Ageing and the eye

Our eyesight gets worse as we get older. This is an unfortunate fact of life for all people over the age of about 40.

In this article we will tell you about some of the most common causes of vision loss in older people.

The most important point is that there is treatment available for all these conditions. So it’s really important that older people get their eyes checked regularly. Especially because if vision loss occurs slowly, many people will not notice for a long time.

What are some of the signs of visual loss in older people?

  • Difficulty with close work e.g. reading or sewing
  • Falling over
  • Bad mood
  • Bumping into objects
  • Headaches
  • Not recognizing people

PRESBYOPIA

Over the age of 45, all people will develop something called presbyopia. This means that the eye becomes worse at focussing on near objects. It causes difficulty with close work, for example reading and sewing. Presbyopia is a part of normal ageing, but affects some people more than others. The treatment very simple: a pair of eye glasses which can be worn when doing close work.

CATARACTS

A cataract is when the lens at the front of the eye becomes cloudy. In Africa, around 60% of blind people are blind because of cataracts. It is the most common cause of blindness in the world.

Risk factors for cataracts include: older age, diabetes, smoking, and sunlight. Ageing is the most common cause of cataracts. However cataracts can also occur in new born children. This is called congenital cataract.

Cataracts cause a decrease in vision. Over time vision gets worse and worse. Symptoms include: blurry vision, seeing halos around lights, and difficulty seeing especially at night.

But the good news is cataracts can be treated!

In the early stages, eye glasses can correct the visual loss. Later on, a simple and cheap operation can cure cataracts. An eye surgeon removes the cloudy lens and replaces it with a new one. This can be performed at any time – it is never too late. Once the cloudy lens is replaced, the patient can see normally again.

GLAUCOMA

Glaucoma is the commonest cause of irreversible blindness in the world. In this disease there is damage to the optic nerve, which takes messages from the eye to the brain. The pressure inside the eye is often high in glaucoma.

There are two main types of glaucoma:

Acute angle closure glaucoma: this occurs when pressure inside the eye rises very quickly. Symptoms start very suddenly, e.g.:

  • Sudden headache and painful, very red eyes
  • Nausea and vomiting
  • Decreased vision and seeing halos around lights

Primary open angle glaucoma: this is the most common type of glaucoma. It develops slowly over many years. It is caused by the drainage channels in the eye becoming gradually blocked over time.

In the early stages of the disease there are no symptoms. Over time visual acuity decreases, and people develop ‘tunnel vision’. This means they lose the ability to see around the edges of their vision, although central vision remains o.k. until the late stages of the disease.

Primary open angle glaucoma is more common among people with African heritage. Other risk factors include: high blood pressure, being short-sighted (myopia) anddiabetes.

Glaucoma can be treated with eye drops, and sometimes surgery. However it is not possible to reverse any damage that has been caused. The treatment can only prevent vision getting worse. Often people with primacy open angle glaucoma do not know they have it, as their vision gets worse slowly. Therefore it is very important to check your eyes regularly, especially for older people.

DIABETES

Having diabetes greatly increases your risk of developing eye diseases which can cause vision loss and blindness.

Diabetes makes you much more likely to develop cataracts and glaucoma. It can also cause a disease called diabetic retinopathy. In diabetic retinopathy the blood vessels which supply the eye are damaged, and this causes damage to the eye. Diabetic retinopathy often does not cause any symptoms for a long time, and then suddenly causes irreversible visual loss. However there is treatment that can stop this happening. That’s why it’s so important for people with diabetes to have an eye examination by an eye doctor at least once a year.

So, in summary: get your eyes checked!

This article is part of Eye Health Week at Right for Education.

DR. ELIZABETH BROWN

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