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Oh, my aging eyes! What can I do to preserve sight?

March 15, 2018 | UCI Health
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Just as your body ages, so too will your eyesight begin to change as you grow older. Some changes are driven by heredity, others are exacerbated by the dry, sunny Southern California weather. All are made worse by smoking.

Here’s the good news: Nearly all age-related vision changes can be treated with medicine or outpatient surgery, says Dr. Mitul Mehta, an ophthalmologist with the UCI Health Gavin Herbert Eye Institute

Mehta, an assistant professor of vitreoretinal diseases and surgery, describes the eye conditions that can affect the aging eye:

Presbyopia

With age, the lenses of the eyes become less flexible and make it difficult to focus on close objects, a condition called presbyopia. That’s why nearly everyone needs reading glasses as they reach their mid-40s or 50s.

A few types of eye surgeries can correct this condition. And here’s the best news: In some people who receive treatment for presbyopia, distance vision may actually improve.

Dry eyes

Our eyes produce tears to protect the cornea, the clear outer layer of the eyeball. But a lifetime of inflammation caused by sun, wind, high blood pressure, stress and other factors, may cause the eye to produce fewer tears. People in their 50s typically begin noticing burning, stinging or even eyes that brim with tears.

Dry eyes are easily treated with over-the-counter artificial tears or with nighttime application of gels.

Eating fish high in omega-3 fatty acids, such as salmon, tuna and halibut, or taking flax or chia seeds, may help prevent the condition from developing.

Glaucoma

There are different forms of glaucoma, a largely hereditary condition that can cause irreversible blindness by damaging the eye’s optic nerve. It is usually caused by a buildup of fluid at the front of the eyeball.

Glaucoma is known as the “silent disease” because symptoms don’t appear until very late in the disease process. That’s why eye exams are recommended every two to three years after age 40.

Detected early enough, the majority of cases can be controlled with eye drops alone. Laser and surgery may also help.

Floaters

As people age, almost everyone experiences floaters — tiny white or black specks that move around in their field of vision. They occur when the jelly-like fluid behind the eye’s lens starts to break down, usually when people are in their late 50s and 60s.

Floaters are usually not a serious problem. However, a sudden shower of floaters accompanied by light flashes needs to be checked by an eye doctor right away.

Cataracts

When the eye's natural lens begins to turn cloudy or discolored, vision becomes hazy, focus is difficult and glare affects eyesight. Surgery restores vision by replacing these cloudy lenses called cataracts with a synthetic lens.

Cataracts may begin to form as early as age 50, but most people don’t require surgery until their late 60s or 70s. Cataracts are the largest cause of vision loss in U.S. adults.

You can help prevent cataracts by taking vitamin C, as well as decreasing your exposure to wind and the sun’s UV rays by wearing sunglasses (preferably brown polarized lenses) and hats.

Fuch’s dystrophy

This is a rare condition that causes the cornea to start degrading. Affecting just 4 percent of people over age 40, Fuch’s dystrophy causes vision to be poor in the morning on arising, then improving as the day goes along.

People typically begin to experience the condition in their 60s or 70s. It can be treated by a cornea specialist with ointments, eye drops and surgery.

Drooping eyelids

As people reach their 70s or 80s, their eyelid skin may begin to droop over their eyelashes and interfere with vision, usually peripheral vision at first. Eyelids beneath the eye may also begin to sag.

Both conditions are easily fixed with outpatient surgery.

Age-related dry macular degeneration (AMD)

This condition occurs when a part of the retina known as the macula begins to thin with age and to develop clumps of protein. AMD doesn’t create total blindness, but it does result in the loss of essential central vision, which we need for basic functions, such as seeing facial expressions, driving, reading, cooking or fixing things around the house.

AMD tends to run in families. The first signs begin to appear when people are in their 60s, although vision may not be seriously compromised until age 70 or older.

There is no approved treatment. However, reducing sun exposure and eating a diet rich in fruits and vegetables — particularly dark leafy greens — may help prevent or control it. Special supplements available over the counter also help control AMD.

How to keep your eyesight strong

The National Institute on Aging offers the following tips to maintain healthy eyes:

Regular eye exams are also important to catch problems before they can develop into something more serious.

The bottom line, says Mehta: “Eat right, exercise, drink lots of water, and don’t smoke. Also, see your eye doctor every two or three years, and once a year when you hit your 50s.”

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