Eyes right

As we get older, our bodies begin to work less efficiently – and the eyes are no exception. Fiona Marsden finds out about the key age-related eye conditions, and what you can do about them.

Retaining good eyesight is a major contributor to independence in later life. You can’t turn back the clock, but knowing about age-related eye conditions can alert you to changes in your vision that warrant professional attention. So let’s dive in and see what we can see.

Cataracts are one of the most common age-related eye conditions. They’re not caused by disease, but by a change in the protein structure of the eye’s lens as we grow older. Long-term exposure to ultraviolet (UV) light from the sun can also play a role. “Like wrinkles, cataracts are an inherent part of ageing,” says Shirley Loh, optometrist and spokesperson for the Optometrists
Association Australia (OAA). “If you live long enough, you’re quite likely to get one.” Symptoms include clouding of the lens,
blurred or hazy vision, and a noticeable increase in sensitivity to glare. If untreated, the clouded areas become larger and
thicker, and can cause blindness. Fortunately, cataracts are easily treated by minor surgery, usually under local anaesthetic.

An ophthalmologist (eye specialist) removes the cloudy lens and replaces it with a plastic intra-ocular lens (a lens implanted in the eye).

Age-related macular degeneration (AMD)
AMD is the leading cause of vision impairment and blindness in Australians over 50 years of age. According to Loh, this is because Australians are living longer, and AMD becomes more common as people get older. “The retina is a film that coats the back
of the eye and captures and processes light,” Loh explains. “The macula is only a tiny spot on the retina, but it accounts
for around 95 per cent of useful vision.” AMD occurs when the macula is damaged or broken down. The condition damages central vision and makes it difficult to see small details of objects, such as print in a newspaper. Side vision is unaffected. AMD symptoms vary, but can include ‘patchy’ vision (for example, missing words when you read) or finding that straight lines such as doorways take on a wavy appearance. In some cases, people with preexisting eye problems like cataracts may not notice the additional symptoms of AMD, so it takes an eye test to pick it up. If you have AMD, little can be done to ‘cure’ it. Your medical practitioner can discuss these.

Changing what you eat could also help. The OAA recommends a diet rich in Omega-3 fatty acids (found in oily fish, eggs, green
leafy vegetables and nuts), which may help reduce the progression of existing AMD. If you don’t have AMD, you can take steps
to help prevent it, no matter what your age. AMD has been linked with UV exposure and smoking – so slide on those sunnies and kick the nicotine habit!

Getting older also increases your chances of developing glaucoma, in which nerve cells transmitting information from the eye to
the brain become irreversibly damaged. If left untreated, the condition can gradually erode peripheral vision and, ultimately,
cause blindness.

However, recent advances in medical treatment may offer potential to preserve the vision you currently have. Your Symptoms can include blurred vision, apparent coloured rings around lights, and eye pain and redness. By the time symptoms appear, vision is permanently affected.

Since glaucoma can’t be prevented, early detection through eye examinations is essential. In most cases, treatment involves eye drops and medication, although surgery is occasionally required.

Diabetes-related eye conditions
According to the OAA, around seven per cent of Australians aged over 25 have diabetes, increasing to nearly one-quarter of people aged over 75. Of these, more than 70 per cent will develop diabetes-related eye changes within 15 years of diagnosis.

Most diabetes-related eye conditions affect the retina, and can cause blindness if not carefully monitored and treated.
“The OAA recommends annual eye checks for all diabetics, and more frequently in some cases,” says Loh. “Once the retina is damaged, it’s almost impossible to get that vision back.”

And then there’s …

Just like other muscles in the body, our eyes’ focusing muscles lose flexibility with age. This affects our close vision.
“This loss of flexibility is universal and affects even people with previously normal vision,” says Loh. “It starts from
around age 20, but you don’t notice it until about 45. At this point, the condition becomes known as presbyopia.”
Multi-focal or single-vision reading glasses are the most common and least invasive correction methods. You can also
choose multi-focal contact lenses, laser surgery or multi-focal intra-ocular lenses.

A pterygium (pronounced with a silent ‘p’; plural: pterygia) is a pinkish growth on the surface of the eye. Whilst not harmful in itself, it can cause embarrassment and considerable discomfort as it grows. If untreated, it can grow over the eye surface and
affect vision. Pterygia are associated with UV exposure and are more common among people in northern Australia. Although lubricating drops may help with the discomfort, surgery is the only treatment.

Dry eye
Another body function that becomes less efficient with age is tear production. “The tear film has three layers made of
different substances,” says Loh. “If one layer isn’t producing tears properly, you may experience symptoms including blurred vision, a sandy or gritty feeling, or overproduction of compensatory tears.” If the condition persists, an optometrist can find out which tear layer is the culprit, and determine the most suitable treatment product.

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