Dr. Keith Walter, associate professor of opthamology, with a patient in the Eye Center at Wake Forest Medical Center
Everyone’s vision changes with age. Just about everybody over age 45 experiences minor sight issues, such as trouble with near-vision focus. Most of these problems are part of the aging process and usually can be addressed with corrective lenses. But more serious eye problems occur much more frequently with advancing age, to the extent that approximately one-third of Americans experience some form of vision-reducing eye disease by age 65.
For most people, regular exercise, a balanced diet and other smart lifestyle choices, such as not smoking and avoiding excessive exposure to sunlight, can lessen the risk of developing serious eye problems in later years. The most important factor, however, is having comprehensive eye examinations on a regular basis, even in the absence of symptoms.
“Many eye diseases do not have early warning signs, and their onset can be very gradual, so exams are very important to identify vision changes and determine whether they are merely age-related or something more serious,” says Craig Greven, M.D., professor and chairman of the Department of Ophthalmology at Wake Forest Baptist Medical Center in Winston-Salem. “In many instances, the negative effects of eye diseases can be eliminated, minimized or slowed if diagnosed at an early stage.”
The American Academy of Ophthalmology recommends a comprehensive dilated eye exam at least once every two years for individuals 65 and older and more frequent exams for those with a history of eye problems or known risk factors, such as diabetes.
The nature, symptoms and treatment of the three most common eye diseases in seniors vary considerably.
A cataract is the clouding of the eye lens that can cause blurred vision, reduced peripheral vision and other problems. Though considered an eye disease, cataracts are so common among seniors that they can also be considered a normal aging change. Cataracts typically develop slowly and painlessly. As vision worsens, the only treatment is surgery, very safe and remarkably effective. More than 90 percent of patients report improved vision after undergoing the procedure.
Glaucoma refers to eye conditions that lead to damage of the optic nerve, often caused by increased fluid pressure inside the back of eye. The first noticeable sign is often reduced peripheral vision at which point the optic nerve has already suffered damage. While glaucoma cannot be prevented or cured, early detection and treatment (ranging from eye drops to microsurgery) can slow its progress and prevent extensive sight loss.
Macular degeneration, the most common cause of severe vision loss in people over 60, occurs when the macula, the central part of the light-sensing retina, deteriorates. The first sign of the disease is usually the distortion of straight lines. At latter stages it can mean blind spots in the center of the vision field or the loss of central vision altogether. Sight lost to macular degeneration, with new treatments, sometimes can be restored, but there are treatments that can also delay or reduce the severity of the condition.
“The key is having your eyes checked regularly so any condition can be detected as early as possible,” Greven says, “and it should be a comprehensive eye exam; regular vision-acuity tests, such for eyeglasses or a driver’s license, will not detect sight-threatening disorders.”
The Eye Center provides state-of-the-art technology with top-level service and patient care. Additional information is available online at www.wakehealth.edu/Ophthalmology or by calling 336-716-4091.