Age-Related Eye Diseases

Senior citizens, 65 years or older, should have an ocular examination performed by an ophthalmologist every one to two years at a minimum, even without any existing risk factors.  More frequent examinations are warranted, even if no ocular symptoms are present, for any individual at higher risk for developing eye disease.  These risk factors may be based not only on ocular history but also  upon medical history such as diabetes mellitus, family history such as diabetes, or race in which certain conditions are much more prevalent.  Newly diagnosed diabetes mellitus is a common reason for a senior citizen to have baseline examination at the prompting of an endocrinologist.  Family history of eye diseases such as macular degeneration, cataracts, diabetic retinopathy, and glaucoma not only are more common in family members but increase in frequency with age.  After conducting a comprehensive medical and ophthalmic history including the use of medications, an ophthalmologist will be able to tell you if there is any significant ocular disease detected and the frequency of examinations that will be required depending upon your risk, the severity of the condition, and other factors.

While many seniors expect general attrition in their eye sight, it is not uncommon for ophthalmologist to see patients in their 90s who have excellent vision in both eyes.  Elderly patients frequently think that failing vision is normal. Minor changes in vision are normal, often do not pose significant risk for the vision and can easily be overcome.   Seniors may experience dimness of vision and require more light merely because their pupils do not dilate at dark or because of progressive cataract or other problem as simple as presbyopia.  It is important that seniors and their caregivers understand that proper eye care is a significant component of their overall health care.

Naturally-Aging Eyes

Naturally-aging eyes experience reduced contrast sensitivity, which may make it difficult to differentiate similar colors and patterns.  It is normal for them to experience some difficulty in adapting to changes in light and dark environments as well as glare.  Floaters usually occur when the vitreous gel in the eye liquefies in patients in their 50s and 60s resulting in tiny specks in the vision.  Depth perception and reduced ability to see colors are also common along with decreased tear production and dryness of the eyes.  These mild symptoms usually are not indicative of severe eye problems.

Serious Warning Signs

An ophthalmologist should immediately be contacted if there are severe and persistent symptoms that include:

• Loss of vision
• Sudden blurred or hazy vision
• Double vision
• Pain in or around the eye
• Seeing flashes of light in one or both eyes
• Halos around lights at night
• Painful or intense sensitivity to light
• Discharge or foreign body in the eye
• Changes in the color of the iris or clarity of the cornea or watch crystal
• New onset or sudden change in floaters or flashing lights
• Distortion or waviness of vision

The Unaware Patient: Check Each Eye Separately

Dr. James Maisel, who has practiced in Long Island as retina specialist for over twenty years as a retina specialist in Long Island, NY, recounts that “each spring I commonly have children bringing their snowbird parents into the office.  A typical story is that they were unaware that their eye symptom was potentially a problem until they arrive home.  The child immediately sought eye care.  The parent had already seen an optometrist and ophthalmologist and were now referred for retina care typically for macular degeneration, retinal detachment or  a retinovascular problem typically involving one eye.  Many patients come to the office and have poor or no vision in one eye and are unaware of it until the fellow eye is covered for the eye exam and the deficit is suddenly revealed.”  Seniors especially may take slow onset of decreased vision for granted and learn to accommodate for it.  This is commonly seen with cataracts that act as variant degrees of darker sunglasses in some cases. This problem can temporarily be overcome with bright lighting and the individual gets used to always being somewhat in partial darkness.