60's + Eyes

You might not realise that other health issues can affect the strength of your vision as well. In particular, diabetes and high blood pressure can lead to vision problems – especially if these conditions are allowed to continue without treatment. When you see your optometrist, list all of your current health issues and your family history of illness. The more your eye care professional knows, the more they can help protect your eye sight for years to come.

Long-term Eye Health is also maintained by exercise, diet, and rest^1-2^. Exercise improves blood circulation, which improves oxygen levels to the eyes and removes toxins. Make sure you are eating foods rich in antioxidants and getting enough rest. Studies have shown that antioxidant minerals and other vitamins may help combat free radicals, and slow or prevent related diseases. Free radicals are unstable molecules – unchecked, they can damage cells in the eye, which may lead to serious vision problems, such as cataracts and Age-related Macular Degeneration (AMD).

As we age, eye exams become even more important. Vision problems may develop with no physical symptoms until they’re quite advanced.

When you see your optometrist, make sure you talk about your current concerns, health issues and your family history. The more your eye care professional knows, the better protected you’ll be against potentially debilitating vision loss.
Then, your optometrist will conduct tests to check for:

• Vision - The optometrist can check for short-sightedness (myopia), long-sightedness (hyperopia), astigmatism and presbyopia. While you look at an eye chart, the optometrist will assess your vision for long distance and reading, and, if necessary, determine a prescription for corrective lenses.
• Coordination of eye muscles - The optometrist will assess how well your eyes work together by asking to you to look at different objects while they cover and uncover your eyes.
• Visual fields test - The optometrist will use a piece of equipment called the visual field screener to assess the full horizontal and vertical range and sensitivity of your vision, which can be a good indicator to the health of your visual system.
• Pupil response to light - the optometrist will shine a light in your eyes and watch the pupil's reaction. The health of the front and the back of your eyes - The optometrist will use either a handheld torch called an ophthalmoscope or a table-mounted microscope called a slit lamp to look for any abnormalities.
• Measurement of eye pressure - the optometrist will release a puff of air onto your eye using an instrument called a tonometer.  This tests the pressure inside the eye, an early indicator of glaucoma. 

What can I do to self-monitor my vision between professional visits?

One way to self-monitor between professional visits is by looking at an Amsler grid. This is a pattern that resembles a checkerboard with a dot in the centre. While staring at the dot, you may notice that the straight lines in the pattern appear wavy. Or you may notice that some of the lines are missing. Print and take the quick vision test using the Amsler grid (PDF). By looking at an Amsler grid regularly you can monitor any sudden changes in your vision. If you do notice any changes, contact your optometrist right away.

Here's how:

1. Do the test with each eye separately by covering the eye that’s not being tested.
2. Hold the test grid directly in front of you, about 14 inches from your face, and look at the dot in the centre of the grid, not at the lines.
3. While looking at the dot, all the lines, both vertical and horizontal, should appear straight and unbroken.
4. If any of the straight lines appear wavy, or you notice that some of the lines seem to be missing, note their location on the grid for future reference.

Remember, this test is not meant to replace your regularly scheduled eye examinations. The best way to detect and monitor for conditions affecting the macula is for your eye care professional to use special instruments to examine the back of the eye.

Many eye diseases have no early symptoms. They may be painless, and you may see no change in your vision until the disease has become quite advanced. Only your eye care professional will be able to tell if you have an eye condition and options to care for your eyes.

What should I look for?

If you are experiencing an unusual vision symptom, see your eye care professional immediately. Here are some clues to help you determine what may be happening to your eyes.

• Cloudy vision

If you’re having trouble reading and watching television, and driving at night has become uncomfortable because of the glare of oncoming headlights, you may have cataracts^3^.  Almost all of us will develop cataracts as we age, because the lens within your eye becomes more opaque as we get older. Luckily, cataracts have become a "normal" problem to rectify. In an outpatient procedure, your ophthalmologist can replace your eye’s lens with an artificial lens, called an intraocular lens (IOL), resulting in a dramatic restoration of your sight.

• Loss of peripheral vision

Abnormally high pressure inside your eye can lead to glaucoma^4^ – and it often has no symptoms until damage to your vision has begun. It may seem that you don’t have the side-to-side vision you’re used to, producing an experience called “tunnel vision.” Early detection, treatment and management can save your vision.

• Blurred images and dull colours

When reading the newspaper or street signs takes a major effort, and colours have lost their intensity, you may have the early warning signs of eye conditions that affect the macula. The macula, the part of your retina that’s responsible for central vision, deteriorates to the point where it may create a blind spot in the middle of your field of vision^5^. AMD’s progress is often slow but it’s the leading cause of blindness in people over 65. Some cases can be treated with surgery, but the more prevalent form of macular degeneration is currently untreatable. In an important clinical study, people with intermediate to advance AMD at high risk for more advanced stages of AMD lowered their risk by about 25% when treated with a high dose combination of vitamin C, vitamin E, beta-carotene, and zinc. 

Bausch + Lomb provided the high-potency, antioxidant vitamin and zinc supplement evaluated in the National Eye Institute's Age-Related Eye Disease Study (AREDS).

• Floating spots and flashes of light

It’s normal to see the occasional floating black speck or even a pinpoint flash of light in your eye^6^. The vitreous, or gel-like part of your eye that maintains the shape of your eyeball, sometimes contains cells and bits of fibre that seem to float between the retina and the lens of our eyes. If you experience a sudden increase in the number of floaters or notice that existing floaters have become more noticeable, and if they’re accompanied by bright, flashes of light and/or a curtain or shadow at the edge of your vision, this may be a warning sign of impending retinal detachment – a tear between the vitreous part of the eye and the retina. If left untreated, this tear can expand and lead to a serious loss of vision. See your eye care professional immediately if you experience any of these symptoms.

• Diabetes and Your Eyes

High blood sugar and hypertension (high blood pressure) can damage the tiny blood vessels within your retina^7^. If you have type 1 or type 2 diabetes, tell your optometrist – and have your eyes examined every year to watch for a complication called diabetic retinopathy. This painless condition has no symptoms until it becomes serious, but it can be controlled and treated – and its progress can be slowed significantly if it’s found before you experience vision loss.

• Low Vision

Many people over 65 have some loss of sight beyond the normal, age-related vision correction issues like presbyopia or cataracts. For example, glaucoma can cause a permanent loss of peripheral vision^4^, and macular degeneration can block a portion of your field of vision in one or both eyes^5^. This state of your eyesight is known as low vision^8^, a condition that can’t be corrected with glasses, contact lenses or surgery.

Although low vision is untreatable, there are many products available to help people who have it perform everyday tasks – including magnifiers, large-text reading materials, and more. Plus, there are certain eye care professionals who specialise in rehabilitation for low vision, who can help you continue many of your normal activities with some modifications though some of the following links:

http://www.rnib.org.uk/
https://actionforblindpeople.org.uk
https://www.sense.org.uk

Your low vision specialist will begin by evaluating your specific case, asking you about the activities you’re having trouble performing on a daily basis. Testing will help to determine exactly what types of devices and aids are helpful to you: spectacles, magnifiers, telescopes, reading stands, lamps, and others.They will then help you plan a rehabilitation program possibly involving an occupational therapist and other health care professionals as needed, so that you may resume your independent life within your condition’s limitations.

A regular eye exam is the best way to protect your eyesight – and an easy precaution to take. Another way to safeguard your vision is through proper eye nutrition.

Nutrition is a key component of eye health?

As part of an eye-healthy diet, choose foods rich in antioxidants, like vitamins A and C, such as dark leafy, green vegetables and fish^9^. An inadequate intake of antioxidants, as well as over consumption of alcohol and saturated fats may create free-radical reactions that can harm the macula. High-fat diets can also cause deposits that constrict blood flow in the arteries. The eyes are especially sensitive to this, given the small size of the blood vessels that feed them.

What if diet just isn’t enough?

Studies indicate that proper nutrition is important to maintaining eye health. As we age, our eyes may not get enough nutrition through diet alone.

Does smoking affect the eyes too?

Smoking exposes your eyes to high levels of oxidative stress and it is a known risk factor for developing AMD, with smokers up to four times more likely of developing AMD than non-smokers^11^. To help you quit, visit the NHS smoking cessation website https://www.nhs.uk/smokefree

Exercise

Exercise is important because it improves blood circulation, which, in turn, improves oxygen levels to the eyes and the removal of toxins and may help protect the retina^10^.

Wear Sunglasses

Being outdoors in the sun can feel wonderful – but it can be tough on your eyes. Fortunately, there's an easy solution: sunglasses. Be sure to choose a pair that can block harmful ultraviolet (UV) rays. Also, a hat with a wide brim will reduce the amount of UV radiation exposure from above or around the periphery of your sunglass lenses.

At the Computer

After two hours of staring at a computer screen, you can end up with the same kind of repetitive stress in your eye muscles that a keyboard causes in your wrists. Here are a few tips to help reduce the impact of computer eyestrain:

• Keep your computer screen within 50-60cm of your eyes
• Keep the top of your computer screen slightly below eye level
• Minimise the distance between your computer screen and any documents you need to reference while working
• Adjust lighting to minimize glare on the screen
• Use the 20-20-20 rule and take a break every 20 minutes to focus on an object over 20 feet away for 20 seconds
• Blink frequently to restabilise your tear film

Eye Injuries

If your eye is injured, you should always get immediate, professional medical attention. It’s simply the best way to safeguard your vision.  Here are some symptoms that may signal a serious eye injury:

• Obvious pain or vision problems
• Cut or torn eyelid
• One eye that does not move as completely as the other
• One eye that protrudes more than the other
• Abnormal pupil size or shape
• Blood in the white of the eye
• Something imbedded in the eye
• Something under the eyelid that cannot be easily removed

Just about everyone over age 60 needs some sort of vision correction. It’s just a normal, natural part of aging. The good news? You have several options to maintain your 20/20 vision for years to come.

Many seniors have presbyopia, which is the inability to see clearly at near distances, like when reading. To correct your vision to 20/20, you’re probably familiar with bifocal or multifocal spectacles. But you may not be aware that contact lenses can correct presbyopia as well.  Multi-focal contact lenses can correct presbyopia so you can see comfortably up close and at a distance.

Magnifiers and Vision Accessories

Reading the newspaper, doing embroidery, building models, and seeing the numbers on small technical instruments can become challenging as we age. Brighter lighting can help with close-up work, but sometimes you need additional help.
Magnifying glasses bring fine print and needlework into focus, and they come in many sizes to help you match the level of magnification you need with the task in front of you.