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The National Eye Institute (NEI) reports that as of the most recent census, 3.3 million Americans aged 40 or older are blind or have moderate to severe vision impairment (low vision). If no changes to eye care are made, the NEI predicts that the number of visually impaired people could be as high as 5.5 million by the year 2020 — a whopping 60% increase largely due to our aging population. Visual impairment and blindness are most often caused by one or a combination of several eye diseases and conditions. The NEI cites the following as the most prevalent eye diseases and conditions:
Age-Related Macular Degeneration (AMD). Age-Related Macular Degeneration (AMD) is the leading cause of permanent impairment of reading and fine or close-up vision among people aged 65 years and older, according to theCenters for Disease Control (CDC). The CDC estimates that 1.8 million Americans aged 40 years and older are affected by Age-Related Macular Degeneration (AMD). Another 7.3 million who have large deposits in the retina called drusen are at increased risk of developing AMD. By 2020, due to our aging populations, the number of Americans with AMD is predicted reach an estimated 2.95 million.
AMD occurs when the macula, an area of the retina that allows you to have detailed central vision, breaks down. It does not affect peripheral vision, which is the ability to see general shapes “out of the corner of your eye” even when you’re looking straight ahead. There are two main types of AMD:
Cataracts. A cataract is a clouding of the lens of the eye that causes the lens to lose its ability to properly focus light, resulting in blurry vision. The CDC reports that an estimated 20.5 million (17.2%) Americans aged 40 years and older have a cataract in one or both eyes. Beyond that, 6.1 million (5.1%) have had their lenses removed surgically to eliminate cataracts. By 2020, the total number of Americans who have cataracts is estimated to jump to 30.1 million.
Diabetic Retinopathy. In diabetic retinopathy, uneven blood sugar levels interfere with circulatory function in the retina, causing small blood vessels to swell and rupture. This results in clouded retinal swelling and clouded vision. Diabetic retinopathyis the leading cause of blindness among Americans between the ages of 20 and 74 years. The CDC reports that an estimated 4.1 million people are affected by retinopathy and that an additional 899,000 patients have vision-threatening retinopathy.
Dry Eye. This condition happens if you don’t produce enough tears or a high enough quality of tears to keep your eyes hydrated. Dry eye is uncomfortable and can cause vision to be impaired and interfere with activities of daily living.
Glaucoma. This condition accounts for about one in every eight cases one of blindness in the United States, yet it is treatable if it is caught early. In glaucoma, an excess of ocular (eye) fluid that doesn’t drain properly causes damage to the optic nerve, resulting in blurred vision, a narrowed field of vision with some loss of peripheral vision, and eventually total blindness.
The three main types of glaucoma are:
Retinal Detachment. The middle of the eye contains a gel called the vitreous that is connected to the retina. As we age, the vitreous sometimes shrinks and pulls on the retina. This pulling can result in a tear or partial detachment of the retina from the back of the eye. This is painless and results in seeing flashes or floaters, dark spots or shapes that intermittently appear in the line of vision. Retinal tears allow for fluids to seep through torn areas and peel the retina away from the back of the eye, sometimes detaching it entirely, resulting in severe loss of vision or blindness.
In addition to the diseases and conditions cited by the NEI, there are several eye conditions that are less severe, but affect a large amount of people each day.
Early detection of these most common eye diseases and conditions, especially those that are age-related, gives patients much higher chances of retaining their vision.
Age-Related Macular Degeneration (AMD] )
If blood sugar (glucose) levels are too high for stretches of time, the capillaries (small blood vessels) that supply blood to the retina can be damaged. After a while, the capillaries start leaking fluids and fats. This in turn causes edema or swelling in the eyes. A condition called ischemia, in which the capillaries close off completely, can also occur.
Dry Eye (keratoconjunctivitis sicca)
The hormonal changes that come with menopause are the most common cause of this condition, which is why women are affected far more often than men.
Open Angle and Normal Tension – These forms are often idiopathic, meaning that there is no known cause, but some causal factors may include
Age-Related Macular Degeneration (AMD)
Open Angle and Normal Tension
If you or your doctor notice changes in your vision that suggest an eye disease or condition, you may be referred to an ophthalmologist (medical doctor specializing in the eye) for diagnosis. Below are the leading methods of diagnosis for eye diseases and conditions:
The National Eye Institute along with other respected sources warns that regular eye exams are crucial, especially for older adults, because vision-robbing eye conditions most often have no symptoms until damage has already been down.
The symptoms for different eye conditions and diseases vary and can be hard to detect, so be sure to get regular eye exams, especially if you are an older adult. Many eye conditions and diseases do not show symptoms until damage has been done, so it is important to be attentive to your symptoms and get treatment as they arise.
The following are symptoms that you may experience:
In many cases, depending on the eye disease or condition you have and your response to treatment, your vision may not be not noticeably impaired and you won’t experience any pain or only mild discomfort.
However, you may need to compensate for partial loss of vision if you have a condition such as wet AMD that can’t be treated. Ask your eye care specialist about low-vision rehabilitation devices and services that will help you learn coping strategies so that you can to continue to live independently.
Many people with some vision loss have to stop driving. If that happens to you, visit SeniorDrivingAAA.comto get information about affordable and convenient ways to maintain your mobility.
Here are some top tips for living well with vision impairment:
Serious eye diseases and conditions often have no symptoms until irreversible damage to vision has been done. If you wear prescription glasses and/or contacts, you probably go to an optometrist for an annual check-up to make sure your prescription hasn’t changed and to order a new batch of contacts if you’re running out of them. Optometrists conduct vision tests to check for basic vision impairment, and can prescribe glasses and contact lenses. They can also spot early warning signs and give you a referral to an ophthalmologist, an eye doctor with a medical doctor degree, for a more thorough examination. If you do not wear contact lenses or glasses, chances are you miss out this periodic optometric screening. Many times, family doctors with conduct a visual acuity test, which is a series of letters decreasing in size on a chart that patients are asked to read to the best of their ability. This gives doctors the opportunity to do as the optometrists would.
The standard recommendation for all adults over the age of 40 is to have an eye exam at least every two years, and for adults over 65, to have an eye exam every year. According to the National Federation of the Blind, prompt detection and treatment can preserve your vision for a lifetime even if you do contract a serious eye condition or disorder. Schedule an eye exam with an optometrist. If he or she spots any problems that may be of concern, you will most likely be referred to an ophthalmologist, a medical doctor specializing in eyes, for further testing. Be sure to make an appointment with the ophthalmologist and follow recommendations regarding the frequency of follow-ups should any diseases or conditions be detected.
People with diabetes or at risk of developing gestational diabetes are recommended to get additional ophthalmic screening.
The American Academy of Ophthalmology recommends the eye screening schedule:
Medline Plus, a service of the National Library of Medicine, reminds us our best defense is to have regular checkups because eye diseases do not always have symptoms. Early detection and treatment are the keys to preventing vision loss.
Beyond that, a healthy diet that has sufficient vitamin and other nutrients will help keep your eyes lubricated and free of infections.
Also, avoid second hand smoke and if you smoke, kick the habit.
Protect your eyes from injury by wearing plastic eye guards if you’re involved in any activity that poses a risk of flying objects or particles.
Finally, remember that overexposure to the sun is just as bad for your eyes as it is for your skin. Wear sunglasses and stay away from tanning beds, as UV rays can be harmful and may exacerbate your vision issues.
Age-Related Macular Degeneration
Here is what was in the dietary supplement that was tested in the study:
• Vitamin C – 500 mg
• Vitamin E – 400 IU
• Lutein – 10 mg
• Zeaxanthin – 2 mg
• Zinc oxide – 80 mg
• Copper (as cupric oxide) – 2 mg (to prevent copper deficiency, which may be associated with taking high amounts of zinc. Another large study showed that taking folic acid and vitamins B6 and B12 benefited women with AMD.
Another large study showed that taking folic acid and vitamins B6 and B12 benefited women with AMD. But remember, however, that vitamin supplements don’t cure AMD or give you back any vision that has been lost.
Cataracts. If your vision is only slightly blurry, you may only need a change in the prescription for your glasses and/or contacts. However, if that doesn’t cause enough improvement, you may want to consider surgery. Waiting for the cataracts to “ripen” is no longer necessary and recovery is faster than it used to be.
The National Federation of the Blind reports that a great deal of progress has been made recently in the development of improved forms of cataract surgery, including use of freezing probes and ultrasonic devices that make removal of the lens possible through a small opening. An estimated 95% of patients regain useful sight.
Retinal Breaks and Detachment
Age-Related Macular Degeneration (AMD). The National Center for Complementary and Alternative Medicine (NCCAM) notes that a follow-up to the NIH Age-Related Eye Disease Study found the following results regarding proposed changes to a supplement containing high doses of vitamins C and E, beta carotene, and zincthat may delay the progression from dry AMD to wet AMD:
Cataracts. NCCAM reports that supplements of antioxidants (vitamins C and E and beta-carotene) do not prevent cataracts or slow their progression.
Diabetic Retinopathy. No dietary supplements have been shown to be helpful for diabetic retinopathy.
Retinal Detachment. No alternative treatments have been proven to be effective.
In addition to your regularly scheduled visits to your eye care professionals, get immediate medical attention if you notice any sudden change in your vision or experience unusual symptoms such as extreme eye pain, burning, itching, redness, or fluid coming out of your eye. Also, get help if you have an eye injury.
Before you visit your doctor, write down a list of questions and concerns. Consider bringing a friend or family member along who can help you make sure you get all the information you need. In addition, writing down the doctor’s answers and recommendation for later reference is a good idea. Also come prepared with your medical history, information about any allergies you have, your family medical history, and a complete list of all medications you take including over-the-counter herbs and supplements.
Here are some questions you might pose when you visit your optometrist:
Here are some questions you might pose if you are referred to an ophthalmologist:
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