The Aging Eye: Why You Should Put the Optometrist on Your List of Doctors to See
By Jamie Rosenberg, OD, FAAO
Getting older is not for the weak of heart, or at least that’s what I’ve been told by my patients. People are living longer and are experiencing many changes to their bodies as the years pass. When I can catch my retired parents between pickleball games, they are typically on their way to or from the doctor for one thing or another. Checkups and health maintenance are now essential to living well in our later years. Now, the goal is to find early signs and prevent a person from even having a disease altogether.
The eye is no exception to the marvels of aging and is also a great example of the powers of preventative medicine. Many eye diseases are age-related meaning that they do not come on or cause issues until later in life. Additionally, many eye conditions have no symptoms whatsoever, especially in their early stages. Three common eye conditions found in older adults are cataracts, macular degeneration, and glaucoma.
The most common age-related ocular condition is a cataract. Cataracts are not considered a disease but rather a normal part of the aging process. The eye has an internal structure known as the lens, much like the lens inside a camera. When we are young, the lens is perfectly clear like the windshield in brand new car. As the years pass, it slowly becomes more yellowed and opaque causing vision to be like looking through a dirty windshield. When the clear lens begins to take on this cloudy appearance, we refer to it as a cataract.
By the time most people are 69 years old, the lens has become cloudy enough that it needs to be removed with surgery and replaced with an implant. Vision changes from cataracts are so gradual that many people will often not realize how poor their vision has become until they are attempting to read the eye chart in the office, or possibly the DMV. Routine examination ensures that surgical removal of the cataract occurs at the proper time and patients aren’t living with sub-par vision.
Macular Degeneration is an eye disease that effects 14% of Caucasians over the age of 80, according to the National Institute of Health. This explains why it’s true name is “Age Related” macular degeneration. This disease affects the macula, which is a small area of the eye responsible for your central, straight ahead vision that is used to read and look at fine detail. Often, early stages of the disease have no impact on vision, but as the diseases progresses it can cause central dead spots to occur. For example, a person with macular degeneration would be able to look at your nose, but your nose itself would appear to be a greyish blob in the center of the rest of your face. In certain cases of macular degeneration, medicine can be injected into the eye periodically to prevent further vision loss. Identifying patients who might benefit from an injection can be sight saving.
The last condition up for discussion is Glaucoma. Glaucoma is a degenerative disease of the optic nerve, which is what connects the eye up to the brain. As this condition progresses, patients gradually lose side vision until they have only tunnel vision remaining. Imagine a TV where the pixels on the edge of the screen had burned out. Missing a few would not really prevent you from enjoying your program. In fact, you could watch the characters in the center of the TV and still be able to follow the story along with a significant number of broken pixels. Similarly, a person with severe glaucoma may have lost all of their side vision and not be aware of it! Sadly, side vision loss can then degrade further to total lights-out blindness.
Because glaucoma has no symptoms, every eye exam includes several checkpoints to determine whether or not you have glaucoma or if you may be at risk for developing glaucoma in the future. There are many different types of glaucoma and many complex factors that play a role in the disease. The good news is that blindness from glaucoma is preventable and regular examination is the key to prevention.
While these three conditions are the most common, getting your eyes checked can uncover a large range of issues. Examination can reveal vascular issues such as diabetes or high blood pressure, arthritis and other autoimmune disease, vitamin deficiencies, or even cancer. Impressively, the eye can be thoroughly examined with only the use of eye drops and without invasive procedures. Checking in on your eye health will ensure that you’re doing all you can to keep your vision at its best and, if you’re like my parents, that you can keep up your shot on the pickleball court.
Dr. Rosenberg lives in Lyndhurst and is an optometrist with the Cleveland Eye Clinic, working in their Bedford and Downtown locations. She is a fellow of the American Academy of Optometry, residency trained in ocular disease, and particularly passionate about geriatric eye care.