Age Related Expectancies
Eye Care for the Aging Eye
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Ptosis is usually not much of a problem initially. Often times though, the droppiness of the lid progresses until you find yourself getting headaches along your forehead from trying to keep your eyebrows help up to pull the lids higher. Or, you may begin to notice neck pain from leaning your head backwards, trying to see through then narrowing area between your lids. If, during relaxation, the lid margin is beginning to cover the pupil margin, your superior peripheral vision is being blocked by the lid.
Ptosis can be a part of normal gaining; can occur after injury, or as an aftereffect of cataract or other eye surgery It can be a muscle problem, a tumor, a nerve problem or even a symptom of a systemic disease like diabetes. If you believe droopy lids are becoming a problem for you, tell your eye doctor. Specific testing can be performed to assess the severity of the problem and determine treatment or surgical options.
Watery Eyes, also known as epiphera, can be a very annoying and sometimes painful problem. The constant wiping away of tears can cause irritation to the skin surrounding the eye. Usually there is a mechanical reason for the tearing. As briefly mentioned before, one possible cause is actually dry eyes. There are three different layers to the tear film: A thin layer of mucin (which helps hold the tears onto the eye), followed by a thicker layer of aqueous (the salt water we think of with tears, produced by the lacrimal gland), and a thin layer of oil (that helps prevent evaporation of the tears). If the tears are evaporating off the eyes too quickly from a reduction in the amount of oil, the lacrimal gland may produce more tears. These new tears still do not contain the correct distribution of oil, mucin and aqueous. They can spill right over the lid instead of resolving the true problem.
A second cause may be the lid position. The lower lid may fall forward in a position called ectropia. This can cause the puncta to sit away from the eye and the tears are unable to go down the natural tear drain. A simple lid surgery can pull the lower lid back towards the eye and solve this problem.
A third cause of tearing would be a blockage in the lacrimal drainage sytem. Your eye doctor can perform a simple test to see if tears are passing from your eyes down through the puncta and into the lacrimal drainage passageway. If a blockage is suspected, a thin probe is inserted and the blockage is assessed. Sometimes a simple probe under a local anesthetic is all you need to open the drain again. In more stubborn cases, saline solution can be flushed through, trying to break up the blockage and clear it out.
There are several different types and causes of cataracts. If we all live long enough we will likely have some lens changes in our eyes. UV light is associated with cataracts, so wearing sunglasses with UV protection or having a UV coat applied to your regular glasses may slow down cataract progression. Uncontrolled diabetes, radiation treatment, lead exposure, steroid use, diuretics and major tranquilizers may contribute to cataract formation. Some researchers believe that a diet high in antioxidants such as beta carotene (vitamin A), selenium and vitamins C and E, may put off cataract formation, while eating a lot of salt may increase your risk. Other factors that can increase the likelihood of developing cataracts include smoking, air pollution, and heavy alcohol consumption.
Cataracts are monitored by your eye doctor until they begin to interfere with your day to day activities. When that happens, cataract surgery is usually indicated. Surgery today is much simpler than it was in the past. It’s an outpatient procedure, and in the vast majority of cases, it is performed under local anesthesia only.
Macular degeneration is the leading cause of vision loss and blindness in Americans 65 years of age and older. This disease breaks down our sharpest most sensitive vision, our central vision. There are two forms of macular degeneration: dry (atrophic) and wet (exudative). The dry form is more common, and less devastating to vision. Macular degeneration is more common over age 65. Caucasions and women are more likely to be affected. It can also occur as a side effect to some medications and tends to run in families.
Ways you can monitor for macular changes would be to cover one eye and look at something straight, like a door frame or a window sill. Watch to see if the door frame’s appearance changes when viewed with one eye alone. Macular degeneration can make straight lines look wavy. It can also cause a shadowy area to appear in your central vision. To monitor for early macular changes, have a complete eye exam every year. Sometimes more frequent monitoring is necessary.
Many Americans are seeing impaired. Even a diagnosis of legal blindness does not mean they are unable to see at all. Legal blindness is defined in the United States as a visual acuity of 20/200 or worse in the better eye with corrective lenses (20/200 means that a person must be 20 feet from an eye chart to see what a person with “normal” vision can see at 200 feet), or have a visual field restricted to 20 degrees diameter or less in the better eye. Numerous devices exist to help people with impaired vision see more clearly. The sad fact is that many individuals with impaired vision are unaware that anything other than magnifiers exists to help them. Telescopes and magnifiers are only the tip of the iceberg. There are high tech gadgets that can allow people to read again who never thought they could. Many retirement communities are investing in CCTV’s in their common rooms for their residents to use. CCTV’s magnify books, magazines, newspapers, photos, even fingers (if you want to trim nails or apply nail polish onto a TV screen, where the magnification is only limited by the size of the television.
If you, or someone you know, is unable to see comfortable even with an updated glasses prescription, a very good local low-vision resource is this non-profit organization:
Edith Bishel Center for the Blind and Visually Impaired
628 N. Arthur
Kennewick, WA 99336