Glaucoma and Vision Facts All Older Adults Should Know

January is Glaucoma Awareness Month. Nearly all of us face vision changes as we grow older, whether it’s needing “cheater reader” magnifying glasses from the drugstore or having laser surgery for glaucoma. In order to stay active and independent as long as possible, you need to know what age-related changes are normal and which ones can indicate a more serious problem. Here’s what you need to know about keeping your eyes healthy and when to see your doctor.

Glaucoma and seniors

According to the Eye Diseases Prevalence Research Group, more than 2.2 million Americans have glaucoma, but only half actually know it. This may sound strange, but due to the nature of glaucoma – a category of eye diseases caused by increased pressure inside the eye that leads to vision loss – the progression of the disease is usually very gradual and painless. Unfortunately, once glaucoma causes vision loss, the damage is permanent and irreparable, so it’s important to get regular full eye exams to check for any damage.

While glaucoma can strike anyone at any time, the risk is especially higher in people over the age of 60. Here’s what you need to know about glaucoma.

What is glaucoma?

Glaucoma is one of the leading causes of blindness. And yet, once detected, it can be slowed in most cases – sometimes via surgery. The vision that is lost, however, cannot be restored. Most cases of glaucoma develop slowly, with a gradual loss of peripheral (or side) vision. However, by the time people notice they have lost some of their side vision, glaucoma has already stolen away much of their ability to see.

Early signs of glaucoma

If you notice any of these possible glaucoma symptoms, see you eye doctor as soon as possible.

• Loss of side vision
• Inability to adjust to darkened rooms
• Blurred or foggy vision, especially when awakening
• Frequent switching of glasses

These symptoms aren’t always caused by glaucoma, but if they are, early detection can help slow the progress of the disease

What causes glaucoma?

There are several different types of glaucoma, and most involve the drainage system within the eye. At the front of the eye, there is a small space called the anterior chamber, where a clear fluid constantly flows to nearby tissues. Whenever this liquid cannot drain, however, it adds pressure to the optic nerve, eventually causing damage, albeit usually painless and gradual.

Open-angle glaucoma is the most common form of glaucoma, and causes peripheral eyesight to slowly diminish. A person eventually feels like he or she is viewing the world through a tunnel or a paper towel roll. More uncommon is angle-closure glaucoma, where intraocular pressure causes the iris to press against another part of the eye and interfere with draining, sometimes causing a painful acute glaucoma attack that requires immediate medical attention. Finally, low-tension glaucoma can occur without any detectable increased intraocular eye pressure; it is thought to be caused by poor blood flow to the optic nerve.

Is glaucoma hereditary?

According to the Glaucoma Research Foundation, your risk of developing primary open-angle glaucoma is up to nine times higher than average if one of your parents or siblings has the disease.

Different races are affected differently by glaucoma, and we’re not sure why. Statistics show that glaucoma is more common and detrimental among African-Americans, even at a younger age (starting around age 40). For example, glaucoma is five times more likely to strike someone of African-American descent than a Caucasian, and four times more likely to cause vision loss. Starting at the age of 60, Mexican-Americans become significantly more at risk as well.

People with diabetes, who have had an eye injury, or who have taken cortisone medication for an extended period of time are also at higher than average risk for developing glaucoma.

What’s the treatment for glaucoma?

Treatments for glaucoma focus on lowering the pressure inside the eye. Prescription eye drops and pills are the most common course of treatment. Laser or scalpel surgery is an option in cases where drops and pills aren’t effective. In severe cases of glaucoma, surgeons may place a small shunt in the eye to drain excess fluid and keep pressure at a manageable level.

Early detection is key

Knowing these risk factors should encourage seniors to have regular, full eye-exams once a year from age 55 on. However, if you have a family history of glaucoma, you should begin annual exams at the age of 50. Only a full vision checkup, including tonometry, visual field exam, visual acuity test, and a dilated eye exam can determine if you have any of type of glaucoma.

Omega 3 fatty acids may help

While studies on humans are still relatively limited, some glaucoma research suggests that increased omega3 fatty acids (like those found in wild salmon, tuna, herring, mackerel, anchovies, and sardines) may help decrease your chances of increased ocular pressure. Fish oil supplements may also be helpful. It’s interesting to note that cultures with omega 3-rich diets, like that of Japan, actually see a decrease in intraocular pressure as the population ages. In the United States, where the diet is often lacking in omega 3 acids, pressure in the eye typically increases with age.

Other age-related causes of vision loss

Almost everyone’s vision suffers as we grow older, but in most cases, the changes are manageable with regular checkups and care. Here are three types of vision changes to know.

Cataracts

Nearly 75% of people over 65 years have some degree of cataract, making it the most common of eye disease related to aging. A cataract is a clouding of the eye’s normally clear lens. The only effective treatment is to surgically remove the cataract. This greatly improves vision in the vast majority of cases. Of course, many people do not need to have surgery. If your vision is not severely impaired by cataracts, you may choose to simply avoid certain activities such as driving at night.

Early warning signs of cataracts:

• Blurred vision
• Double vision or ghosted images
• Sensitivity to glare
• Frequent switching of glasses, none of which help you see better

Macular Degeneration

Macular degeneration usually strikes people over the age of 60. The macula is a small spot in the center of your retina. It’s the most sensitive part of your retina and provides the sharp vision you need for reading and seeing colors clearly. When macular degeneration occurs, your center vision may become blurred, distorted or you may develop a blind spot.

When a large amount of central vision is lost, people find it very difficult to do simple, everyday tasks that require sharp vision. This includes reading, sewing, driving or even recognizing faces. Fortunately, macular degeneration rarely results in complete blindness. Side vision is usually not damaged.

There are two forms of age-related macular degeneration (AMD). The wet form, although less common, causes the most severe loss of sight. It is called “wet” because tiny blood vessels grow rapidly beneath the retina. They often break, leaking blood and fluid. The “dry” form, accounting for 75 to 85 percent of AMD cases, is caused by a breakdown or thinning of the tissues in the macula. Vision loss with dry AMD is usually not as severe.

Treatment can be effective for certain types of AMD, but it must take place early in the course of the disease. Many people with AMD can keep their independence, live a normal life, and continue to enjoy many of their favorite activities while using low-vision aids, such as magnifiers, to maximize their remaining vision.

Early warning signs of macular degeneration:

• Sudden hazy or blurred vision
• Recurrent pain in or around the eyes
• Double vision
• Halos around lights
• Unusual sensitivity to light or glare
• Change in color of the iris
• Sudden development of persisting floaters

Diabetic Retinopathy

Diabetic retinopathy is the leading cause of new blindness in the Unites States for people age 20 to 74. This disease affects the vision by damaging the blood vessels in the retina. As a result, vision may become blurred and, if untreated, may lead to blindness. Careful control of blood sugar levels greatly reduces your chances of developing this condition. If detected early, laser therapy may effectively reduce the risk of severe vision loss. The longer you’ve had diabetes, the greater your risk of diabetic retinopathy. For this reason, people with even mild diabetes should have their eyes examined at least every year.

Early warning signs of diabetic retinopathy:

• Blurred vision is the most common symptom

Other ways vision changes with age

There are four common conditions that affect your vision as you get older. Nearly all of us experience these and other changes in our vision as we grow older.

Watery or Dry Eyes

It is common for older eyes to make too many or too few tears. As a result, your eyes may constantly feel watery or dry. Your eye doctor may recommend drops to relieve the problem.

Reduced Night Vision

For most of us, the older we get, the harder it is to see in reduced light. Take extra precautions when traveling at night and keep your eyeglass prescriptions up to date.

Presbyopia

The older we get, the harder it is to focus on objects and words that are close up. This condition is called presbyopia. It is caused by the formation of small crystals that make the lens of our eye less flexible. As the condition progresses, the muscles around the lens can’t reshape the less flexible lens enough to focus up close. Your eye doctor can prescribe glasses or contact lenses that can help.

Floaters

Floaters are the tiny, dancing spots you may see when looking toward a light-colored background like a clear blue sky. Floaters are generally harmless unless you notice a sudden increase in them or they’re accompanied by flashes of light. If these symptoms occur, consult your eye doctor immediately.

How to care for your eyes as you get older

Our vision changes naturally throughout our lives. For example, as you grow older:

• Your eyes need more light to see.
• It can be harder for you to tell the difference between some colors (particularly dark shades of blue and green).
• Adjusting to glare and darkness becomes more difficult.

The most important thing you can do to preserve your vision is to have your eyes examined regularly. Other steps you can take include:

• Wear your prescription eyewear as your doctor recommends.
• Use bright task lighting to help you read, cook, and do other tasks safely.
• Take any medications your doctor prescribes you for glaucoma, dry eyes, or other conditions.
• Talk to your doctor about how your changing vision may affect your ability to drive. Be realistic about what you can safely do – especially when it comes to driving at night.
• Wear sunglasses with proper UV filtration can help slow the development of cataracts and protect against glaucoma-related light sensitivity.
• Understand that you may need extra help or home modifications for safe aging-in-place if your vision deteriorates.

Finally, get help right away if you notice sudden, drastic changes in your vision or develop severe eye pain. Early diagnosis and treatment are the keys to preserving your vision for as long as possible.

For more information on in-home care services near you, contact our senior living advisors at 1-800-805-3621.

Megan Hammons

Megan Hammons lives in the Central Texas countryside just outside of Austin, pursuing her love for copywriting after a career in high-tech marketing. She is part of a large, diverse family and enjoys spending time with the multiple generations living in her community.