Care for your eyes

Poor eyesight is not inevitable with age. Some physical changes occur during the normal ageing process which can cause a gradual decline in vision, but many people maintain good eyesight into their 80s and beyond.

Older people may need brighter light for such tasks as reading or cooking.

Certain eye disorders and diseases occur more frequently in old age but a great deal can be done to prevent or correct these conditions.

Suggestions to help protect your eyes

1. Have regular health check-ups to detect such treatable diseases as high blood pressure and diabetes, both of which may cause eye problems.

2. Have a complete eye examination every 2 or 3 years, since many eye diseases have no early noticeable symptoms. The examination should include a vision (and glasses) evaluation, eye muscle check, a check for glaucoma and thorough internal and external eye health examination.

3. Seek more frequent eye health care if you have diabetes or a family history of eye disease. Some diseases such as glaucoma run in families. Make arrangements for care immediately if you experience signs such as loss or dimness in vision, eye pain, excessive discharge from the eye, double vision, or redness or swelling of the eye or eyelid.

Common eye complaints

Presbyopia (prez-bee-oh’pe-uh), a gradual decline in the ability to focus on close objects or to see small print is common after the age of 40 years.

People with this condition often hold reading materials at arm’s length and some may have headaches or ‘tired eyes’ while reading or doing other close work. There is no known prevention for presbyopia but the focusing problem can be easily compensated for with reading glasses.

Floaters are tiny spots or specks, which float across the field of vision. Most people notice them in well lit rooms or outdoors on a bright day. Although floaters are normal and usually harmless, they may be a warning of certain eye problems, especially if associated with light flashes. If you notice a sudden change in the type or number of spots or flashes, seek advice straight away from your eye specialist.

Dry eyes occur when too few tears are produced. The result is itching, burning eyes. Watery eyes may also result from dry eyes. Dry eyes may result in reduced vision if not treated. An eye specialist can prescribe special eye drop solutions ‘artificial tears’ to correct the problem.

Excessive tears may be a sign of increased sensitivity to light, wind or temperature changes or dusty conditions. In these cases, protective measures (such as wrap around sunglasses) may solve the problem. Dry eyes may also result in excessive tears.

Excessive tears may also indicate more serious problems, such as an eye infection or a blocked tear duct, both of which can be treated and corrected.

Eye diseases common in the elderly

Cataracts are cloudy or opaque areas in part or all of the transparent lens located inside the eye. Normally the lens is clear and allows light to pass through. When a cataract forms, light cannot easily pass through the lens and this affects vision.

Cataracts usually develop gradually, and are without other symptoms except dulling of vision, and/or problems with glare. Some remain small and do not seriously affect vision. If a cataract becomes larger or denser however, it can be surgically removed.

Cataract surgery is a safe procedure, which is almost always successful. The clouded lens is removed and replaced by a synthetic lens. The procedure is generally done under local anaesthetic in a day care unit. After surgery glasses will still be necessary for some aspects of vision e.g. reading and/or driving. Cataract patients should discuss the risks and benefits of this elective procedure with their eye specialist.

Glaucoma occurs when there is too much fluid pressure in the eye, causing internal eye damage and gradually destroying vision. The underlying cause of glaucoma is often not known but, with early diagnosis and treatment, it can usually be controlled and blindness prevented. Treatment consists of special eye drops, oral medications, laser treatments or, in some cases, surgery.

Glaucoma seldom produces early symptoms and usually there is no pain from increased pressure. For these reasons, it is important for eye specialists to test for the disease during routine eye examinations in those over 35 years of age.

Retinal disorders are a leading cause of blindness. The retina is a thin lining inside the back of the eye made up of nerve endings, which receive visual images and pass them on to the brain.

Retinal disorders include:

1. Age-related macular degeneration (ARMD) - a condition in which the macula (the central area of the retina) loses its ability to function efficiently. The first signs may include blurring of reading or distortion of straight lines.

Progress of the condition may be rapid or very slow. Early detection of ARMD is important as a few cases may be treated with laser, radiotherapy or steroid.

2. Diabetic retinopathy only occurs in diabetics who have had periods of poor diabetic control. These periods of poor control may have been over several years before any sign of retinal trouble is evident. In the early stages of the condition, the blood vessels may leak fluid, which distorts vision. In the later stages, new vessels may grow and release blood into the centre of the eye, resulting in serious loss of vision. Any diabetic should consult their eye specialist regularly. Diabetic retinopathy is treated with laser to prevent further vision loss.

3. Retinal detachment is a separation of the retina from the supporting structure of the eye. It produces a sudden loss of vision, often like a curtain descending in front of vision. Ophthalmological advice should be sought immediately. Treatment of a detached retina is quite specialised.

Low-vision aids

Low-vision aids include magnifying glasses, telescopic devices, and closed circuit televisions. Some are hand held; others rest directly on reading material.

The Low Vision Centre (a service of the Royal Society for the Blind) provides services, which assist people facing vision loss to maximise use of remaining vision. These services include assessment for magnifiers, counselling and training to maintain independence.

Have you had your eyes checked by an optometrist in the last 2 years?

Useful contacts

For further information about vision problems contact:
Low Vision Centre
230 Pirie Street, Adelaide SA 5000
Tel. 8232 4777, Freecall™ 1800 657 554 
Web www.rsb.org.au