Vision & Eye Diseases

Number of people affected:
15 million or more

Who gets it:
Seniors over age 60

Symptoms:
Changes in vision, peripheral (side) vision, cloudy vision, vision failure

Treatments:
Eye drops, medication, surgery

Doctors to see:
Ophthalmologist

There are four major age-related eye diseases (AREDs) — glaucoma, cataracts, age-related macular degeneration and diabetic retinopathy that affect seniors.

Glaucoma - Glaucoma damages the eye's optic nerve and results in vision loss and blindness. Sometimes, there are no initial symptoms, so as many as 1 million people may have glaucoma and do not know they have it. It is one of the main causes of blindness in the United States.

Cataracts - A cataract is a clouding of the lens within the eye. The lens is composed of water and protein. If the protein clumps together, it starts to cloud over a small area of the lens. This cloudy mass of protein — called a cataract — can grow larger, making it hard to see. If the cataract worsens, surgery may be necessary to remove the cloudy lens and replace it with a new lens.

Macular Degeneration - Macular Degeneration (MD) diminishes sight in a dramatic way: It affects the central vision. Although people with MD rarely go blind because of it, many find it difficult to read, drive and perform other daily functions. The macula is located in the center of the retina, which is the light-sensitive layer of tissue at the back of the eye. Deterioration of the macula results in eye disease.

Diabetic Retinopathy - This potentially blinding disorder is a complication of diabetes. Diabetes causes abnormal changes in the retina’s blood vessels. Blood vessels can become leaky and begin to grow where they should not. These new vessels tend to break and bleed, or hemorrhage. As they try to heal, these blood vessels will contract and detach the retina.

Glaucoma - At first, Glaucoma has no symptoms. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing.

Cataracts - People with cataracts begin to complain about glare and cloudy/fuzzy vision, double vision in one eye, or glare from lamps and the sun.

Macular Degeneration – MD affects central vision. People with MD find it difficult to read, drive and perform other daily functions that require central vision.

Diabetic Retinopathy - Symptoms include shadows or dark objects that "float" across your field of vision, blurred or distorted vision, partial loss of vision and pain in the eye.

Age-related eye diseases are diagnosed through a comprehensive eye exam, performed by an ophthalmologist. A comprehensive eye exam should include at least the following three tests:

• Visual acuity test: The familiar eye chart measures how well you see at various distances.
• Pupil dilation: Drops are placed into the eye to widen the pupil. This reveals more of the retina and other signs of disease. After the examination, close-up vision may remain blurred for several hours.
• Tonometry: A standard test that determines the fluid pressure inside the eye. There are many types of tonometry. One uses a purple light to measure pressure; another, an "air puff," test, which measures the resistance of the eye to a puff of air.

Treatments include:

Glaucoma - There are many different types of medications (in eye drops or pills) that are used to treat glaucoma. In some people, however, medications alone do not control the eye pressure, and surgery needs to be performed. One type of surgery uses a laser -- called trabeculoplasty -- to improve the flow of fluids out of the eye. This can be done in your doctor's office. There is also conventional surgery -- called trabeculectomy -- in which your doctor creates a new drainage path in the eye, under the eyelid.

Cataracts - Surgery is the only way to correct vision loss caused by cataracts.

Macular Degeneration - People with MD can be treated with laser surgery. Anti-angiogenesis drugs and low-vision devices are also useful.

Diabetic Retinopathy - There is no cure for diabetic retinopathy. However, laser treatment (photocoagulation) is usually very effective at preventing vision loss if it is done before the retina has been severely damaged. Surgical removal of the vitreous gel (vitrectomy) may also help improve vision if the retina has not been severely damaged.

Glaucoma – People aged 50 and older, and African Americans aged 40 and over are at greatest risk. Other risk factors include: family history of glaucoma, taking steroid medications and being near-sighted.

Cataracts - Getting older is a major risk factor for cataracts. Women are at slightly higher risk than men for cataracts, and people with a family history of cataracts are more likely to have cataracts.

Macular Degeneration - Age is the biggest risk factor for developing MD. After age 75, up to 46% of people may have some form of it. Family history, race (whites appear to have a higher risk than blacks or Hispanics) and smoking are other risk factors.

Diabetic Retinopathy - Consistently high blood sugar and high blood pressure are associated with retinopathy. If your loved one has type 2 diabetes and uses the medicine rosiglitazone (Avandia, Avandamet, Avandaryl) to treat your diabetes, you may have a higher risk for problems.

For those with an age-related eye disease, there are several things caregivers can do to improve quality of life for their loved one:

• Make sure your loved one takes all medications, as prescribed by the doctor
• Check lighting in the home and ensure the space is adequately lit
• Keep eyeglass or contact lens prescriptions up-to-date and have regular eye exams
• Adjust carpets and furniture to avoid potential hazards
• Take advantage of low-vision aids and adaptive technologies such as video enlargement systems, large print items and speech software for computer systems, which can help people with impaired vision make the best use of their remaining vision

For those with macular degeneration - Check the vision in each eye using an Amsler grid every day or as often as the doctor recommends. If any of the lines on the grid change or begin to appear wavy and curved, or if you notice that your vision is getting worse, call your doctor.

For Diabetic Retinopathy, make sure your loved one keeps his or her blood sugar levels near normal.