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Dr. Brian Abert, O.D. FAAO recently visited the Park Regency Thornton Assisted Living Center in Thornton, Colorado. He was asked to speak to the residents there about the importance of eye care, and ways that preventative eye care can preserve vision. One of the residents was interested in a copy of Dr. Abert’s talk, so we decided to make it available here on the practice website!

It is important to appreciate that eye care is needed for all ages. Many of the diseases that we will discuss today are preventable, and having guidance on how to prevent those diseases when you’re younger can prevent or reduce the severity of disease when you are older. The American Optometric Association recommends children be seen at 6-12 months of age. We generally recommend yearly eye exams for all adults, and certainly annual eye exams for those patients over the age of 60.

The eye is unique in that even very small amounts of disease can cause dramatic changes to functionality. As much as we believe in the importance of regular eye care as a tool to catch eye disease early, many diseases first present as the symptoms that patients may experience:

Age-Related Eye Symptoms

  • Blurred Vision – Can be caused by cataracts, macular degeneration, dry eye, corneal disease, and diabetic retinopathy among others. Refractive error, that is, your glasses prescription, can also fluctuate over time. Therefore, nearsightedness, farsightedness, astigmatism, and presbyopia (needing reading glasses) can change with age and result in blur.
  • Dry Eye – This sometimes presents as a gritty, sandy feeling in the eyes. Some patients even remark that they feel like they have something in their eyes. Often times the eye will be blurred between blinks.
  • Central Vision Blur – This often presents as the inability to recognize faces, or difficulty reading. Most commonly associated with macular degeneration.
  • Glare at Night – Headlights lose their sharp focus and patients complain of starburts. The common culprits here are cataracts and dry eye.
  • Floaters – Can be caused by serious retinal disease or relatively benign changes to the fluid at the back of the eye. Symptoms range from mild annoyance to serious vision defects.

Review of Eye Diseases

  • Cataracts – Cataracts affect 22 million Americans age 40 or older. When your natural internal eye lens gets foggy, you are essentially looking out of a dirty windshield. No amount of glasses correction or eye drops can change your vision when you have a dense cataract. The procedure to remove cataracts is generally safe and effective, though it is a good idea to wait until your cataracts affect your daily life significantly before electing to undergo the surgery. Cataracts require a scalpel surgery to remove them, though the common secondary cataract that forms after the initial surgery can usually be treated with a non-invasive laser procedure.
  • Macular Degeneration – More than 2 millions American over the age of 50 have macular degeneration. Oxidative damage builds up at the most sensitive part of the retina, the macula. This results in problems reading, recognizing faces, and driving. Side vision is often unaffected. Treatment may include self and office monitoring, high-dose antioxidants, laser surgeries, and injections.
  • Glaucoma – Glaucoma affects 2.3 million Americans over the age of 40. Side vision loss related to the internal pressure of the eye. Most forms of glaucoma have a gradual onset and early diagnosis is key to preventing functional vision loss. Glaucoma treatment is usually accomplished adequately with topical medications, shunt-insertion, laser surgeries are other options for challenging cases.
  • Diabetes – The leading cause of adult blindness in the United States. Diabetes can cause bleeding and swelling in the retina, early cataracts, and is thought to complicate glaucoma. Treatment centers around your systemic health management and getting blood sugar under control is a must.   To address diabetic retinopathy specifically, there is a host of laser and scalpel surgeries that are aimed at stabilizing the vision loss seen in this disease.
  • Other Retinal Disease – Retinal holes, tears, and detachments should ideally be diagnosed and treated early. Warning signs include flashes of light and floaters in vision.
  • Dry Eye – An estimated 3.2 million women age 50 and over and 1.68 million men age 50 and over are affected by dry eye syndrome. Given that the cornea is the most sensitive part of the body, dry eye needs to be recognized as a serious, and fairly easy to treat, eye disease. Eye drops, or artificial tears, can provide relief in some patients, while severe cases may need prescribed anti-inflammatory medications, ointments, or tear duct plugs.

Preventative Eye Care

  • Regular Eye Care – While many eye diseases have symptoms that you can easily notice, some of have symptoms that change slowly over time or symptoms that don’t occur until you are late in the disease. Cataracts blur vision slowly and generally only affect vision harmlessly. Patients often times don’t realize how bad their vision is because their vision didn’t just get bad over night. Glaucoma isn’t generally noticed by the patient until late in the disease –when it is more challenging to treat. Retinal disease is much easier to treat in its early stages. Part of your annual check-up is dilating the pupils, checking the health at the front and back of the eye, checking the lens for cataracts, measuring your eye pressures, and checking your vision.
  • Nutrition – Cataracts and macular degeneration both respond well to high antioxidant diets. The AREDS study demonstrated that high antioxidant supplement intake positively affected the outcomes of those patients with mid to late stage macular degeneration. This is generally translated to our recommending that patients take vitamin supplementation if a patient has high risk factors, or early signs of disease.
  • Sun Protection – Cataract and macular degeneration both are related to tissue oxidation, so preventing exposure to oxidizing wavelengths of light (specifically ultraviolet, or UV) can likely reduce the severity of those diseases.   Especially given that we live at altitude and have a higher UV Index than those patients living on the coast, sun protection outdoors is a must.

You don’t need to wait for your yearly exam to check your eye health. Examples of when you could utilize your health insurance “mid-year”

Conclusion

Eyes are too precious not to care for properly. Most treatments are more easily accomplished when disease is identified early. Annual eye exams are the base level of care for anyone over the age of sixty. Our role as optometrists is to diagnose these diseases early, and either treat or coordinate treatment of any disease. Sometimes we need to just monitor a disease to be sure it doesn’t progress. Sometimes we will initiate treatment with topical or systemic medication. If you require surgery, we will refer you to one of the many specialists that we work with in the area to be sure that your eyes will continue to provide you with great vision.

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