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The Ageing Eye

Scientific Diagram - Cutaway of the human eye with labelsSight can be snatched away by a variety of assaults as we age. Three such threats are cataracts, glaucoma and macular degeneration. If you are older than 50, you are at risk and must be vigilant, because age is the main risk factor for these diseases.

Half the population between 65 and 74 has cataracts; after age 75, about 70 percent do. And glaucoma is most common in people over 60.

So as you grow older, grow wiser too. Learn what steps you can take to prevent vision problems and what to do about them.

For many of us, less severe sight ailments begin around age 40 with the onset of presbyopia. Not to worry, it doesn’t signify a disease; it’s simply the inability to focus on objects up close, and it’s readily corrected with a pair of 99-baht reading glasses (surgery to extend arm length is a less appealing option).

Other age-related vision changes, however, usually are diseases that do require medical intervention. The most common of these is cataracts. Most retired expats have various stages of cataracts, a condition readily corrected through surgery. For most, there is no urgency; cataracts usually progress slowly.

Eye diseases that are not so benign in older folk include glaucoma and macular degeneration.

The good news is that you can forestall sight deterioration and reduce the risk of eye diseases through healthy lifestyle--including diet, exercise, avoiding bright sunlight, and not smoking.

Equally important is the need for periodic eye exams. In general, healthy people in their 20s and 30s who have no vision problems should see an ophthalmologist every five to 10 years. Between the ages of 40 and 65, get an exam every two to four years, and after age 65 about every year or two. If you wear glasses, have a family history of eye disease, or have a chronic ailment that puts you at greater risk of eye disease, such as diabetes, have your eyes checked more frequently.

For a closer look (no pun intended) at some common eye conditions, let’s begin with presbyopia, which is simply difficulty focusing on objects up close. This is due to hardening of the lens inside your eye, which routinely accompanies aging.

For a time, you can compensate for this change by just holding reading material farther away from your eyes, but eventually you will need reading glasses, multifocal contact lenses or multifocal eyeglasses. Some corrective surgery options for presbyopia also are available, such as laser eye surgery (LASIK) and conductive keratoplasty. Presbyopia generally worsens with advancing years. You may notice the need for more frequent changes in eyeglass or contact lens prescriptions, and that you need one pair of eyeglasses for reading a book and another for computer work, for example.

More serious is cataracts--the clouding of the normally clear lens of the eye, as if you were looking through frosted glass. It typically develops gradually over a period of years. Roughly half of all 65-year-olds have some degree of cataract formation; the percentage is even higher among those in their 70s.

While modern cataract surgery is safe and effective (100 percent of vision lost to cataract formation usually is restored), there is no urgency to undergo surgery immediately upon being diagnosed with the condition. On the other hand, it is better to have cataracts removed before they advance too far.

Cataract surgery involves removing the lens of the eye and replacing it with a plastic lens. However, some individuals are not bothered too much by their cataracts and are able to manage by changing eyeglass prescriptions and protecting their eyes from too much sunlight; exposure to sun speeds up the growth of cataracts, particularly problematic here in the tropics. So wear sunglasses that protect the eyes from UV light, which also helps prevent glaucoma, macular degeneration, and eye cancer (not to mention crow’s feet).

In contrast, it’s imperative that glaucoma be diagnosed and treated early. The disease causes the loss of peripheral (side) vision due to optic nerve damage usually associated with intense pressure on the eye itself. Your risk of developing glaucoma, a leading cause of blindness, increases with each decade after age 40, from around 1 percent in your 40s to up to 12 percent in your 80s. To prevent total blindness it is important to diagnose glaucoma early through regular exams by an eye doctor.

The damage caused by glaucoma is permanent, but treatments are available to prevent further vision loss. The most common treatment is daily use of eye-drops to lower eye pressure. In some cases, laser and conventional surgery are also options.

Perhaps the most serious and perilous of all eye diseases is age-related macular degeneration (AMD)--the leading cause of irreversible vision loss among the elderly. It begins with the slow loss of central vision and ultimately can lead to the inability to read, drive or recognize familiar faces.

The health of the macula (an oval spot in the center of the retina that's essential for central vision) depends on a very rich blood supply; anything that interferes with circulation can cause damage to the macula and decrease its ability to function.

Unhealthy diet and lifestyle choices can reduce the supply of oxygen and vital nutrients to the eye, eventually leading to the death of cells in the retina and macula. To help prevent macular degeneration and other vision problems, it is vital that you quit smoking, cut back on sugar, white flour, fried foods, and trans-fats, and load up on antioxidants such as vitamin C, vitamin E and lutein. Particularly, eat lots of dark, leafy green vegetables most days, take vitamins, eat fish, take omega-3 supplements, exercise daily, maintain a healthy weight, eat fruit and nuts every day, reduce intake of refined carbohydrates, and control blood pressure and cholesterol.

Such lifestyle guidelines are appropriate for everyone and even more so for older readers. Once again, have your eyes examined by a qualified eye doctor. And if you can’t quit smoking, have your head examined.