Most of us get our eyes checked routinely — especially if we need a prescription for glasses or contacts. But there’s a more important reason to get annual examinations after age 65: the changes that occur with age.
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Even if our vision seems fine, certain age-related eye conditions develop very slowly, notes Cleveland Clinic Cole Eye Institute ophthalmologist Richard Gans, MD. By the time we notice any changes in our vision, it may be too late to repair the damage.
Fortunately, ophthalmologists can detect changes earlier than we can. Prompt treatment can halt much of the vision loss that common conditions can cause.
Eye conditions that we become more susceptible to as we age include macular degeneration, diabetic eye disease, glaucoma and cataracts.
Macular degeneration: The biggest cause of age-related vision loss
The nerve cells in the back of the eye (the retina) are very close together in the area where the eye focuses the images that we see. This part of the retina is called the macula. As people age, the macula tends to change in ways that cause a gradual loss of sharp vision.
Sometimes, the macula actually begins to break down, and new blood vessels can grow where they do not belong. This condition is called age-related macular degeneration or AMD. Signs that a person might have this condition include:
- A decline in our ability to see fine details when looking directly at an object
- Straight lines starting to look wavy or broken.
- Dark spots, lines or shadows appearing in our field of view.
Thankfully, treatments are now available that may help to slow vision loss and maintain useful vision for many years — if they are started early enough.
Retinopathy: One of the more serious complications of diabetes
As we age, our risk for developing diabetes increases. One of the major effects of diabetes is to make blood vessels leak. When the blood vessels beneath the retina (the nerve cell lining in back of the eye) leak, fluid can build up. This blurs vision and damages the retina.
Eventually, this condition, called diabetic retinopathy, causes blood vessels to break open and bleed. When new blood vessels grow to take their place, the result can be permanent vision loss.
If you have diabetes, the best way to avoid retinopathy is to follow your doctor’s advice about diet, exercise and medication — and to schedule yearly eye examinations.
Glaucoma: A painless condition that is slow to develop
The eye is often compared to a camera. The front of the eye contains a lens that focuses images on the inside of the back of the eye. This area inside the eye is covered with special nerve cells that react to light.
In some people, these nerve cells become damaged by pressure inside the eye. This is called glaucoma. Glaucoma is usually painless and causes no noticeable symptoms except for the loss of vision. But because there are many, many nerve cells in the back of the eye, and only a few are damaged at a time, noticing changes in vision can take years.
Your eye doctor can detect glaucoma much earlier, however. If you have glaucoma, prescription medication can lower pressure within your eye. This slows visual damage for some patients. Surgery is also an option when glaucoma is more severe.
But by getting the right treatment early, you’ll have many years of good vision left.
Cataracts: A clouding of vision that surgery reverses
The eye contains a lens that focuses light so that we can see. Sometimes this lens turns cloudy, and this is called a cataract. Most cataracts are a normal result of aging, although they can be caused by injury or other medical conditions. The only treatment for cataracts is to surgically remove the clouded lens.
Cataract surgery is usually performed with local anesthesia — the patient is awake but does not feel the procedure. The surgeon makes a small opening in the front of the eye so that the cloudy lens can be removed. Without its natural lens, the eye is out of focus — like a camera that has lost its lens.
To fix this problem, an intraocular lens is implanted, usually where the natural lens had been. Almost 2 million people per year in the United States have cataract surgery and get intraocular lenses. Newer intraocular lenses can correct nearsightedness or farsightedness so that glasses and contacts may no longer be needed.
Don’t lose sight of eye exams
Everyone needs an annual exam by an eye doctor at least every other year after age 40. If we have certain risk factors — such as a family history of eye disease or diabetes — then we need a comprehensive eye exam every year at all ages.
After age 65, seeing the eye doctor every year is critical for healthy vision.