as well as smaller household items. Help yourself or a loved one by choosing implements that contrast with surroundings; for example, dark cutting boards for light food items (and vice versa) and dark linens in lighter bedrooms and bathrooms. Doorjambs painted in contrasting colors and dark tape on stair edges increase visibility and safety in the home.
• A little designation goes a long way. Assigning specific places and containers for like items helps seniors with vision problems easily find the things they need. Visual and tactile systems in the home are also helpful. For example, a visual system might employ large labels, colored stickers or tape to help seniors with failing vision identify different objects. In a tactile system, raised plastic dots, sandpaper cutouts, rubber bands, or felt might be used.
• Support from family and friends is invaluable to a senior with reduced vision. Like Susan in the beginning of this blog, many seniors can no longer drive safely due to failing eyesight and/or impaired hearing. This can be both literally and psychologically debilitating for older adults whose daily lives revolve around the ability to get from place to place on their own. Offer to drive them on errands, appointments, social visits, and regular fun outings with you and other family and friends. Get to know their needs and commitments and make regular arrangements to take them where they need to go. This will likely require significant adjustments to your own routine, but the physical, emotional and moral support it will lend your loved one will be well worth it. If it is not feasible for you to transport your senior yourself, make arrangements on their behalf with an elder transportation service, a trusted neighbor or friend, an available relative (young people who’ve recently mastered driving are often willing volunteers!), or a municipal or religious resource center.

Focusing on the Future

Depending on the degree of eyesight impairment, the ability to remain in one’s own home may change. Many find that a senior living environment like Barclay Friends is the best choice for quality care and optimal living. We are here to answer your questions, assess your needs, and guide you in the process of making decisions.