Eye Diseases of the Elderly

Eye Diseases of the Elderly
Although eyesight deteriorates with age, most people don’t bother to have their eyes checked until their symptoms have become so severe that they can no longer be cured.  In this post, we will introduce the most common eye diseases affecting the elderly and provide some useful advice on taking care of your eyes and protecting your long-term vision.

Dry Eyes

Dry eye syndrome is a common condition caused by aging, hormonal changes, and certain diseases such as diabetes, rheumatoid arthritis and thyroid abnormalities.  Dry eye can also occur in patients who have undergone LASIK treatment and people who have been wearing contact lenses for more than ten years.  Some medicines such as antihistamines and antihypertensives may also cause dry eye syndrome.   

Symptoms

Symptoms of dry eye syndrome include irritation, grittiness, red eyes and itchiness. When they eyes become irritated, a signal is sent through the nervous system to the brain, which responds by flooding the eyes with tears to lubricate them.  

Treatment and Prevention

There are various simple steps you can take to protect your eyes, such as blinking constantly when reading a book or working on a computer for a long time, using protective eyewear, and avoiding dust and smoke. Another option is to use artificial tears, which come in two types.  Eye drops with preservatives are good for patients with mild dry eyes, while preservative-free eye drops provide relief for frequent users.
 
If the artificial tears don’t solve the problem, the doctor may insert plugs into the tear ducts to prevent excessive drainage of tears.  Temporary plugs are used in mild cases, while the tear ducts can be closed permanently if the problem is more severe.  
 

Cataracts

A cataract is when the lens inside the eye becomes cloudy, blocking light from entering the retina and impairing vision.  Cataracts can be caused as part of the normal aging processes or by other risk factors such as diabetes.  

Symptoms

The symptoms of cataracts include poorer overall vision, a faded perception of colors, double vision, and sensitivity to light. 

Treatment

Cataracts are treated by surgically removing the cloudy lens and replacing it with an artificial lens.  The most commonly used method of removing the cataract is ultrasound treatment, which doesn’t usually require stitches and results in a quick recovery time.  In some cases, however, it’s necessary to make an incision to remove the cataract and replace it with the artificial lens, resulting in a longer recovery period. 
 

Glaucoma

Glaucoma is a usually very gradual loss of vision caused by damage to the optic nerve mostly resulting from increased fluid pressure in the eyes. High risk factors include a family history of glaucoma, age (over 40 years), underlying diseases such as diabetes, and steroids. If you’re taking steroid eye drops, it’s important to use them exactly as and when prescribed by your doctor to reduce the risk of glaucoma.

Symptoms

Most people aren’t unaware that they have glaucoma because it develops very gradually, starting with the peripheral vision and spreading slowly to the central vision.  Some patients suffer mild eye pain but because this disappears in response to medication, they ignore it.  A sharp rise in fluid pressure in the eye may lead to severe headache, red eyes, vomiting, and the appearance of haloes around lights.  However, it is more common to experience a gradual increase in eye pressure which is more difficult to notice.
 

Treatment

Eye drops are used to help drain fluid from the eyes.  In certain cases, the doctor may use laser surgery for patients who have severe symptoms or who do not respond to medication.  If glaucoma is detected at an early stage, treatment can prevent further vision loss, but it cannot restore vision already lost so it’s important to have your eyes checked regularly.
 

Age-related Macular Degeneration

Age-related Macular Degeneration (AMD) causes the center of the retina to deteriorate, resulting in impaired vision. There are two main types of AMD – dry and wet.  Dry AMD is the more common and results in a gradual loss of central (but not peripheral) vision.  Wet AMD is less common, but more aggressive.  It occurs when the retina deteriorates and abnormal blood vessels start to grow beneath it.  This causes swelling and hemorrhaging, resulting in acute loss of vision.
Factors that may increase the risk of AMD include age, prolonged exposure to the sun, smoking, obesity, high blood pressure and a family history of the condition. AMD also tends to be more common in women than in men.

Symptoms

Symptoms of Dry AMD include a blind spot in the center of the field of vision, visual distortion, and difficulty reading.  Symptoms of Wet AMD include an abrupt onset of the loss of vision. 

Treatment

There is no cure for AMD, but it can be slowed down and even prevented from causing more damage. Lasers can be used to destroy abnormal blood vessels, while injections are commonly used to block the development of abnormal blood vessels.  The injections can help reduce vision loss and some patients have actually regained vision that was lost.  
 

Diabetic Retinopathy

Although diabetic retinopathy is not directly associated with aging, it is a common problem in people with diabetes and the risk of catching diabetes is something that increases with age.    

Symptoms

Often there are no symptoms, although some patients may have blurred vision, visual distortion in the center of the field of vision, or dark shadows across their vision.  People with diabetes who develop glaucoma may also experience some eye pain.    

Treatment

Laser or injection are the most likely treatments for patients with retinal swelling, while patients with retinal detachment and hemorrhaging may require surgery. 
 
Even if your eyes seem normal, you should still have them checked by an ophthalmologist regularly as you become older.  Start by closing one eye and then the other to check for indicators of eye problems such as straight lines that appear curved or wavy, or shadows moving across the field of vision. If you find any abnormality, please see an ophthalmologist immediately so that the condition can be treated before it’s too late. Also, try to reduce any lifestyle-related risks, such as smoking, and look at ways to control your weight by eating healthily and engaging in moderate physical activities on a regular basis. By following this simple but effective advice, you can keep your eyes healthy and maintain good vision as you grow older.
 
Compiled by Dr. Maytinee Sirimaharaj, Ophthalmologist, Eye Center, Bumrungrad International Hospital
 
Posted by Bumrungrad International