Healthy Aging Column – that All- Important Eye Exam

With aging, almost everyone needs to use reading glasses, because everyone loses some visual acuity. Reading glasses are only an inconvenience. Glaucoma (excess internal eye pressure), cataracts (cloudiness in the eye’s natural lenses), and macular degeneration (damage to the portion of the retina that is responsible for reading and other detailed task) are the three major causes of vision loss as we age.

As we age, is it critical to see an ophthalmologist or optometrist regularly for an eye examination. Early detection of age-related disease is key to preserving your vision. If you currently have normal vision and no major risk factors for cataracts, glaucoma or macular degeneration and if you are between the ages of 40 and 65, you should have an eye examination every two to four years. However, if you are over 65, the American Academy of Ophthalmology recommends you have an examination every one to two years.

These exams are important so that your doctor can detect changes in your vision and counsel you on the best ways to preserve your eyesight. Eye examinations should include a comprehensive dilatation, meaning the doctor will use special eye drops to widen (dilate) the pupils and examine the eyes from front to back.

Following is information about age-related vision loss from the September 2003 Focus on Healthy Aging newsletter from Mount Sinai School of Medicine. By having an annual eye examination, you may be able to prevent or delay the onset of vision loss from these conditions.

Cataracts occur when the natural lens of the eye becomes cloudy and less able to focus light into clear images. The most common form of the disease that occurs in older adults is nuclear sclerosis, which causes a yellowing of the lens. Cataracts become more common with aging, but there is no specific cause known. Symptoms of cataracts include dimmed or blurred vision, poor vision for distant and/or nearby objects and seeing glare or haloes around objects in bright light.

While studies suggest that wearing polarized sunglasses in bright sunlight may help, there is no proven way to prevent cataracts. When cataracts are just beginning, you can maximize your vision by reading and performing tasks with indirect lighting. The permanent treatment for cataracts is to replace the cloudy natural lens with an artificial implant.  

Glaucoma is excess pressure inside the eye that gradually causes loss of peripheral vision.  The condition is not reversible. There is no specific ways to prevent glaucoma. People with a family history of the disease and African Americans have a higher risk of having glaucoma.

There are two types of glaucoma, and they have different symptoms. The most common form, open-angle glaucoma, typically has no early symptoms. This makes it even more important to have regular eye exams. The other form of glaucoma is narrow-angle glaucoma, which may cause a decrease in visual sharpness, pain in the eyes or head and occasionally nausea and vomiting. You may also see haloes around lights.     

Macular degeneration, or AMD, is the leading cause of vision loss and legal blindness for people over age 65. It causes gradual but painless damage to the macula. The macula is the central portion of the retina needed for reading and other detail-oriented visual tasks. People with AMD will gradually find it difficult to read, drive a car or identify faces, as they will only have peripheral vision. There is "wet" and "dry" AMD. In dry AMD, spots of debris called drusen collect in the macula. In wet AMD, abnormal blood vessels grow beneath the retina and leak fluid or bleed.

Research suggest that people with early signs of dry AMD can slow progression of the disease by taking a cocktail of zinc plus the antioxidant vitamins C, E, and beta-carotene. You should consult your doctor on whether to take the vitamins and the exact amounts to take.   However, it important to note that these vitamins have not been shown to prevent AMD in the studies completed to date. For wet AMD, laser treatments can slow the vision loss, although the overall benefit is modest.

The important thing to remember is that regular examinations by an ophthalmologist are essential to early detection and treatment of age-related vision loss.

Additional information on Healthy Aging is available from the Colorado State University Cooperative Extension Web site at by going to Info Online, Consumer and Family, and selecting Healthy Aging.   

by Jean Justice,  Family and Consumer Extension Agent, Colorado State University Cooperative Extension, Southeast Area/Otero County