February is Age-related Macular Degeneration/Low Vision Awareness Month. Eye disorders and blindness don’t receive as much attention as they should. While not typically a threat to life, blindness and conditions that affect the vision can severely impact a person’s quality of life.
Problems with vision can occur at any time and we commonly associate many of those changes with advancing age. Advanced age is inevitable, but because of it we may be at higher risk for some eye diseases such as glaucoma, cataracts, macular degeneration and diabetic retinopathy being the most common. The only means of detection is through early recognition and treatment that generally begins with a comprehensive exam and dilation of the pupils.
Glaucoma is the second most common cause of blindness known, affecting more than 2 million Americans aged 40 and over. The front of the eye is filled with a fluid known as aqueous humor. When something slows or blocks the flow of this fluid, pressure builds up in the eye. That buildup and the increased pressure that results is known as glaucoma which can damage the optic nerve if left untreated.
Diagnosis is made by an ophthalmologist who will likely begin by dilating the pupils, allowing him or her to view the inside of the eye. Then a test known as tonometry may be performed to check eye pressure. Treatment will depend on the type (there are four) of glaucoma present. Some forms can be treated with eye drops or medication, while others may require laser therapy or surgery.
As prevention, all adults should have a complete eye examination prior to the age of 40, or sooner if there are known risk factors, a family history, or other eye concerns.
Cataracts can be compared with the cloudiness of looking through a dirty window or one covered with fog. Generally speaking, cataracts are slow-growing and may unknowingly be present for quite a period of time. However, they will eventually interfere with a person’s ability to see. Other than cloudiness, signs can include difficulty seeing at night, seeing halos around lights such as from oncoming automobiles while driving, light sensitivity, yellowing or fading of colors and double vision in one eye. As the cataract covers more and more of the lens of the eye, a person will have increased difficulties seeing. It is at this stage an ophthalmologist will likely make a determination to remove the growth. It is sometimes difficult for the average person to understand why a specialist may choose to wait when a known cataract is present; however, the benefits of repair must always outweigh the risks involved.
As with glaucoma, there are several forms to include those that affect the center, the edges or back of the lens. Some cataracts may be present at birth or develop during early childhood while others may develop following eye trauma, radiation therapy, or even surgery to correct other eye problems such as glaucoma. Each type will present with different symptoms.
Risk factors include exposure to harmful UV rays, obesity, a family history, advanced age, high blood pressure, diabetes, the extended use of corticosteroids, and the over-use of alcohol.
Macular degeneration can be categorized as either dry or wet. The dry form is most common and is a chronic disorder that causes a loss of vision in the center of the field of vision. While symptoms often develop slowly, some individuals may experience rapid deterioration of eyesight, have difficulty distinguishing faces, reading printed material, or driving an automobile. One or both eyes may be affected.
Risk factors include aging, being a cigarette smoker, obesity, having high cholesterol and eating a diet low in fruits and leafy green vegetables.
Testing is accomplished with an ophthalmologist examining the back of the eye to look for the formation of yellow deposits, through angiogram, or optical tomography.
Treatment might include modifying one’s diet to include fish high in omega-3 fatty acids, consuming whole grains as opposed to refined grains, and consuming antioxidants such as 500 mg of vitamin C, 400 IU of vitamin E, and 15 mg of vitamin A. Any regimen should be undertaken only with the guidance of a physician.
Dry macular degeneration can develop into the more severe wet form. While less common, it is characterized by inflammation caused by leaky blood vessels in the back of the eye. Rapid loss of vision can occur.
Diabetic retinopathy is a complication of uncontrolled diabetes. It results from damage to the blood vessels of the light-sensitive tissue at the back of the eye as a result of elevated blood sugar.
Symptoms include impairment of color vision, blurred or lost vision, and “floaters”. As a general rule, both eyes are affected with this disorder.
Causes include a history of elevated cholesterol, hypertension, and most important — elevated sugar levels. Complications can cause vitreous (the jelly-like substance that fills the space between the lens and the retina and gives the eyeball shape) hemorrhage, retinal detachment, glaucoma, and eventual blindness.
Diagnosis will begin with an examination wherein the eyes are dilated and may include angiography and/or optical tomography.
Treatment will always begin with an attempt made to better control sugar levels and may progress to focal laser therapy to halt or slow the leakage of fluid and blood in the eye, shrinking the abnormal blood vessels, removal of blood from the vitreous and more. New treatments are being studied that include injecting medications directly into the eye(s) to treat swelling or abnormal blood vessels.
Your eyes are an extremely important part of your overall health and I’ve barely touched on the wide variety of disorders known. So be sure to visit an eye care professional regularly to allow him or her early detection of any possible problems. Eat well-balanced meals and discontinue smoking if appropriate. Above all — protect those eyes by wearing sunglasses that block between 99 and 100% of UV-A and UV-B rays from the sun.
Readers seeking additional information can contact Prevent Blindness America by calling 1-800-331-2020 or visit their website www.preventblindness.org.
