Common Age-Related Eye Diseases
By the age of 65 years, most of the elderly have some form of vision impairment due to four major eye-related diseases – glaucoma, cataracts, age-related macular degeneration or diabetic retinopathy.
Cataract is clouding of the lens inside the eyes. The lens is composed of water and proteins. When the protein arrangement gets disturbed cataract tends to develop. The initial symptom is difficulty in night vision and glare when viewing lights in the night. Cloudy vision or double vision can also be present. Eventually, the distance vision and near vision are also affected, and the patient cannot see well at all. The only way to correct this is by surgery.
Surgery for cataract is technically advanced and phaco-emulsification of the lens is performed using ultrasound energy. All surgeries are performed through small 2.2 or 2.8mm incisions and no sutures are needed at the end of surgery. Surgery is a day care procedure and the patient can get discharged with an hour or so. The surgery is performed under topical anesthesia which is using drops to numb the eye. The visual needs of the patient can be matched by inserting the intraocular lens at the time of surgery. The lenses can be monofocal when one needs glasses at least for near work or multifocal when the patient can see both distance and near clearly. Newer lenses are now available to neutralize astigmatism. The advanced lenses can reduce the spherical and the chromatic aberrations and improve night vision and contrast. In addition, the most recent advances are an an extended range of vision lenses and accommodating lenses which mimic the natural eye closely. What is most heartening is that cataract surgery is the safest surgery amongst all surgeries on the human body.
At first, glaucoma has no symptoms. However, as the disease progresses, a person with glaucoma may notice his or her side vision gradually failing. Glaucoma is a disease of the optic nerve which is also called as the silent thief of sight as it silently damages the eyesight. Progressive damage to the nerve fibers of the retina leads to loss of both the field of vision and the visual acuity. Early detection is a must and eye examination of all above the age of 40 years is recommended especially the first-degree relatives of people affected by glaucoma. The causes could be drainage issues in the trabecular meshwork or it could be due to narrow angles or trauma or post inflammatory. The most common types are open angle and closed angle. The risk factors include race – African or Asian, prolonged steroid use, a relative with glaucoma, age over 40 years, having high myopia or hypermetropia.
Early detection can be done only by regular eye check up with visualization of the optic nerve cup and checking the intraocular pressures, in case of any concerns it is best to perform a visual field examination. Treatment includes close monitoring and periodic review, use of drops to control the pressures, surgeries like trabeculectomy, newer trabeculoplasty lasers, and glaucoma drainage devices.
Every elderly person should have a comprehensive eye examination performed by an ophthalmologist including checking the visual acuity, intraocular pressures, and a dilated eye examination.
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